This document summarizes the journey of integrating separate clinical systems into a single electronic patient record at a hospital. It discusses who will participate in the journey, what has been accomplished so far including quick wins, and next phases of the project. Physicians have provided positive feedback on improvements from the clinical portal such as having all patient data in one place and signing off results electronically. Future phases aim to incorporate additional data, pathways, and fully electronic documentation and ordering.

1. TSCUH Start of
Journey to a more
ELECTRONIC PATIENT RECORD
Dairín Hines
Acting Head of ICT / Clinical Informatics Manager

2. Who will come on the
Journey ?

3. Journey – what to pack?

4. Clinical Portal:
Taking 5 Separate systems along the
Yellow Brick Road towards a single sign
on Electronic Patient Record
Our Vision/Destination –Less Reliance on Paper

5. Who came on the Journey -­‐‑What’s In It For Me??
I want to see
all patient data
in one place
I want to see all
clinical
correspondence
I want to sign
off results
electronically
I want to
review patient
Labs and
Radiology
I only want to log on
once to one system
I want to view
patient diagnosis
reports
Safety First:
Patient
confidentiality
Comply with
standards
I want to view ED
aUendances

6. Road Blockages / Obstacles Faced??
Technical
Communication
Contributors -­‐‑ Decision Makers
Organisational Goals -­‐‑ Sponsor Goals
Resources
Time
Access

7. ! “Useful, intuitive, I’m looking forward to the next phase. I love
the encounters view, it’s much faster and easier than IPIMS”
Dr. Nuala Murphy – Consultant Endocrinologist
! “Versatile, efficient and user-­‐‑friendly”
Dr. Ciara McDonnell – Consultant Endocrinologist
! “A great advance”
Mr. John Caird – Consultant Neurosurgeon, Chair Medical Board
! “I like it, very easy and quick to load. The interface is good.
I like being able to access lab results, radiology reports and
images all in one place.”
Dr. Wail Mohammed – Neurosurgical SpR
Thoughts So Far…
Since Starting this Journey

8. Phases and Quick
Wins
! Shared Care
! Home Leave
! ED Homepage
! Age on worklists
! Antimicrobial guidelines
! Added counts to list results
! Read receipts for messaging
! Send patient record links to other clinicians
! Enhancements to default Homepage
! Printed lists – Notes column
! Trial of medicines complete
! New/Return OPD on lists

9. Print your clinic list
Review your outpatients prior to clinic
Shows patients admiMed under your care and
shared care
Homepage presents to you your current inpatients
Review your lists
Find your patient
Select Patient

10. View future appointments and past encounters
View minimum data set from Theatre
Potential for more, e.g. ASA Score, Waiting Lists
Review patient
Demographics, Encounters, Theatre

11. Quickly navigate between patients on your list
Maintain a worklist of frequently accessed patients
Navigate to another patient
Use worklists to manage your Patients

12. Previous Workflow
! Each result must be accessed individually.
! Values outside reference range are difficult to
decipher
! No audit trail
Cumulative View
Graph Function
Clinical Portal
! Clinical Documents View displays visual indicators of
status of result
! Send result to other portal users for opinion and advice
! Full audit trail
Single Result View
List View
Monitor Laboratory Results

13. Previous Workflow
! Access Physician Portal to order
! Access iSite Enterprises to view reports and images
! Results displayed in date order but not grouped by modality
Future Developments:
Links Menu will include
! BNF
! Journal Links
! Decision Support Tools
! VigneUes
Clinical Portal
! Reports organised by modality in Clinical Documents Tree
! Reports and images viewable in Patient Context
! Order from Physician Portal link on Links Menu
! Reports can be sent to other portal users via Messaging
service for opinion and advice and opened in patient
context
List View
Report
Radiology Image
Order/View Radiology Results
Communicate

14. Previous Workflow
! Laboratory and radiology reports are printed,
distributed to clinical areas for manual signature
! Signatures difficult to decipher
! Reports are filed in patient charts
Clinical Portal
! Reports can be signed off electronically
with opportunity to record comment in
multiple locations
! Full audit trail available
List View
Single Result View
Cumulative View
Results Sign Off

15. ! List of patients shared across a number of users.
! Patients are added to a shared worklist from the
patient summary page
! Add notes/comments, urgency and follow-­‐‑up date
to any worklist entry
Create Shared Worklists
Add Patients
Manage Your Team

16. WHAT NEXT?
Management of Handover, PEWS, close watch
flagging, data from other systems , other data
elements, hospital wide pathways and much more.
Phase 2
Portal
Outputs
Paper to Electronic Process
ED View
CCD
Sign-­‐‑Off Bloods/Radiology
Patient Alerts
Discharge Summary
Shared Worklists
Clinical Docs
Problem Lists -­‐‑ Diagnosis
Waiting Lists
Phase 3
Pathways in 2 disciplines with more electronic documentation and one
hospital wide
Phase 4
! Full Order Communications To Include Text Based Referrals
! Notifications
Continuing along the Yellow Brick Road

17. Any Questions??