an electronic patient record for the cleft lip and palate managed clinical network in scotland...
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An electronic Patient Record for the Cleft Lip and Palate Managed
Clinical Network in Scotland (CLEFTSiS).
A solution not without challenges.
John Clark, Lead Clinician
and
Trudie McDonald, Network Manager
• Background• Requirement for an EPR• Funding• Procurement• Development• Implementation• Rollout
Multidisciplinary Care from birth to 20 yrs
Concerns about the quality of care
The Clinical Standards Advisory Group (an independent source of advice to the UK Health Ministers and to the NHS) was asked to investigate the care provide in the UK.
Background to the UK cleft service
Resources should be concentrated in 8 - 15 UK centres instead of the current 57. There should be one centre in Scotland
Reorganisation of Scottish services following the CSAG report
A Managed Clinical Network (CLEFTSiS) was established in April 2000 to provide and co-ordinate the highest standard of care for patients with cleft lip and/or palate, as far as possible in their own locality, to agreed national standards and guidelines.
There would be only one centre – Scotland – with not less than two WTE cleft surgeons vested in three people who undertake surgery according to an agreed common protocol.
HDL (2002) 69
PROMOTING THE DEVELOPMENT OF MANAGED CLINICAL NETWORKS IN NHSSCOTLAND
“A key factor in the success of MCNs is the use of integrated clinical information systems that span traditional organisational barriers”
• Background• Requirement for an EPR• Funding• Procurement• Development• Implementation• Rollout
Combined clinic and treatment sites
•Photographs
•Study models
•Radiographs
•Video/sound recordings
•Audit data•Surgery
•SLT
•Orthodontics/dentistry
•Audiology
•Clinical psychology
Records required for outcome assessments
• Background• Requirement for an EPR• Funding• Procurement• Development• Implementation• Rollout
Scottish Telemedicine Action Forum (STAF)
Funded a pilot to develop an EPR linking 5 sites;
Perth(Admin Centre for the MCN)
AberdeenEdinburghGlasgowInverness.
• Background• Requirement for an EPR• Funding• Procurement• Development• Implementation• Rollout
The CLEFTSiS EPR project
ProcurementUndertaken within the framework of EC/WTO rules governing Public Sector procurement under the direction of the Head of the Business Advisory Group of the Information Services Division (ISD).
commissioned to develop the EPR based on their system:
• Background• Requirement for an EPR• Funding• Procurement• Development• Implementation• Rollout
Dataset and protocols
Design
A patient record familiar to clinicians
Stages in a protocol clearly displayed with coloured
buttons providing links to other forms
Colour coded flags are set to show the status of interactions with the
patient
Manage the clinical network by defining roles and including
participating hospitals or health authorities
Examples of reports that can be generated by
Excelicare
Patient review summary
• Background• Requirement for an EPR• Funding• Procurement• Development• Implementation• Rollout
NW Manager and Audit secretaries
Network Manager, Perth Royal Infirmary (0.5 WTE)
Audit Secretary, Perth Royal Infirmary (1.0 WTE)
Audit Secretary, Glasgow (Yorkhill/Dental Hospital) (0.6 WTE)
Audit Secretary, Edinburgh (RHSC) (0.6 WTE)
Audit Secretary, Aberdeen (RACH) (0.4 WTE)
CLEFTSiS Admin Support03/12/2003 - v3
Architecture ExcelicareClient PC
ExcelicareData Store
Server
ExcelicareClient PC
TaysideFirewall
ExcelicareClient PC
InvernessFirewall
EdinburghFirewall
ExcelicareClient PC
Dial In Server
ExcelicareClient PC
NHSNet /Healthnet
GrampianFirewall
GlasgowFirewalls
ExcelicareClient PC
ExcelicareClient PC
IT Infrastructure Challenges
Network firewalls
- chain of contacts/procedures
Switchover from CW to BT ( NHSNet / HNC)
Trouble-shooting - who can solve what?
IT Infrastructure solutions?
raise awareness at local Trust IT level of usage of NHSNet/Firewalls for cross-Trust projects
central Technical person to oversee x-Trust interfaces / firewalls?
ensure support for tracing problems is part of HNC contracts (or provide TraceRoute type tools..)
• Background• Requirement for an EPR• Funding• Procurement• Development• Implementation• Funding the rollout
Cost to Health Boards
£0
£5,000
£10,000
£15,000
£20,000
£25,000
£30,000
£35,000
Arg
yll &
Cly
de
Ayr
shire
& A
rran
Bor
ders
Dum
frie
s &
Gal
low
ay Fife
For
th V
alle
y
Gra
mpi
an
Gre
ater
Gla
sgow
Hig
hlan
d
Lana
rksh
ire
Loth
ian
Ork
ney
She
tland
Tay
side
Wes
tern
Isle
s
Initial
Annual maintenance
Achievements
Improved collection of audit records
Able to perform ad-hoc queries for analysis/research
National system with centrally held data (including multi media) and client connections into five Trusts
Software EPR tool with potential to grow with the service
Developing good relationships with IT staff in the five sites
Possibility that it will be adopted UK wide
Thank you!
to
You, the audience for your attention
STAF for funding the project
CLEFTSiS members for their contribution and on-going support
The staff of AxSys Technology