Electronic Anaesthetic Record Systems SCATA Nov 2003 Duncan

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

Current Situation n n 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 Telemedicine, other multimedia and telematics applications

Proposed Solution from EPR n n n Free standing PCs in 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? n n n 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 n n 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 n n n Large scale, enterprise wide Integrate with monitors for automated records Integrate with EPR systems Reports Links to EPR prescribing

Available Systems n n n n Philips Drager Recall Winchart Deio GE Medical Docusys Civica

Drager / Recall n n n Installed in the North West Well automated ? Links to theatre management systems ? Links to EPR Costs – relatively expensive - £ 400 k for a 12 theatre setup Working demo on site for a week, good sales response, gave quotes

Winchart n n n n Australian I have not seen a running system Well automated ? Links to theatre management systems ? Links to EPR Costs – relatively cheap £ 180 K for a 12 theatre system Came to meet, demo the system and give prices

Philips n n n Actively marketed in the UK Good interface Seems well automated They say it can interface to EPR Cheap - £ 72 K for a 12 theatre suite Couldn’t get the company to communicate or return calls or arrange information or a demo….

GE Medical n Only seems automated when attached to their own monitors and equipment

Docusys n n n 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 n n Only works with one monitor make Seems to be well automated ? cost No EPR integration

Civica Galaxy Anaesthesia n n 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? n n 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? n Procurement strategy for IT 2003/2004 n n 22 St. HA 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? n Consolidation within the EPR industry Torex own Hollowbrook computer services, AAH Medical, Pennine Medical Systems, 20% of the GP contracts and SMS Uk n Torex recently bought Winchart and Civica Galaxy anaesthetic systems n I-soft bought Torex and claim to have a level 6 EPR system n Torex are one of the successful PSPs n

Thank You