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
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 and telematics Telemedicine, other multimedia applications
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!
• Dont 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 isnt 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
• Couldnt 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