npex user experience: technical challenges · •pathology underpins every aspect of patient care....
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Consistently high quality, safe care with outstanding outcomes
Experience is our overriding priority.
NPEx User Experience: Technical Challenges
Karim PremjiPathology IT Systems Manager.Clinisys Domain Lead (System Admin)
of
Pathology Requesting &
Referral Management.
Starring
NHS Scotland
Co-starring
NPEx
• Pathology underpins every aspect of patient care.
• Majority of work carried out in house.
• Specialist work sent to tertiary centres for analysis.
➢ Time taken to prepare and dispatch.
➢ Waiting for postal delivery.
➢ Manual transcription of results.
➢ Delay in patient care.
• Specialist work received from tertiary centres for analysis.
➢ Time taken to book in the work.
➢ Resource expenditure to produce, print and post result.
➢ Delay in patient care.
• NUH
➢ Referrals in 40,000 requests/year.
➢ Referrals out 7,000 requests/year.
➢ Referrals labs >100 (in & out).
• Pathology underpins every aspect of patient care.
• Majority of work carried out in house.
• Specialist work sent to tertiary centres for analysis.
➢ Time taken to prepare and dispatch.
➢ Waiting for postal delivery.
➢ Manual transcription of results.
➢ Delay in patient care.
• Specialist work received from tertiary centres for analysis.
➢ Time taken to book in the work.
➢ Resource expenditure to produce, print and post result.
➢ Delay in patient care.
• NUH
➢ Referrals in 40,000 requests/year.
➢ Referrals out 7,000 requests/year.
➢ Referrals labs >100 (in & out).
• NHS Scotland – distributed pathology service.
• Functional distribution of laboratory resources.
• Delivery of high quality health care independent of location.
• Different approach to NHS England’s 29 pathology networks.
• No pressure to force changes/sharing of hospital LIMS.
• NHS Scotland – distributed pathology service.
• Functional distribution of laboratory resources.
• Delivery of high quality health care independent of location.
• Different approach to NHS England’s 29 pathology networks.
• No pressure to force changes/sharing of hospital LIMS.
• NHS Scotland – distributed pathology service.
• Functional distribution of laboratory resources.
• Delivery of high quality health care independent of location.
• Different approach to NHS England’s 29 pathology networks.
• No pressure to force changes/sharing of hospital LIMS.
• NPEx proven solution (NUH journey started in 2010).
• Project plan tried and tested to get ER solution installed &
tested.
• Installed in numerous trusts with different LIMS.
• NPEx accessible through secure website.
• VPN allows for secure transfer of PID and satisfies IG
requirements.
• Scalable solution to allow for growth.
• Incremental approach from NHS Scotland allows for lab2lab
connection to be done in parallel and speed up installation.
• Over 90% of work is made up of blood science work where
results are:-
➢ Quantitative.
➢ Qualitative.
➢ Both.
• Covers BT, MB and CP.
• NPEx proven solution (NUH journey started in 2010).
• Project plan tried and tested to get ER solution installed &
tested.
• Installed in numerous trusts with different LIMS.
• NPEx accessible through secure website.
• VPN allows for secure transfer of PID and satisfies IG
requirements.
• Scalable solution to allow for growth.
• Incremental approach from NHS Scotland allows for lab2lab
connection to be done in parallel and speed up installation.
• Over 90% of work is made up of blood science work where
results are:-
➢ Quantitative.
➢ Qualitative.
➢ Both.
• Covers BT, MB and CP.
• NPEx proven solution (NUH journey started in 2010).
• Project plan tried and tested to get ER solution installed &
tested.
• Installed in numerous trusts with different LIMS.
• NPEx accessible through secure website.
• VPN allows for secure transfer of PID and satisfies IG
requirements.
• Scalable solution to allow for growth.
• Incremental approach from NHS Scotland allows for lab2lab
connection to be done in parallel and speed up installation.
• Over 90% of work is made up of blood science work where
results are:-
➢ Quantitative.
➢ Qualitative.
➢ Both.
• Covers BT, MB and CP.
• NPEx proven solution (NUH journey started in 2010).
• Project plan tried and tested to get ER solution installed &
tested.
• Installed in numerous trusts with different LIMS.
• NPEx accessible through secure website.
• VPN allows for secure transfer of PID and satisfies IG
requirements.
• Scalable solution to allow for growth.
• Incremental approach from NHS Scotland allows for lab2lab
connection to be done in parallel and speed up installation.
• Over 90% of work is made up of blood science work where
results are:-
➢ Quantitative.
➢ Qualitative.
➢ Both.
• Covers BT, MB and CP.
• NPEx proven solution (NUH journey started in 2010).
• Project plan tried and tested to get ER solution installed &
tested.
• Installed in numerous trusts with different LIMS.
• NPEx accessible through secure website.
• VPN allows for secure transfer of PID and satisfies IG
requirements.
• Scalable solution to allow for growth.
• Incremental approach from NHS Scotland allows for lab2lab
connection to be done in parallel and speed up installation.
• Over 90% of work is made up of blood science work where
results are:-
➢ Quantitative.
