john clark, lead clinician and trudie mcdonald, network manager
DESCRIPTION
An electronic Patient Record for the Cleft Lip and Palate Managed Clinical Network in Scotland (CLEFTSiS). A solution not without challenges. John Clark, Lead Clinician and Trudie McDonald, Network Manager. Background Requirement for an EPR Funding Procurement Development - PowerPoint PPT PresentationTRANSCRIPT
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An electronic Patient Record for the Cleft Lip and Palate Managed
Clinical Network in Scotland (CLEFTSiS).
A solution not without challenges.
John Clark, Lead Clinicianand
Trudie McDonald, Network Manager
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• Background• Requirement for an EPR• Funding• Procurement• Development• Implementation• Rollout
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Multidisciplinary Care from birth to 20 yrs
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Concerns about the quality of care
The Clinical Standards Advisory Group (an independent source of advice to the UK Health Ministers and to the NHS) was asked to investigate the care provide in the UK.
Background to the UK cleft service
Resources should be concentrated in 8 - 15 UK centres instead of the current 57. There should be one centre in Scotland
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Reorganisation of Scottish services following the CSAG report
A Managed Clinical Network (CLEFTSiS) was established in April 2000 to provide and co-ordinate the highest standard of care for patients with cleft lip and/or palate, as far as possible in their own locality, to agreed national standards and guidelines.
There would be only one centre – Scotland – with not less than two WTE cleft surgeons vested in three people who undertake surgery according to an agreed common protocol.
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HDL (2002) 69
PROMOTING THE DEVELOPMENT OF MANAGED CLINICAL NETWORKS IN NHSSCOTLAND
“A key factor in the success of MCNs is the use of integrated clinical information systems that span traditional organisational barriers”
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• Background• Requirement for an EPR• Funding• Procurement• Development• Implementation• Rollout
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Combined clinic and treatment sites
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•Photographs•Study models•Radiographs•Video/sound recordings•Audit data
•Surgery•SLT•Orthodontics/dentistry•Audiology•Clinical psychology
Records required for outcome assessments
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• Background• Requirement for an EPR• Funding• Procurement• Development• Implementation• Rollout
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Scottish Telemedicine Action Forum (STAF)
Funded a pilot to develop an EPR linking 5 sites;
Perth(Admin Centre for the MCN)
AberdeenEdinburghGlasgowInverness.
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• Background• Requirement for an EPR• Funding• Procurement• Development• Implementation• Rollout
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The CLEFTSiS EPR project
ProcurementUndertaken within the framework of EC/WTO rules governing Public Sector procurement under the direction of the Head of the Business Advisory Group of the Information Services Division (ISD).
commissioned to develop the EPR based on their system:
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• Background• Requirement for an EPR• Funding• Procurement• Development• Implementation• Rollout
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Dataset and protocols
Design
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A patient record familiar to clinicians
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Stages in a protocol clearly displayed with coloured
buttons providing links to other forms
Colour coded flags are set to show the status of interactions with the
patient
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Manage the clinical network by defining roles and including
participating hospitals or health authorities
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Examples of reports that can be generated by
Excelicare
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Patient review summary
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• Background• Requirement for an EPR• Funding• Procurement• Development• Implementation• Rollout
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NW Manager and Audit secretaries
Network Manager, Perth Royal Infirmary (0.5 WTE)
Audit Secretary, Perth Royal Infirmary (1.0 WTE)
Audit Secretary, Glasgow (Yorkhill/Dental Hospital) (0.6 WTE)
Audit Secretary, Edinburgh (RHSC) (0.6 WTE)
Audit Secretary, Aberdeen (RACH) (0.4 WTE)
CLEFTSiS Admin Support03/12/2003 - v3
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Architecture ExcelicareClient PC
ExcelicareData Store
Server
ExcelicareClient PC
TaysideFirewall
ExcelicareClient PC
InvernessFirewall
EdinburghFirewall
ExcelicareClient PC
Dial In Server
ExcelicareClient PC
NHSNet /Healthnet
GrampianFirewall
GlasgowFirewalls
ExcelicareClient PC
ExcelicareClient PC
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IT Infrastructure Challenges
Network firewalls - chain of contacts/procedures
Switchover from CW to BT ( NHSNet / HNC)
Trouble-shooting - who can solve what?
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IT Infrastructure solutions?
raise awareness at local Trust IT level of usage of NHSNet/Firewalls for cross-Trust projects
central Technical person to oversee x-Trust interfaces / firewalls?
ensure support for tracing problems is part of HNC contracts (or provide TraceRoute type tools..)
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• Background• Requirement for an EPR• Funding• Procurement• Development• Implementation• Funding the rollout
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Cost to Health Boards
£0
£5,000
£10,000
£15,000
£20,000
£25,000
£30,000
£35,000
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InitialAnnual maintenance
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Achievements
Improved collection of audit recordsAble to perform ad-hoc queries for analysis/researchNational system with centrally held data (including multi
media) and client connections into five TrustsSoftware EPR tool with potential to grow with the serviceDeveloping good relationships with IT staff in the five sitesPossibility that it will be adopted UK wide
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Thank you!to
You, the audience for your attention
STAF for funding the project CLEFTSiS members for their
contribution and on-going support
The staff of AxSys Technology