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The Humber IHE-XDS Multi Disciplinary Team (MDT) Project. Dr. Richard Harries, Consultant Radiologist Dr. Stephen Trowell, Head of Informatics Northern Lincolnshire and Goole NHS Foundation Trust. Humber XDS project initiation. Clinically led:
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The Humber IHE-XDS Multi Disciplinary Team (MDT) Project Dr. Richard Harries, Consultant Radiologist Dr. Stephen Trowell, Head of Informatics Northern Lincolnshire and Goole NHS Foundation Trust
Humber XDS project initiation Clinically led: • Consultant Radiologist [Dr. Richard Harries] introduced IHE compatibility to the Trust during a Radiology Information system upgrade • Engaged SHA in discussions around potential benefits to the Local Health Community • Identified potential benefits to XDS deployment within a Multiple Disciplinary Team (MDT) meeting environment
Humber Current MDT facilities • Joint team meetings implemented using video conferencing facilities linking Hull and Grimsby • Two large flat panel screens for image display • PC linked microscope • PACS workstation • Laptop • Presentations by Radiologist, Pathologist etc referring to images shared on video screens • Patient records other than images in paper form (some recent records are available in electronic form, some only in hardcopy form)
Humber MDT meeting XDS enhancement • Two objectives • Proof of concept of XDS implementation in the UK environment • Enhancement of MDT meeting facilities by access to selected documents during and after meetings • Initial project: added functionality • Rapid selection and display of Discharge Summaries, Outpatient Clinic Notes and Operation Notes • Availability of these documents following the meeting • Follow on project: access to Reports e.g. CDA
Document Access • Document search and retrieval • Centralised XDS Registry/Repository • Document access from both Video conference rooms • Video conference room PCs upgraded for XDS document search and display (facility for panel monitor display of PC screen exists) • Document access from other locations? • Continuous subsequent access to documents by authorised staff
Document preparation for MDT meetings • Current process involves finding and collecting the record folders for the patients on the list for that day • Summaries and notes already in electronic from: • Pull from local hospital store • Convert to pdf • Create metadata • Some automatic • Some supplied by operator • Submit to XDS repository
Humber XDS deliverables Proof of concept will: • Define suitable metadata tags for each document type • Define tag creation process for text records • Using tagged documents in XDS repository • Use of central document registry • Document retrieval will be demonstrated from • Northern Lincolnshire and Goole Foundation Trust and • Hull and East Yorkshire Hospitals Trust • Access control will be established to ensure legitimate relationship policies are adhered to
Benefits to MDT participants • Less risk of errors when matching records to patients. • Greater probability that the entire relevant patient record will be used to support clinical decision making. • Facilitates ease of viewing key documents originating in other health care provider organisations. • Less manually resource intensive task to collate relevant records prior to MDT meeting. • During MDT meeting, more consistent and seamless presentation of information – fewer interruptions whilst looking for pertinent information.
Benefits to the Foundation Trust • Facilitates improved clinical decision making, thereby reducing risk of incorrect conclusions being drawn. • Facilitates a consistent, standard approach to MDT meetings so easier for staff to sit on multiple MDT’s. • Contributes to a culture of innovation.
Benefits to patients and GPs • Facilitates improved clinical decision making, thereby reducing risk of incorrect conclusions being drawn. • Potential to send a link electronically to GP and/or patient so that they can access a file summarising the outcome of MDT discussions. (patient only has access to that specific document)
Benefits to Local Health Community [SHA]: • Demonstrates potential for cross-organisational sharing of documentation – applicable to many areas beyond MDT environment. • Generates a local understanding of the benefits and issues around IHE XDS technology. • Continues to place the region at the forefront of health informatics advances.
Issues – implementation challenges Despite good alignment with national and local NHS Quality agenda….. • Understanding of XDS in both clinical and informatics/IT Trust departments is limited to a few individuals • Engagement of Trust in IHE technology • “We already have an Integration Engine and NPfIT products – why do we need another method of interfacing systems?” • SHA supportive – potential benefits to the LHC • Excellent support from IHE-UK, and commercial partners
Humber XDS project summary • The Humber IHE-XDS MDT project aims to develop local understanding of IHE technology • Through MDT’s, can demonstrate a proof of concept • Easily scalable rollout, engaging many clinicians • Suitable basis for future deployment • Small scale [Trust based] proof of concept carries minimal risk • XDS is a method, not a product – it does not specify everything that we need to make the project successful!
Group Feedback • Questions ? • What else should the project team consider? • How does this relate to your areas? • What other potential applications are there for XDS? • How does the NHS agree standard metadata for document classification?
Humber XDS project – related projects • Electronic Discharge summaries • Joining Pharmacy records to ward-based clinical records to create a single discharge summary • PAS developments • Clinical Viewer software could be configured to generate pdf documents at source • Electronic Document Management • Digitising legacy paper records – XDS compatible?