➢ Qualitative.
➢ Both.
• Covers BT, MB and CP.
• Ease of use, navigation and sending away work.
• New assays created with a minimum of five clicks.
• Complex tests reported in blood sciences, e.g. trisomy or
complex immunology.
• Expansion into MB and MD.
➢ MB
o Aspergillus galactomannan.
o 1-3 beta D glucan
o Quantiferon TB gold test.
➢ MD
o Factor V Leiden
o Prothrombin gene
o Alpha 1 antitrypsin
• NPEx functionality extension, Bowel Cancer Screening
Programme BCSP.
• NPEx enabler for external quality assessment services.
• Ease of use, navigation and sending away work.
• New assays created with a minimum of five clicks.
• Complex tests reported in blood sciences, e.g. trisomy or
complex immunology.
• Expansion into MB and MD.
➢ MB
o Aspergillus galactomannan.
o 1-3 beta D glucan
o Quantiferon TB gold test.
➢ MD
o Factor V Leiden
o Prothrombin gene
o Alpha 1 antitrypsin
• NPEx functionality extension, Bowel Cancer Screening
Programme BCSP.
• NPEx enabler for external quality assessment services.
• Ease of use, navigation and sending away work.
• New assays created with a minimum of five clicks.
• Complex tests reported in blood sciences, e.g. trisomy or
complex immunology.
• Expansion into MB and MD.
➢ MB
o Aspergillus galactomannan.
o 1-3 beta D glucan
o Quantiferon TB gold test.
➢ MD
o Factor V Leiden
o Prothrombin gene
o Alpha 1 antitrypsin
• NPEx functionality extension, Bowel Cancer Screening
Programme BCSP.
• NPEx enabler for external quality assessment services.
Additional data also sent back to NPEx withscreening result
• Ease of use, navigation and sending away work.
• New assays created with a minimum of five clicks.
• Complex tests reported in blood sciences, e.g. trisomy or
complex immunology.
• Expansion into MB and MD.
➢ MB
o Aspergillus galactomannan.
o 1-3 beta D glucan
o Quantiferon TB gold test.
➢ MD
o Factor V Leiden
o Prothrombin gene
o Alpha 1 antitrypsin
• NPEx functionality extension, Bowel Cancer Screening
Programme BCSP.
• NPEx enabler for external quality assessment services.
Additional data also sent back to NPEx withscreening result
• Ease of use, navigation and sending away work.
• New assays created with a minimum of five clicks.
• Complex tests reported in blood sciences, e.g. trisomy or
complex immunology.
• Expansion into MB and MD.
➢ MB
o Aspergillus galactomannan.
o 1-3 beta D glucan
o Quantiferon TB gold test.
➢ MD
o Factor V Leiden
o Prothrombin gene
o Alpha 1 antitrypsin
• NPEx functionality extension, Bowel Cancer Screening
Programme BCSP.
• NPEx enabler for external quality assessment services.
Additional data also sent back to NPEx withscreening result
• Ease of use, navigation and sending away work.
• New assays created with a minimum of five clicks.
• Complex tests reported in blood sciences, e.g. trisomy or
complex immunology.
• Expansion into MB and MD.
➢ MB
o Aspergillus galactomannan.
o 1-3 beta D glucan
o Quantiferon TB gold test.
➢ MD
o Factor V Leiden
o Prothrombin gene
o Alpha 1 antitrypsin
• NPEx functionality extension, Bowel Cancer Screening
Programme BCSP.
• NPEx enabler for external quality assessment services.
Additional data also sent back to NPEx withscreening result
• Ease of use, navigation and sending away work.
• New assays created with a minimum of five clicks.
• Complex tests reported in blood sciences, e.g. trisomy or
complex immunology.
• Expansion into MB and MD.
➢ MB
o Aspergillus galactomannan.
o 1-3 beta D glucan
o Quantiferon TB gold test.
➢ MD
o Factor V Leiden
o Prothrombin gene
o Alpha 1 antitrypsin
• NPEx functionality extension, Bowel Cancer Screening
Programme BCSP.
• NPEx enabler for external quality assessment services.
Additional data also sent back to NPEx withscreening result
• Numerous Laboratory Information Management System (LIMS)
in use across the UK.
• Each LIMS has a different I/F for electronic requesting/results
solution.
• Clinisys WinPath V5 Sp28 LIMS over 14 years old.
• ER solution based queue handling and flat files.
• Transfer of requests/results to NPEx done via CSV files.
• Limitations as LIMS has a hundred line limit.
• ER Solution can not handle embedded results.
• Patient/request data not transferred to NPEx.
• Numerous Laboratory Information Management System (LIMS)
in use across the UK.
• Each LIMS has a different I/F for electronic requesting/results
solution.
• Clinisys WinPath V5 Sp28 LIMS over 14 years old.
• ER solution based queue handling and flat files.
• Transfer of requests/results to NPEx done via CSV files.
• Limitations as LIMS has a hundred line limit.
• ER Solution can not handle embedded results.
• Patient/request data not transferred to NPEx.
