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Renalspecific information systems in the UK
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Title: Renalspecific information systems in the UK
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Renal-specific information systems in the UK
- RCPL workshop
- 22nd October 2008
- Charlie Tomson
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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
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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
http//www.renal.org/rixg/RenalITfunctionality0406
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- 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
fn_crcl
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Proportion of functions surveyed by renal unit
hihlts
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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
http//www.renal.org/rixg/RenalITfunctionality0406
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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
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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
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Silos
- Renal IT systems
- Not fully integrated with other sources of
information - Renal IT managers
- Not fully integrated with Trust IT departments
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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
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For example
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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
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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
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Thank you
- For copies of slides, or comments, please email
mecharlie.tomson_at_nbt.nhs.uk
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