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QEQMH stand alone system on 2 lap top computers. Clinics held in 2 different out-patient ... Mr Donald Duck 632767. D day. IT @ EKHT and 4S both brilliant. Manual ...

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Merging of two v6 DAWN databases

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merging of two v6 dawn databases

Merging of two v6 DAWN databases

Joanna Nightingale

Head Biomedical Scientist

East Kent Hospitals NHS Trust

east kent hospitals nhs trust
East Kent Hospitals NHS Trust
  • QEQMH – stand alone system on 2 lap top computers
  • Clinics held in 2 different out-patient areas
  • Clinic also held at primary care site
  • 1700 patients on DAWN
  • DAWN not used for letter generation
Kent and Canterbury hospital
  • Networked DAWN
  • Used remote user license for PCT sites
  • 3500 active patients on DAWN
  • Approx 2000 patients not on DAWN
William Harvey Hospital
  • Pharmacist led out-patient appointments
  • Paper based system
  • Approx 1700 patients being anticoagulated
models of service delivery using dawn
Models of service delivery using DAWN
  • Out patient clinics
  • Postal service
  • Patients self testing
  • In patient dosing
  • INR’s entered manually and via an interface
the vision
The vision
  • One database for seamless patient movement across Trust sites.
  • Upgrade to V7.
  • Introduce DAWN V7 onto WHH site.
  • Equilibrate services for patients which ever site they visit.
local issues
Local issues:
  • Ensure all aspects of service from QEQMH could be delivered across a network
  • Printing issues A4 letters / label
  • Merging of databases. Patient data on both systems
  • Different practices
  • How to train users
pre merger and upgrade considerations
Pre merger and upgrade considerations
  • Data cleansing
  • Training
  • Printing
  • Clinic flows
  • Process maps
data cleansing
Data cleansing
  • Drugs with duplicate descriptions
  • Organisations with duplicate descriptions
  • Patients with DOB requiring investigation
  • Patients with duplicate hospital numbers
  • Patients with duplicate name / DOB combinations
  • Patients with >1 result on same date
data cleansing 2
Data cleansing 2
  • Patients with no prime AC reason
  • Patients with start dates in need of investigation
  • Patients without a dosing regime
  • Patients without a target range
  • Treatment dates in need of investigation
KCH deemed controlling site
  • Master lists from KCH
  • All QEQMH data appended or amended to fit the master list
  • All duplicate patients had to be assigned to one site only. Data from subsidiary site had to be entered onto record manually.
pre merge upgrade data checks
Pre merge / upgrade data checks
  • Required 2/3 people
  • Slow
  • Managed 2-3% of database over 10 working days
  • V6 not as well formed / clean as hoped
  • Many notes typed in V6 inserted in strange places!
  • V7 not intuitive
training on v7
Training on V7
  • Delivered by 4S
  • On site
  • Via IT link sharing desk top with 4S - using BRIDGIT software
trial conversion data
Trial conversion data
  • Initially thought number of patients going up did not match number of patients arriving back
  • Data copied into practice system for training
  • Interface difficult to test. Flat field also being upgraded to HL7
  • Letters needed to be tested
show stoppers for ekht
Show stoppers for EKHT
  • Letters / printing
  • Further data take off to validate patient numbers and records
17/08/2006 INR 1.7 Sun Mon Tue Wed Thu Fri Sat
  • 4 3 4 3 4 3 4
  • Warfarin mg/day
  • NEXT TEST 1 WKS Aug 24Mr Donald Duck 632767
d day
D day
  • IT @ EKHT and 4S both brilliant
  • Manual system for 2.5 days in total
  • Un-anticipated problems with firewall to get the sparkly product back in.
  • V7 is well loved product
  • Information on screen is much more visual
  • Deemed a robust and modern product by IT @ EKHT
  • IT felt very successful software merge and upgrade
  • Looking forward to software upgrade
  • More mouse strokes on V7, some RSI
  • Errors with new users not accepting dosages correctly
  • Batch dosing not available – using customised list views. Process is slower but less errors in lab
  • Printing always seems problematic!
look at us now
Look at us now!
  • So now we have 1 database for QEQMH and KCH
  • WHH ready to go live in pharmacy / pathology
  • We have our first PCT site dialling in as second organisation and recording their clinic information on the database
the future
The future
  • All in patient activity recorded on all 3 sites
  • WHH about to go live using DAWN – awaiting printing solution from IT @ EKHT
  • Further PCT sites (GP practices and PCT hospitals) to dial in and share database
  • PCT pharmacy practices need coded connection roll out for access