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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 ContentSpfIT 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