Medical Informatics Medical Informatics Assignment 2Assignment 2

Patient Discharge System

By King Ken Law

Philip McCormac

Edel Hughes

IntroductionIntroduction

What is the patient discharge system?The purpose of the systemHow the system worksPros and cons of the systemConclusion

How the Discharge system fits How the Discharge system fits in with other Main Systemsin with other Main Systems

DEPENDENCIES AND FLOW

NURSING TERM INALS M EDICAL RECORD TERM INAL

DECISION SUPPORT SYSTEM

PAS EXTRACT DATABAS E DISCHARGE DATABAS E

DISCHARGE INFORM ATION SYSTEM(NT SERVER)

INVOICE

PATIENT ADM ISSION SYSTEM(PAS)

What is the patient discharge What is the patient discharge system?system?

•Discharge system records admission, audit and expected date of discharge information

•Form (electronic or manual) completed by discharge co-ordinator

•Patient details, arrival date, admission date

•Expected date of discharge

Manual Discharge FormManual Discharge Form

Computerized formComputerized form

The purpose of the systemThe purpose of the system

•Co-ordination of discharge planning, identifies anticipated length of stay

•Used as predictor for effective bed management

•Provides list of expected discharges on a shift basis: Patient informed

Medication counselling

Transport

GP or District nurse informed

Purpose continuedPurpose continuedConsolidates information such as medication

and aftercare measures Generates a letter to go back to the patient’s

GP, or district nurse providing information on discharge

Medical researchPerformance assessmentComparative analysis

How does the system work?How does the system work?

GP referral – PAS finds patient number or assigns a new one.

Secretary checks detailsForm and estimated date of discharge noteTreatmentOn discharge – two options

Use discharge system on pcUse hand written doc and pass to coding

CodingCoding

Each morning staff in the Coding department print off the discharges completed the day before.

They will visit the ward and get patient records for any further supplementary coding

The information is brought back and put on the discharge system and PAS. It is then passed to the consultant for final verification.

Verification can be carried out by the consultant using a PC or by coding department returning form as a GP discharge letter.

Advantages of Coding Advantages of Coding Department to DoctorsDepartment to Doctors

Doctors do not need to know ICD10 (Diagnosis) or OPCS4 (procedure) codes but rather provide as text.

The minimum information such as primary diagnosis and procedure and the coding team will pick up the rest and assign the appropriate codes on PAS

Pros and cons of the systemPros and cons of the system

ProsIf the consultant uses a computer instead of

the discharge form, a list of patients to be coded can be easily generated – saving time.

Pros and Cons of the systemPros and Cons of the system

ConsHave to look up big books for codes – time

consumingHave to enter codes into the discharge

system and PAS separately – tedious work and repetitive entry prone to human error

Coders must still go and get patient notes from relevant ward.

ConclusionConclusion

The current system works but is flawedMany different systems in operation at onceSystems do not share data forcing data to be

entered multiple timesMany improvments possible such as

computerised searching for ICD10 codes instead of thick books