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Renal-specific information systems in the UK

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Renal-specific information systems in the UK

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    1. Renal-specific information systems in the UK RCPL workshop 22nd October 2008 Charlie Tomson

    2. Renal computing in the UK Every renal centre in the UK has an IT system that supports care of RRT patients A mini-Electronic Patient Record Links to laboratories, PAS, etc Proton, Clinical Vision, Mediqal eMEd, RenalPlus, Vitaldata, Renalware, several ‘bespoke’ systems

    3. What do current renal IT systems do? RIXG survey March 2006 83 item questionnaire piloted and refined Sent to all Clinical Directors, system managers of PROTON systems, other suppliers 41 responses

    4. Survey results 41/61 (67%) UK renal units replied Of units that replied: All in England used an EPR Huge range of complex functions Evolved over 40 years

    6. Functionality of renal IT systems Able to combine data from several Trusts Details of kidney disease, treatment timeline, co-morbidity Lab data downloads from multiple labs Serial data on contacts, weight, BP, dialysis treatments, visits, +/- letters, discharge summaries Tabular and rapid graphical display of results Transplant status, antibodies, UKT data Prompts for ‘tests due’ and care pathways Calculation of dialysis dose Drug treatment Etc etc

    9. Data items collected Demographic details Timeline of RRT Laboratory variables (quarterly) Renal-specific drug Rx (e.g. ESAs) Blood pressure Vascular access National Renal Dataset submitted to ISB

    10. Lessons learned to date If humans are required to enter information, they will enter it in the wrong place if it is physically possible to do so Extensive validation and error correction is unavoidable if data are to be turned into information that clinicians trust Data entry screens must reflect and support the way clinicians work

    11. Silos Renal IT systems Not fully integrated with other sources of information Renal IT managers Not fully integrated with Trust IT departments

    12. Renal Clinical Content SpfIT Release 2 design project Funded by Fujitsu, then SPfIT/OCCO System-independent 24 ‘products’ relating to specialist care of kidney patients, e.g. Haemodialysis Home haemodialysis patient training record Renal supportive care record Renal pre-transplant live donor assessment

    13. For example…

    14. Utility Depends on database construction and implementation software Simple collection of these data items would be an electronic version of multisheet paper record OR an integrated EPR with (e.g.) decision support and major clinical advantages Depends on how content of screens is joined up

    15. Summary Every renal centre in the UK uses an IT system capable of supporting clinical care and generating audit returns Highly variable/customisable Oriented to long-term, outpatient care Most exist in silos National Renal Dataset defined

    16. Thank you For copies of slides, or comments, please email me: charlie.tomson@nbt.nhs.uk

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