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A vision of the doctor’s desktop Presentation to SIHI Conference, Portsmouth 1 st October 2004

A vision of the doctor’s desktop Presentation to SIHI Conference, Portsmouth 1 st October 2004. Roger Killen Managing Director The Learning Clinic Ltd. Clinical information supports. Clinical decision making Identification of best practice Review of performance trends

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A vision of the doctor’s desktop Presentation to SIHI Conference, Portsmouth 1 st October 2004

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  1. A vision of the doctor’s desktopPresentation to SIHI Conference, Portsmouth1st October 2004 Roger Killen Managing Director The Learning Clinic Ltd

  2. Clinical information supports • Clinical decision making • Identification of best practice • Review of performance trends • Patient history review

  3. Clinical decision making There are a number of scoring systems which support clinical decision making including: • MEWS (modified early warning score) • MTS (manchester triage score) • P-POSSUM (surgical outcome predictor) • APACHE II (ITU outcome predictor) For each score, there’s a trade-off between quality of the predictor and ease of data collection

  4. Identification of best practice • National and peer benchmarking (e.g. Dr Foster, CHKS) compares: • Mortality rates • Length of stay • Day case rates • Readmission rates • Time to operation Suffer from limited case mix adjustment. Good at early warning of performance outliers for review

  5. Review of performance trends • Compare current outcomes to local history – some NHS trusts do it, some don’t • Can be variously adjusted for case mix factors depending on time and will • Can be updated in very timely fashion to promote improvement • Often burdensome on data collection and analysis

  6. Patient history • NPfIT – electronic patient record • Accessible patient specific information accessible to responsible clinicians

  7. What is the vision? An information system that combines: • Highest quality clinical outcome predictions (case mix adjusted, etc.) • Zero additional burden on the workforce (only use routine data) • Instant updates as patient condition measures become available (electronic data entry on the ward) • Accessible formats – the clinician “gets” the picture at a glance – informs appropriate intervention

  8. Is this realistic? The technologies to deliver to this vision are here: • Wireless LAN on various wards means instant updates • Hand held computing power means electronic data capture on the ward is a reality • Research evidence shows that linking administrative and clinical databases provides reliable outcome prediction • Accessible formats created by DK team (expertise in intuitive computing for the user)

  9. Summary The vision: • Real time view of patient progress via intranet • Robust prediction of outcomes • Suggested intervention supported by research based protocols – ie. who should attend the patient and when, NOT what should the clinician do! When can I see this? Book early for the next SIHI conference – a “work in progress”

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