CLINICAL PORTAL Hospital Services. Presented by Stephen Parsons
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1 1 CLINICAL PORTAL Hospital Services Presented by Stephen Parsons
2 Dependence on Interoperability 2 Multiple modular solutions centred on Series of interface engines Web based applications Data exchange processes XML based clinical repository Clinical and Business Applications EPR / clinical functionality Electronic Scheduling No traditional PAS Data Warehouse / reporting & performance Darzi Clinical 5 re-affirms direction
3 Heart of Interoperability Enterprise wide Patient Master Index epmi Single source patient ID Intelligent index data handling rules Component build API, master tables etc Integration Engine Ensemble Message management / transformation Enterprise Service Bus ESB message table Local patient tables for message filtering Application based interfaces SOAP, web services, HL7, server switching, DTS, FTP, flat file 3
4 4 HL7 SOAP/Web Proprietary Messaging Architecture Blood Track Radiology A & E Pharmacy Theatres Pathology ENSEMBLE Departmental Small Systems Anglia Order Comms epmi INT. ENGINE Casenotes GP Practice Exeter SMS Text Reminders Electronic Pat Record Primary EPR Secondary EPR Electronic Scheduling Inpatients Bedman Outpatients Theatres Scanning Small System Doc Man t Infopath Elec Whiteboard C&B / PDS DATA WAREHOUSE
5 5 Sharing of Clinical Information SHARED EPR SERVER SHARED PATIENT INDEX SHARED NETWORK SHARED INTERFACES EPR SERVER SHARED XML FORMAT SHARED WEB BROWSER GP Systems Documents PRIMARY GP s Community Hospital Systems Requests SECONDARY Hospital (Access by Agreement)
6 6 Integrated Care System Commissioners
7 7 Cohorts of Patients INFORMATION AND REPORTING STREAM FOR CLINICAL PANELS
8 8 Paper Lite Process Extend use of EPR Remove paper medical record EPR to facilitate Digital Patient Pathway Secure / rapid access to records 24/7 Speed up the operational pathway stages Clinical data to be more available Reduce the admin burden for paper casenotes Reduce costs
9 9 Key Process Development Areas Interoperability at document level Technology and process Web based technologies More access to IT / Wireless User management SSO Electronic Whiteboard EPR Electronic forms Infopath Electronic order comms Digital Dictation EDM & Scanning Process Electronic results sign off
10 Traditional Casenotes 10
11 11 Electronic Whiteboard Bed occupancy Length of stay Clinical Alerts Results to signed off Referrals Handover actions Pathway - Adv Quality forms
12 12 Technology - Scanning Scanning Solution PDF interface from systems Scan on Demand for Legacy Casenotes Temporary Casenotes scanned after clinic/ discharge DART repository uses metadata links to EPR Barcode driven patient ID and divider sheets Minimal challenge to departmental systems PDF output
13 13 Clinics Outpatient Clinics Legacy casenotes scanned prior to New Appt EPR records used for Follow Up Appts Pack issued for each Clinic to record patient notes Pack contents scanned after each clinic Available in EPR
14 EPR Presentation 14
15 Electronic Whiteboard 15
16 Whiteboard Patient Status 16
17 17 SSO launched PACS image Hyperlink to Image ID from Rad report style sheet SSO opens PACS viewer credentials for user
18 Requests launched from EPR 18
19 Move to the Electronic Ward Traditional Nurse Station Paper Casenotes Paper forms - vary from ward to ward Bottom of bed charts X ray films / paper path results Limited electronic records Electronic Ward Virtual electronic Casenotes Electronic forms designed by staff groups Work flow based electronic referrals Results / alerts / EWS - electronic whiteboards Bedside data recording 19
20 20 SharePoint / InfoPath forms Bespoke designs fast turnaround Intelligence within data field selection Integration with XML based EPR Supports workflow concepts between clinicians Data to SharePoint databases Data queries for Whiteboard / Warehouse reports Value for money Overwhelming buy-in from staff groups
21 EPR link to forms process 21
22 Workflow management of forms 22
23 E-Referrals clinician choice 23
24 Signature management via InfoPath 24
25 Interface with Social Services 25
26 SS Referrals records 26
27 VTE CQUIN via MS Reporting Services 27
28 VTE Completion Progress 28
29 Intelligent form design 29
30 30 Portal / Repository clinical/legal record The Repository EPR is the virtual patient casenote Date / time based entries from other systems Version control for EPR entries history not editable The Portal Evidence of clinical information available at a point in time Clinical decision making auditable against records available Interoperability Strategy
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