• Numerous Laboratory Information Management System (LIMS)
in use across the UK.
• Each LIMS has a different I/F for electronic requesting/results
solution.
• Clinisys WinPath V5 Sp28 LIMS over 14 years old.
• ER solution based queue handling and flat files.
• Transfer of requests/results to NPEx done via CSV files.
• Limitations as LIMS has a hundred line limit.
• ER Solution can not handle embedded results.
• Patient/request data not transferred to NPEx.
• Results not the only elements required by the requesting
laboratory.
• Patient data fields created by NPEx.
• E.g. Date of Scan, Date of Egg Harvest.
• Date of scan in format ddmmyyyy.
• E.g. 12022016.
• Other LIMS limit on number field 999999.
• Added additional field in format ddmmyy.
• Gestation in the format 14 Weeks 3 Days.
• Added additional field for e.g. 14.3 weeks.
• Down’s Result Positive/Negative.
• Requesting lab interface could not handle comments.
• Result field changed to 0 and 1.
• Microbiology.
➢ Complex Reporting
➢ Reporting of Isolates, sensitivities and resistance
• Current ER Solution.
➢ Allows for reporting microbiology culture and sensitivity
data.
• Microbiology.
➢ Complex Reporting
➢ Reporting of Isolates, sensitivities and resistance
• Current ER Solution.
➢ Allows for reporting microbiology culture and sensitivity
data.
• Microbiology.
➢ Complex Reporting
➢ Reporting of Isolates, sensitivities and resistance
• Current ER Solution.
➢ Allows for reporting microbiology culture and sensitivity
data.
• Standard Results, LEU and Bacteria counts.
➢ ESCC –Escherichia Colli (organism).
• List of antibiotics in groups of 8, first three characters show the
antibiotic, the fourth character is the sensitivity.
➢ AUGs - Co-amoxiclav / Sensitive
➢ FOSR – Fosfomycin / Resistant
• Microbiology.
➢ Complex Reporting
➢ Reporting of Isolates, sensitivities and resistance
• Current ER Solution.
➢ Allows for reporting microbiology culture and sensitivity
data.
• Standard Results, LEU and Bacteria counts.
➢ ESCC –Escherichia Colli (organism).
• List of antibiotics in groups of 8, first three characters show the
antibiotic, the fourth character is the sensitivity.
➢ AUGs - Co-amoxiclav / Sensitive
➢ FOSR – Fosfomycin / Resistant
• Haematological Malignancy (HMDN) Work
• Electronic Requesting/Integrated Reporting.
➢ BMA Report.
➢ Trephine Report
➢ Immunophenotyping Report.
➢ Molecular Diagnostic Report.
➢ Cytogenetic Report.
• Haematological Malignancy (HMDN) Work
• Electronic Requesting/Integrated Reporting.
➢ BMA Report.
➢ Trephine Report
➢ Immunophenotyping Report.
➢ Molecular Diagnostic Report.
➢ Cytogenetic Report.
• Haematological Malignancy (HMDN) Work
• Electronic Requesting/Integrated Reporting.
➢ BMA Report.
➢ Trephine Report
➢ Immunophenotyping Report.
➢ Molecular Diagnostic Report.
➢ Cytogenetic Report.
• Haematological Malignancy (HMDN) Work
• Electronic Requesting/Integrated Reporting.
➢ BMA Report.
➢ Trephine Report
➢ Immunophenotyping Report.
➢ Molecular Diagnostic Report.
➢ Cytogenetic Report.
• Referrals to NHSBT
➢ Additional tests to ascertain antibodies
➢ Paper report retuned and need to be transcribed
• Referrals to NHSBT
➢ Additional tests to ascertain antibodies
➢ Paper report retuned and need to be transcribed
• Referrals to NHSBT
➢ Additional tests to ascertain antibodies
➢ Paper report retuned and need to be transcribed
• Quality Control using external quality assessment services.
• The United Kingdom Accreditation Service (UKAS)
accreditation for pathology labs.
• Managing change management and QMS.
• Quality Control using external quality assessment services.
• The United Kingdom Accreditation Service (UKAS)
accreditation for pathology labs.
• Managing change management and QMS.
• Quality Control using external quality assessment services.
• The United Kingdom Accreditation Service (UKAS)
accreditation for pathology labs.
• Managing change management and QMS.
• The technical challenges have all been addressed in some
nature in previous installations.
• Collaboration and resources from trust IT departments.
• Allocating resources to complete the setup and test.
• Staff training and acceptance of new system.
• Change management.
• NPEx and Pathology IT managers resources available to help,
advise and resolve any future issues.
• Opens up options to connect to UK labs for collaboration?
[email protected]+44 115 840 4713
• The technical challenges have all been addressed in some
nature in previous installations.
• Collaboration and resources from trust IT departments.
• Allocating resources to complete the setup and test.
• Staff training and acceptance of new system.
• Change management.
• NPEx and Pathology IT managers resources available to help,
advise and resolve any future issues.
• Opens up options to connect to UK labs for collaboration?
[email protected]+44 115 840 4713