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report of actual or potential duplicates that were then
resolved in McKesson PAS. Whilst this resolution
was achieved manually in PAS, all further updates
were subsequently automated to all other systems
using the interfaces developed in Phase 1a providing
those systems accepted Patient Demographic Update
and Merge messages.
The EMPI was vital for data cleansing but was
also used with a view to enforcing new business
processes, to ensure that data quality was not
degraded by lack of adherence to correct processes.
cEMPI use was extended to the live environment to
highlight the presence of duplicates and provide a
means to resolve those duplicates every time a
provider attempted to search for a patient when
using the portal.
4 PHASE 2: UNIFIED VIEW
The aim of Phase 2 was to implement a single,
composite view of a patient record consisting of data
from all relevant sources focusing initially on those
systems that delivered the most clinical benefit. The
scope of this phase was to present data from, and
provide single-click access to: patient administration
systems, pathology, radiology, PACS, digital
dictation and discharge summaries. Phase 2 was
implemented using Orion Health’s Concerto
™
Medical Application Portal using the Rapid
Deployment Edition so that a rapid implementation
focusing on the major systems of the Trust could be
achieved. Concerto was developed to work with
legacy systems within the Trust, and to integrate
with the Trusts current SSO solution, so that
dynamic patient summaries were obtainable using
information from a range of existing systems
including: McKession PAS, Anglia ICE Result
Viewing (current and past databases), HSS Cris
Radiology Information System, Agfa PACS,
G2/SIRIS documents and Immediate Discharge.
The observed benefits of Phase 2 were improved
user clinical engagement as well as improvements in
efficiency and clinic time. The value of existing
systems was enhanced and patient’s safety and
confidentiality improved.
5 PHASE 3: CLINICAL
ENHANCEMENTS
The objective of Phase 3 is to implement additional
clinical modules that will improve the use of data
within the hospital and drive process improvement.
These include Recurrent Admission Patient Alerts
(RAPA), Clinical Whiteboards for A&E and
outpatient departments and Infection Control and
Bed Management (ICBM).
RAPA is a unified alerting system that alerts care
workers when any patient from an identified cohort
presents in emergency care. In providing these alerts
the Trust can significantly improve the quality of
care provided and also reduce unnecessary
emergency admissions. It is being implemented
within Northumbria for cancer patients, those
terminal patients who have requested to die at home
and patients with identified chronic obstructive
pulmonary disease (COPD).
Orion Health’s Clinical Whiteboards
™
will
provide a user-friendly interactive solution for
providing real time visual information regarding a
patient’s status in relation to their progress along a
clinical pathway. Information can be both physical
in terms of location and also clinical in terms of
status of clinical processes, such as status of tests or
orders.
Concerto contains a solution for ICBM and
provides real time graphical representations of
patients, their locations and status updates on
expected discharge and infection status, enabling
hospital staff to recognise and respond appropriately
to specific patient situations.
Phase 3 is due to initiate in late 2010.
6 CONCLUSIONS
The NHS National Programme for IT is still ongoing
and is not due for completion for several years. As a
result there is a need for Trusts to implement
systems that will meet their needs for coherent
patient information both now and in the future;
services that provide good value for money and are
consistent with emerging central Government
strategy for the NHS. Although Northumbria is still
in the implementation phase of the project in many
facilities, the Concerto Portal and Rhapsody
Integration Engine solutions are already delivering
benefits in terms of accuracy, time and cost and as a
result will provide a good bridge to any services that
are delivered centrally in the future.
REFERENCES
Borrill C., West M., Shapiro D., Rees A.: Team working
and effectiveness in health care. 2000 Brit J Health
Care Mngt 6(8):364-371.
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