lessons from the early adopters
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Lessons from the early adopters
Dr Matthew Johnson
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What will the IBD Registry
do for you
Dr. Matt W. Johnson
Tracey Price + Karen Lithgo
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Affiliations
Service development support
CIMS / Infoflex
Patient Knows Best
Sponsorship for educational meetings
Warner Chilcott
MSD
Shire
Ferring
AbbVie
Almirall
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The Nursing Perspective
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Recent improvements ?
Generic Information Sheets
IBD-R Consent
ECCO Immunity / Vaccination
Simplification of Surgery Tab
Time line
Virtual Clinic Tab
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Why the L&D got involved?
Large cohort of IBD patients (2850)
IBD-SSHAMP
Functional database
Audit + Research - Easy statistical analysis CCG Commissioners - Financial support
Trust Aim = Electronic (paper free) end of 2015
Improve our Service Standards / IBD - GRS
Contribute to National data
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Getting started
Excel list of names + Hosp Nos - 2850
Ported over Rotherham (Ferring) Database - 1450
Data input in routine clinics follows natural history
3m = Uploaded 300 / 1400 during OPAs
Training takes 30-60mins
Cons / IBD Nurses / SpRs / Secretaries / Sx / Paeds
Accessible Trust wide
Live with PAS
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Instant benefits?
Trust wide access (March 2014)
Summary page
Dashboard
Audit / Research Instantly generated letter - CCS
Finances (clinics saved = extra IBD Nurse)
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Help for the future?
Checklists Immunity and Vaccination protocol (ECCO)
Initial + Pre-Biologics reviews
Worklists Colonoscopy surveillance
Multi-Disciplinary Meetings (MDTs)
National IBD Standards + IBD-GRS
Patient Satisfaction Audits
CCG Financial Support
Remote Management - IBD-SSHAMP
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Financial support from CCG
IBD Advice Line = Payment if an OPA is saved 250 / 2205 x 23 = 5,700 / year
Virtual (Telephone) Clinic Tariff = 2350 patients / month at 23 each = 13,800 / year
Outcome = approx 20,000 per yearSecured funding for 1 WTE IBD Nurse
They are supporting a business case for another 2 WTE IBD Nurses basedon our IBD-SSHAMP work
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Cost, Sustainability andDissemination
Cost Savings
IBD - R / PMS = 4,000
PKB = 3,000
Calprotectin = 24,000 (2x/y)
IBD Nurse = 30,000
Virtual OPAs = 36,000 (2x800)
OPAs 800 x 2 x 115
= 184,000
Saved colonoscopies (539)
= 42,000 -120,000
? Preventing hospital admissions ? GP visits ? Reduction in Surgery ? Reductions in opportunistic infections
Total = 97,000 Total = > 226,000
Gross Savings = 130,000 per year
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Site Visit Feedback
Active Users
Luton & Dunstable
St. Georges
Norfork and Norwich
UCH
Princess Alexandra Barts and the London
(Paeds)
Visits David Barker (CEO of
CCUK)
RCP Audit Manager
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New Users
BirminghamRoyal Berkshire
DerbyWorthingtonNottinghamSt. Helens
Barnsley? East Surrey
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User Feedback QuestionsBirmingham
Actual cost was higher because because they were asked to factor in a new server and
didnt have InfoFlex. So far installation appears to be progressing well
St. Georges - S.LondonAre waiting for an upgrade of their InfoFlex 1st before they can utilise the new version
Newham - BartsStumbling block = IT engagement issues
Royal Berkshire - ReadingFunding and setting up have been relatively simple - but already had InfoFlex0.5 WTE in IBD Admin - ? To upload data
St. Helens & KnowsleyDifficulty convincing Trust about the funding for InfoFlex. IT have repeatedly delayed
deadlines as they dont see it as a priority.
UCHUsual IT issues, helped by the fact that InfoFlex was already on boardStuart Bloom is the main data inputter, finding it a little difficult in the clinic setting, butauditing is easy
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Site Issues
Biggest stumbling block
IT = General letter of support to all CEOs
Most common question Does it help with Azathioprine monitoring ?
Most useful comment
Money saved on Secretarial Support
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Patient Experience
I have always been so impressed with the IBD Nurses, who
always remember my colitis history
40 patient audit
- No negative comments
- No issues with data input time in clinic
I dont mind the upload in clinic because I know this informationwill be available if I have to phone up with a flare
I like the new letter system. Last time I was able to notify my GP
instantly of my medication changes Its the way forward
Its all going electronic anyway
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Consenting
Registry Consent - Information Sheet
a) Locally held data
b) Pseudo-anonymised data upload to the National
IBD Registry
c) Pseudo-anonymised data upload for other
research projects
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Patient Satisfaction
So far all have been happy to fully consent
With the exception of one
a) Wary of the security of his personal data
b) Consent for local held data
c) Not for Registry, Research or PKB
d) Pseudo-anonymised
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IBD Registry All ibd i t k