The paperless hospital is it achievable colin sweeney director of ict
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The paperless hospital – Is it achievable? Colin Sweeney Director of ICT. Agenda. Background How paperless are we? EDMS v active record The Pre-requisites What have been the big achievements? Rolling out EPMA across the hospital

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The paperless hospital – Is it achievable? Colin Sweeney Director of ICT

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The paperless hospital is it achievable colin sweeney director of ict

The paperless hospital – Is it achievable?Colin SweeneyDirector of ICT


Agenda

Agenda

  • Background

  • How paperless are we?

  • EDMS v active record

  • The Pre-requisites

  • What have been the big achievements?

    • Rolling out EPMA across the hospital

    • Making continuation notes electronically to increase accuracy and legibility

    • Developing new methods of digitally viewing vital signs using mobile devices

    • Utilising electronic data to audit department's performance and improve patient care

  • What is missing?

  • Obstacles and issues


King s epr milestones

King’s EPR Milestones

  • 1999 Implemented pilot of the initial EPR vision

  • 2002 Completed roll out of orders and results as first stage of EPR

  • 2000-2 Discharge notifications and TTA drugs

  • 2003 Replaced old IRC PAS with i.PM

  • 2004/5 PACS

  • 2005 First attempt at inpatient prescribing

  • 2007 Moved i.PM to CSC as part of iSOFT7

  • 2009 Inpatient noting

  • 2008-2010 Inpatient prescribing roll out

  • 2010 to date – KSSF to help move to paperless/light hospital

  • 2012 Wardware to calculate Early Warning Scores

  • 2012 Assessed by HIMSS as a level 5 EMR

  • 2013 Acquired Princess Royal Hospital


The paperless hospital is it achievable colin sweeney director of ict

Vision and Tactics

Our Vision

A single point of access to information about individual patients in electronic real-time format

How do we get there?

An EPR is a Strategy not a System


What does that mean

i.CM/EPR

RIS

KCH develop-ments

PACS

NNB

Score-cards

Maternity

Choose &Book

i.PM/ PAS

What does that mean?

Data Ware-house/ABC

Theatres

TIE

Pharmacy

E-PSB

Pathology

Finance

A&E

Payroll

PICU

ESR

Specialty

systems

E-Rost-ering

E-Learning

NHS Mail


How paperless are we

How paperless are we?


Pre requisites

Pre-requisites

  • Reliable and stable Infrastructure

    • Wireless and wired

    • Enough equipment

    • Right equipment

  • Committed and dedicated people

    • Executive

    • Clinical Users

    • ICT staff


Hardware

Hardware


Edms pros

EDMS-Pros

  • Provides a complete record

  • Availability

  • Saves on storage space

  • Savings on folders

  • Potential savings on prep clerks

  • Potential savings on archive/retrieval

  • Ad hoc scanning is prone to error


Edms cons

EDMS - Cons

  • Quality of original documents

  • Volume – do you need everything?

  • Are you duplicating information that is already available?

  • Speed of access

  • Continuous paper generation

  • Needs initially to be an industrial scale process

  • Cost


The paperless hospital is it achievable colin sweeney director of ict

Civica WinDIP


Key successes

Key Successes

  • EPMA

  • Continuation Notes

  • Vital Signs

  • Wardview


Drug charts

Electronic Prescribing

Drug Charts


Epma what is it good

EPMA – What is it good?

  • Prescribing process the same as ordering a test

  • Legibility

  • Availability

  • Administration monitored

  • Analysis/audit available

  • Decision support

  • Safety


Epma what is it not so good

EPMA – What is it not so good?

  • It doesn’t look like a drug chart

  • Some of the complex prescribing is not available

    • Chemotherapy

  • The infrastructure needs to be reliable and perform and easy to use

    • Wireless network

    • Computers on Wheels

    • Other devices

  • Patient flows

  • Time to implement


The paperless hospital is it achievable colin sweeney director of ict

Continuation notes


Continuation notes good

Continuation notes - Good

  • Legibility

  • Availability

  • Easy to use

  • Meets national standards

  • More structured


Continuation notes not so good

Continuation notes – Not so good

  • Free Text – hard to analyse

  • Lack of drawing

  • Re-entry of data

  • “Too much information”

  • More devices/screens


Vital signs

Vital Signs


Vital signs good

Vital signs – good

  • Easy bedside entry

  • Calculates Early warning scores

  • Draws graphs

  • Accessible from wherever

  • Nurses extremely positive – want to use tools for more


Vital signs not so good

Vital signs – not so good

  • Although available from EPR data is not currently shared across systems

  • Access to chart while writing a note

  • More equipment/devices

  • Coping with demand/decisions about what goes where


Quality indicators

Using the data to improve care

Quality Indicators


What are we missing

What are we missing

  • Free flow drawing capability

  • Forms – although we have a form builder

  • Consent and patient access

  • Non-PACS images

  • Historic notes

  • Information from outside


Obstacles and issues to going paperless

Obstacles and Issues to going paperless

  • Paper is easier/quicker to use ?

  • What are people used to?

  • Dependence upon a reliable, stable and high performing network and devices

  • The number/variety of devices required


Any questions

Any Questions?

[email protected]


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