Magic and Mayhem 40 years experience with the problems of Shared Community/Acute Hospital IT in Maternity Care Rupert Fawdry FRCS FRCOG Honorary Consultant Obstetrician, UHCW (IT Research)
Jan 02, 2016
Magic and Mayhem
40 years experience with the problems of Shared Community/Acute Hospital IT in Maternity Care
Rupert Fawdry FRCS FRCOGHonorary Consultant Obstetrician, UHCW (IT Research)
Potential advantages of electronic records
• Easier access to previously recorded individual patient data
• Faster transmission of letters, reports, memos
• Reduced duplication in recording of data
• More reliable communication
• Reducing medical errors
• Better quality data immediately available
The dream: a paperless office?
Chasm of partially explored but virtually uncharted territory
Some reasons for – and results of – the Chasm
• 1984 Booking clinic printed items.– 42 UK teaching hospitals generated 571
printed history data items, of which• Only 12 items present in >75% of case records• Only 52 items present in >50% of case records
• 2005 Analysis of C-section Proformas– 8 UK hospitals generated >280 printed items,
of which only 3 items had (nearly) identical wording.
Computers are
• Extremely flexible in creation
• Extremely rigid forever afterwards
• Not Magic!
“Paperless” records? When…
• Hand-held and not reliant on wiring, power etc.; Crash proof & Virus proof
• User-friendly, reliable way of entering free text
• Portable but theft-proof / not worth stealing
• Open source, not reliant on proprietary systems
“Paperless” records? When…• Easily readable by any authorised person,
including the patient
• Easy for authorised person to make context-sensitive amendments any time, any place, anywhere
• Easy access without complicated password procedures
• As secure as paper record held only by individual and health provider
And When…• A single chronologically-arranged, flow-
patterned set of every question and every allowable answer option is– Internationally standardised– Takes full account of all interested parties– Workload/cost classified and logically
prioritised
Are we climbing the right mountain?
Never forget that ifcomputers had been invented
first, and paper & pen later;the latter would probably
have been regardedas the world’s greatest
breakthrough in the historyof Information Technology