Towards a paperless Queen Square Neurophysiology

Transcription

1 Towards a paperless Queen Square Neurophysiology Over the years we have developed a suite of software apps which handle all aspects of the patient journey in Clinical Neurophysiology. Electronic referrals (available from end of 2015) Booking of appointments Notification of patient arrival on day of clinic visit Generation of study reports Automatic ing of reports

2 Towards a paperless Queen Square Neurophysiology After the receipt of a referral all aspects of the patient journey are handled electronically without or with minimal clerical input: 1. Vetting and triaging. 2. Support for booking of appointments (by , SMS and paper letter). (The system is ready for all correspondence with patients through and SMS. However, paper-based appointment letters are still in use because of the difficulty getting access to the patients addresses) 3. Automatic electronic filing of requests so that they are displayed on the PC in the clinic room on the day of the investigation. 4. Automatic electronic archiving of requests. 5. Generation of reports with custom-built apps which help standardisation and quality control and support audits. 6. Automatic secure ing of reports to referrers and deposition on EPR at the time of approval of the report by a consultant.

3 Towards a paperless Queen Square Neurophysiology Although the system s main purpose is to support the work of clinicians, all relevant back office functions are implemented and only a push of a few buttons away with high granularity on single patient and staff level. This includes: 1. Retrieval of reports and requests 2. Detailed information of the patient journey: time stamping when requests were received time from receipt to booking of an appointment time to the appointment waiting times of patients on the day of the clinic visit Time to approval and ing of a report 3. Billing

4 Towards a paperless Queen Square Neurophysiology The referral can be a letter or a paper request form which will be scanned. However, we prefer ed PDF forms. By the end of 2015 it will be possible to submit electronic requests from a custom built app. Paper form PDF form Electronic form Subsequently, all aspects of the patient journey are paperless (with the exception of mailing of patients appointment letters)

5 Towards a paperless Queen Square Neurophysiology The next major improvement will be the implementation of an electronic requesting app. It will be simple and fast for clinicians to operate and available through an icon on trust PCs. The moment a referral is submitted it will be automatically logged and directly made available to clerical staff for booking. From there appointments can be immediately generated or the request can be electronically passed to medical staff for vetting and triaging. From 2016 it will be possible for patients at Queen Square to book many investigations immediately after their consultation with the receptionist in the outpatient department. This will facilitate patient choice and shorten waiting times and reduce administrative costs. Parenthetically, it will be possible to implement this electronic requesting system in a modified version in our partner hospitals, if they can provide a simple access to patient demographics. In the interim semi-automatic PDF forms will be available.

6 Towards a paperless Queen Square Neurophysiology At QS it will be possible to submit an EEG request by manual entry of patient s hospital number and DOB and 6 mouse clicks. Requests for other investigations will be designed in a similar way.

7 Following launch from the desktop icon of a PC, hospital number and DOB need to be entered. 1.) CLICK ONE will retrieve patient s demographics. If postal address, mobile number or address is on record it will be displayed. There is an option to enter it. This can also be done by secretaries or receptionists on Carecast. At the moment a significant delay and source of superfluous work and expense is caused by snail mailing appointment letters to patients. 2.) The referring consultant is automatically recognised from login onto the trust PC. 3.) Secretaries, SHOs, SpRs etc. are automatically recognised from their login and can request on behalf of a consultant by selecting the name from a drop down menu.

8 4.) CLICK TWO: Choice of OP, Ward (from drop down menu) or TCI

9 5.) CLICK THREE: Selection of investigation. Here illustrated by the example of a routine EEG.

10 6.) A list of referral diagnoses is displayed. This is the SCORE profile which is now the standard endorsed by ILAE and the European Federation of Clinical Neurophysiology. CLICK FOUR to select at least one. CLICK FIVE for ok.

11 7.) The final screen summarizes the process. It provides an option to enter free test through keyboard or Cut&Paste. CLICK SIX to submit. The request will without delay (i) Be available for optional vetting or triaging to medical staff members who can then forward the request with a single clock to the booking team or (ii) Will be directly made avaialble to the booking team or (iii) Will be available for the receptionist in the outpatient department.

12 8.) For ward referrals the request will become directly available to the medical staff in Clinical Neurophysiology without the need for clerical input. 9.) For TCI referrals the request will be immediately available for vetting in the Dept. of Clinical Neurophysiology and then passed on to the ward or daycare booking teams.

13 10.) For outpatients, the clerical staff of the Department of Clinical Neurophysiology or the outpatient department, will be able to select clinic appointments from a simple colour coded clinic template in a context sensitive way (as illustrated below for EEG).

14 11.) With ok the appointment will be in registered in the departmental booking system and the referral will be automatically filed. This information is available at each EMG/EEG/EP machine at the day of the appointment and during the reporting session. Alternatively, scanned paper requests or PDF forms are displayed here

15 12.) For outpatient appointments clerical staff can or print appointment letters, patient information sheets with one click.

16 13.) Using to sms a text is sent to the patient.

17 14.) The program also generates a list of appointments that can be transcribed into Carecast. This can be done remotely by staff with VPN from home or anywhere in the trust.

18 15.) For inpatient appointments the request are vetted in Clinical Neurophysiology and with a single click sent to ward booking team. Including comments (here left blank) The ward booking team can book any convenient time months ahead without the need for reserved slots. As soon as the book button is pressed all information is in the right place without the need for any further input until the patient arrives in the Department (no ing, no telephone call, no faxing, no filing etc. with clerical or medical staff in the Department of Clinical Neurophysiology)

19 Towards a paperless Queen Square Neurophysiology It is now possible to submit P2P requests through PDF forms. These can be downloaded form our web site and we make partially prepopulated forms available. They are submitted by to a dedicated mailbox in Clinical Neurophysiology, UCLH.Neurophysiology@nhs.net. From there referrals will be picked up by office staff and moved to our request managing system in a simple semi-automated process.

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