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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 Joanna Nightingale Head Biomedical Scientist 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 • Out patient clinics • Postal service • Patients self testing • In patient dosing • INR’s entered manually and via an interface
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: • 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 • Data cleansing • Training • Printing • Clinic flows • Process maps
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 • 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 • 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 • Delivered by 4S • On site • Via IT link sharing desk top with 4S - using BRIDGIT software
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 • 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 • 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.
Advantages • 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
Disadvantages • 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! • 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 • 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