An Introduction to the DAHNO System: Getting Started Sandy Garrity

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An Introduction to the DAHNO System Getting
StartedSandy Garrity
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Contents

• Lotus Notes (DAHNO) Terminology
• Setting roles and responsibilities
• Installing and connecting
• Creating a patient and the patient pathway
• CSV Data Upload
• Sharing the data between users, sites and the
  audit
• DAHNO System literature and guidance
• Help! Contacting the DAHNO Helpdesk

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DAta for Head and Neck Oncology Background
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Lotus Notes (DAHNO) Terminology

• The DAHNO system is a series of databases
  developed in Lotus Notes
• Lotus Notes uses a method called replication to
  transfer and share data
• Data is entered, stored and encrypted locally,
  then replication takes place with the DAHNO
  servers
• Access to the system requires an ID file to be
  created and stored on your local machine(s)
• DAHNO can be used on machines not connected to a
  network. Connection to a network is only required
  to send data to the central servers.

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Setting Roles and Responsibilities

• There are 3 roles (access levels) within DAHNO
• Reader Can only read patient records
• Author Reader plus creation, amendment and
  deletion of patient records
• Signer Author plus the authority to verify
  patient records as clinically correct
• Decide locally who is going to be responsible for
  data entry and verification. Usually between 2
  and 6 people
• Decide on a routine for collecting, entering and
  verifying data, e.g. MDT meeting, data clerk,
  clinician.

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Installing and Connecting - 1

• Contact the helpdesk with all the required users
  and roles. The Helpdesk will create the ID files
  and email these along with any requested
  documentation.
• Instruct your local IT department to make minor
  changes to your firewall. Details available from
  the helpdesk.
• Using our installation disk install DAHNO onto
  your local machine
• Step 1. Installs the Lotus Notes client
• Step 2. Copy the ID file into
• C\Program Files\lotus\notes\data

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Installing and Connecting - 2

• Step 3. Double click on the Lotus desktop icon to
  start DAHNO for the first time. At the password
  window enter the default password and the system
  will connect with our servers. This will initiate
  a once only download to populate your local
  databases.
• Step 4. On the Welcome screen click on Open
  DAHNO. The system will prompt you to change your
  password. This must be at least 8 characters long
  and contain a least one number or symbol.
• Step 5. The system will prompt you that it needs
  to create a local copy (patient data) on your
  machine. Press Yes and this completes the
  installation.

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Welcome to DAHNO !

• This is the front screen, which once installed
  will be the screen that opens first when you
  start DAHNO.

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Creating a patient and the patient pathway

• DAHNO uses a hierarchical structure to aid data
  entry. This means that you have to follow a set
  path for creating the documents, as DAHNO will
  not allow you to create documents out of sequence.

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• The primary document is the Patient Record.
  This record contains patient details and
  demographics and other relevant data that may
  effect the patient outcome.

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• The 2nd document that needs to be created is the
  Care Spell. This record contains all the
  initial information available at the point of
  referral, along with waiting times.

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• From the Care Spell the Diagnostic Summary must
  be created. This document contains information
  about the tumour site and staging.

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• Once the Diagnostic Summary has been saved the
  next document that can be created is the Care
  Plan. The Care Plan contains all the agreed
  treatments, co-morbidity index and possible
  clinical trials.

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• At any point during the creation of the patient
  Care Spell a user with Signer level access can
  Verify the data, to add it to the audit.
  However, if any data is edited or additional data
  added then the verification is revoked, requiring
  further verification.

Note. The Verify option only appears if you are
a signer and you highlight a Care Spell. Note.
Unverified Care Spells are shown with a red
cross, once verified this turns to a green tick.
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CSV Data Upload

• Instead of entering the data directly into DAHNO
  there is the option to upload data from your
  current head and neck systems
• Volume 3 of the DAHNO manuals specifies all 15
  file specifications required to upload data
• Within DAHNO there is a simple import wizard that
  allows you to test the CSV files prior to
  uploading to the audit
• Once the data has been imported, it is still
  required for a Signer to verify the data.

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Sharing Data Locally

• When a user enters data into DAHNO, that data is
  only at that point held locally on the users
  machine. Not until the user presses the
  send/receive button on the welcome page or closes
  DAHNO down does the data get sent to our servers
• For a second user within the same hospital to see
  the data entered by the first, they also need to
  press send/receive.

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Sharing Data Nationally 1

• There are 2 ways to share patients
• Patient-by-patient
• Global permission
• Patient-by-patient is assigned at the user level
  by opening a patient document clicking on
  Control Access and selecting an individual or
  group from the list.

This option is most commonly used if a patient
were to physically move to another trust.
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Sharing Data Nationally 2

• Global Permissions are used when there is a
  permanent relationship for treating patients
  between 2 or more hospitals
• Global permissions are set up by the Helpdesk
  once the required documents have been signed and
  received
• The permissions can be setup so that a hospital
  could have read only access or that its users
  retain their local access levels.

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DAHNO System literature and guidance

• There is a lot of information, documents, system
  help and on-line help available to the DAHNO
  community.
• Within DAHNO if a field has a ? beside it this
  can be clicked to open information on that fields
  requirements.
• There is a Quick start guide along with a suite
  of DAHNO reference manuals. We also provide
  patient leaflets to comply with the data
  protection act.
• On-line help can be found at www.dahno.com along
  with other DAHNO resources.
• And when none of the above have helped solve your
  problem you can always call ..

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Help!?_at_

• DAHNO Helpdesk!
• e-mail helpdesk_at_dahno.com
• (this is not a secure e-mail)
• or
• Phone [phone]