David Morgan ENT Consultant

1. Electronic medical records and personal digital assistants: ensuring patients get the right treatment David Morgan ENT Consultant Heart of England Foundation Trust and Founding Director of Safe Surgery Systems

2. EMRs and PDAs – Ensuring patients get the right treatment

3. Technology in Healthcare • Improve patient safety • Improve hospital efficiency • Save time and easy to use (2 clicks) • Not tied to hardware • Integrate with other systems (HL7) • Practical examples

4. eHealth Award Winner 2005

5. It’s a matter of Patient Safety… Public confidences of ‘wrong’ failures can be devastating for all involved, (patients, professional, organisational and personal reputations) Systems failures or communication breakdowns

6. Adverse Events – NPSA Data • Currently 60-80,000 per month • Total in NPSA database > 1,000,000 • Between Feb 06 and Jan 07 more than 24,000 reports received of patients misidentified and mismatched with care • Nearly 3,000 related to wristbands and their use

7. Incidence in USA • 3 reports every 2 days • 40% errors ‘reached’ patient • 20% completion of WSS • No reduction in WSS since publication of Joint Commission’s guidelines

8. VTE Prophylaxis • Preventable • Risk assessment • Audit

9. Responsibility for Patient Safety Corporate Manslaughter and Corporate Homicide Act 2007 comes into effect on 6 April 2008 • Common Law offence within the criminal court structures and non-insurable. • Incident referred to Police and staff interviewed under caution • If gross failure in health and safety management found – Trust board risk criminal prosecution • CEO assumes overall responsibility; however, all directors have a 'collective responsibility'

10. Patented system using combination of Smart wristband tags and digital photographs to: Improve safety, prevent misidentification and reassure patients Improve Theatre efficiency and reduce waiting times by managing patients and beds better Save Clinicians’ time by reducing manual input and coding workload.

11. Theatre Efficiency – 1st 3/12

12. HEFT Implementation 2007+(4 theatres and 4 wards) • Non RFID theatres – 6 WSS in 3/12 • RFID theatres – 4 WSS cases prevented • Usability feedback – DVT assessment • Patient feedback (5,000+) • Correctly codes - PBR • Hospital promotion – patient choice • ROI – 6/12

13. Electronic Patient Record Form

14. Electronic Patient Record Form Patient Record Form • Rugged Tablet PC • Mobile wireless connection • Simple Touch Screen ‘buttons’ • Data entered in any order • Prompts for data relevant to incident • Configure to meet Service needs

15. On trial with Air Ambulance Warwickshire Air Ambulance connecting to Heartlands and Walsgrave Hospitals

16. Electronic Patient Record Form • Call Data • Incident Data • Clinical Data • Diagrams of injuries, site and vehicle • Decision Support • “Attack Alert” button

17. A&E Workstation View

18. Tagged Triage Cards 1st Responders & Paramedics at scene A&E Departments Ambulance or Staging area Control Rooms

19. Award 2005

20. ClinicalDecision Support • Portable Access to Medical Information • Suitable for PDA / Laptop / Tablet PC • Piloted at Birmingham Heartlands • 50 Tools & Calculators • 60 ECG Trace Library • 30 Heart & Lung Sounds • Departmental Guidelines

21. Calculator

23. Coroners Study/HEFT Survey • Coroners Study Findings – 2005 • 30 HEFT Juniors in 4 Specialties • Time allocated: • 50% said ‘None’ • 50% said ‘30min’ • Official time allocated: • 2 of the 4 specialties said ‘None’ • Written handover: • 23% said ‘Yes’ • Patient list handover: • 50% said ‘Most of the time’ • Is practice satisfactory? • 33% said ‘No’

24. Uses PDA / Laptop / Tablet PC • Linked wirelessly to Server based application • Process manages Handover of Tasks and Patients • Maintains Audit trail

26. Lord Darzi (Our NHS-Our Future) • Fair – equally available to all • Personalised – tailored to needs of individual • Effective- focused on delivering outcomes • Safe – giving patients confidence

27. Care in Chair System • End-to-end prescribing and monitoring solution • Tailored to each patients’ monitoring needs • Deployed on mobile platform • Bluetooth Device Option • Clinically Validated • Data analysis using ANN option

28. Prescribing Tele-monitoring Package

29. Mobile Component

30. Tele-monitoring results

31. Lack of Adoption of Technology • NHS historically poor at adopting technology vs HCW • Strategic/Tactical/Operational views • CfH programme – contracts NOT solutions • Finance – rule of thirds • Decision making process flawed • Procurement process

32. Email: info@safesurgerysystems.com Web: www.safesurgerysystems.com