Electronic Anaesthetic Record Systems

1. Electronic Anaesthetic Record Systems SCATA Nov. 2003 Duncan Hancox Royal Preston Hospital

2. Current Situation • 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!

3. EPR Levels

4. Proposed Solution from EPR • 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

5. My Theatre PC Anaesthetist

6. Where do we go next? • 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?

7. Standards from the DOH • 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?

8. Commercial Products Requirements • Large scale, enterprise wide • Integrate with monitors for automated records • Integrate with EPR systems • Reports • Links to EPR prescribing

9. Available Systems • Philips • Drager Recall • Winchart • Deio • GE Medical • Docusys • Civica

10. Drager / Recall • 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

11. Winchart • 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

12. Philips • 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….

13. GE Medical • Only seems automated when attached to their own monitors and equipment

14. Docusys • 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.

15. Deio • Only works with one monitor make • Seems to be well automated • ?cost • No EPR integration

16. Civica Galaxy Anaesthesia • Uk developed by an anaesthetist • Cost similar to Winchart • Automated recording from monitoring • Custom integration to EPR modules 1 or 2 way

17. What do WE do next at RPH? • 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?

18. Where is the government and industry heading? • Procurement strategy for IT 2003/2004 • 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.

19. Where is the government and industry heading? • Consolidation within the EPR industry • 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

20. Thank You