Post on 02-Jan-2016
transcript
COBISData
13/11/2009
Progress
J Kinsella
J Kinsella
Anaesthesia Pain and Critical CareBurns
Smoke inhalationBurn Pain
SICS audit GroupDatabase research (ACHE ACCERT)
Scottish Intercollegiate Guideline Network
Data
Janet BaxterElizabeth Bream
Martin ShawCharlotte Gilhooly
Data subgroupCOBIS members
Progress
• Starting point– Some data– Unreliable– Double counting – Inconsistent– Barrier to progress, audit and research
– No joined up working
Progress
• Initial data collection– Good picture– No use for assessing progress, trends etc
Challenges
• Lack of expertise• Busy• Individual goals• Lack of expertise
• Central records systems• NHS firewalls• Caldicott guardians
Opportunities
• Experience
• Good will
• Expertise found
Progress
• Dataset agreed
• Dataset refined
• Data collection system developed
• Challenges overcome
Data collection system
• Complete
• Demonstrated today
• Ready to go live 01/01/10
Burns Audit System
• System needed to be:– Scalable– Reliable– Secure
• Web application– All components are Microsoft derived as this
is the preferred platform of the NHS.
System Overview
Local server
Local client
Firewall
Central Repository
Local Systems
• Local Server– Hosting the web server application– Hosting the database server– File transmission software to central server
• Local client computers– No configuration required all should have a
web browser already
Central Repository
• Server– Hosting the main audit database– Software for receiving files form remote
computers– Reporting tool of some description
• Location– Glasgow, for ease of maintenance and
support
Software Overview
• This can be easily summarised in two parts:– The Information Schema– Initial views of the web application frontend
Information Schema
Information Schema
Information Schema
• Blue: Demographics
• Red: Admitted Cases
• Green: Referred Cases
• Gray: System Audit– Change tracking.
Information Schema
• Patient Journey– Heart of the system– All actions carried out on the patient listed
sequentially here.
Visit demonstrations
• To give an idea of what the system will generally look like:– Login– Main Screen– Patient Information– Case Edit– Injury List– Burns Bundles
Frontend: Logon
Frontend: Main Screen
Admitted and Referred
• These are separate for two reasons– The main aim of the system is only to collect the
severe burns admitted to the units– Security
• Its possible to have referral editing rights without having admitting rights.
• Allowing A & E’s to use the referral section minimising workload of burns unit staff.
• They contain virtually the same information– So views of one will be similar to views of the
other
Frontend: Patient Information
• One way hashes– Essentially a function that can be evaluated in
one direction only and cant be reversed to obtain the original result.
– OneWayFn(CHI) = HashValue– SHA hash designed to military and
government encryption standards– The central repository will match on this
anonymous hash value
Frontend: Case Edit
Frontend: Injury List
Frontend Burns Bundles
Problems remaining
• Staffing
• Computer systems in each centre
Proposed
• Minimum dataset from 01/01/10– If no computer still collect data– Local reporting…local audit– National reporting minimum one per yr
• Trends• Overall picture• Infrom future practice research and audit
What it is not
• A fully electronic case record
• A comprehensive list of everything you can imagine
• Unusable
Questions
• Purpose?– Local and national
• Reporting frequency– For discussion – annual
• Effort required– Piloted
• System failure
• Confidentiality