Transcript Electronic Anaesthetic Record Systems

Electronic Anaesthetic Record
Systems
SCATA Nov. 2003
Duncan Hancox
Royal Preston Hospital
Current Situation
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EPR project under way in my hospital
Anaesthetics was to be incorporated into
the core specification
Was ignored due to funding constraints
Per-se do not have an anaesthetic system
Now the trust realise they would like an
electronic anaesthetic record!
EPR Levels
EPR
Functionality
Detail
1
Clinical Admin
Patient admin and independent
departmental systems
2
Integrated clinical
diagnosis and
treatment support
Integrated master patient index,
departmental systems
3
Clinical activity
support
Electronic clinical orders, results
reporting, prescribing, care pathways
4
Clinical knowledge
and decision support
Electronic access to knowledge bases,
embedded guidelines, rules, electronic
alerts, expert system support
5
Specialty specific
support
Special clinical modules, document
imaging
6
Advanced
multimedia and
telematics
Telemedicine, other multimedia
applications
Proposed Solution from EPR
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Free standing PCs in the theatre
PC to be shared with nurses for theatre
management
Data to be entered manually by the
anaesthetist using a keyboard and mouse
My Theatre
PC
Anaesthetist
Where do we go next?
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No data set or standards established
Try to write an anaesthetic record system
– reinventing the wheel!
Don’t bother with an electronic record
Use a commercial product
Automated records or manual entry?
Standards from the DOH
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For radiology, the DOH states that
information from electronic monitors and
equipment should be automatically logged
and not entered manually
Why isn’t this standard also established for
anaesthesia?
Commercial Products Requirements
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Large scale, enterprise wide
Integrate with monitors for automated
records
Integrate with EPR systems
Reports
Links to EPR prescribing
Available Systems
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Philips
Drager Recall
Winchart
Deio
GE Medical
Docusys
Civica
Drager / Recall
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Installed in the North West
Well automated
?Links to theatre management systems
?Links to EPR
Costs – relatively expensive - £400k for a
12 theatre setup
Working demo on site for a week, good
sales response, gave quotes
Winchart
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Australian
I have not seen a running system
Well automated
?Links to theatre management systems
?Links to EPR
Costs – relatively cheap £180K for a 12 theatre
system
Came to meet, demo the system and give prices
Philips
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Actively marketed in the UK
Good interface
Seems well automated
They say it can interface to EPR
Cheap - £72K for a 12 theatre suite
Couldn’t get the company to communicate
or return calls or arrange information or a
demo….
GE Medical
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Only seems automated when attached to
their own monitors and equipment
Docusys
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Seems to be well automated
Has an automated pharmacy record
system – understands how much of what
drug has been given when to the patient
automatically!
How much? – needs their special drug
containers to work fully.
Deio
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Only works with one monitor make
Seems to be well automated
?cost
No EPR integration
Civica Galaxy Anaesthesia
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Uk developed by an anaesthetist
Cost similar to Winchart
Automated recording from monitoring
Custom integration to EPR modules 1 or 2
way
What do WE do next at RPH?
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Anaesthetic record data set needs to be
established rapidly
Implement EPR links (eg xml export) between
independent AIMs and EPR systems?
Convince Trusts that AIMs are a mandatory part
of EPR rather than an optional extra
Try to persuade the EPR companies to include
automated anaesthetic record keeping – how
best to do it?
Where is the government and
industry heading?
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Procurement strategy for IT 2003/2004
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22 StHA will make purchasing decisions from PSPs
Prime Service Providers (2-5) should reduce the
number of players dramatically.
Current EPR projects and procurements are being
held back until then.
IT companies put development on hold and consider
redundancies – if they are excluded from a PSP
consortium they will not make any sales in the UK.
Where is the government and
industry heading?
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Consolidation within the EPR industry
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Torex own Hollowbrook computer services,
AAH Medical, Pennine Medical Systems, 20%
of the GP contracts and SMS Uk
Torex recently bought Winchart and Civica
Galaxy anaesthetic systems
I-soft bought Torex and claim to have a level
6 EPR system
Torex are one of the successful PSPs
Thank You