Population Based Screening Programmes Do We Need Health Informatics

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Population Based Screening Programmes Do We Need
Health Informatics?

• Dr Emilia Crighton
• CPHM
• Public Health Screening Unit
• NHSGGC

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NHSGGC Public Health Screening Unit

• 1.2 mil population
• 237,000 eligible p.a.
• Cancer screening programmes cervical breast
  bowel
• Pregnancy and newborn screening programmes
  communicable diseases Downs syndrome and other
  foetal anomalies newborn bloodspot (PKU
  hypothyroidism CF)
• Newborn Hearing Screening
• Diabetic Retinopathy
• Pre School Vision Screening
• Abdominal Aortic Aneurysm

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NHSGGC Public Health Screening Unit

• Challenges
• Governance
• Failsafe
• Annual reports

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Project Scope

• Project Scope - To develop an integrated IT
  System to support the pregnancy and newborn
  bloodspot screening programme being rolled out
  across Greater Glasgow Clyde-
• Pregnancy Newborn Screening Programme
• Downs Syndrome and Neural Tube Defects (1st
  Trimester CUBS, 2nd Trimester serum, Fetal
  Anomaly Scan)
• Communicable Diseases in Pregnancy (HIV,
  Syphilis, Hepatitis B, Rubella)
• Haemoglobinopathy (Sickle cell disorders,
  Thalassaemia)
• Newborn Bloodspot (PKU, CHT, CF, MCADD, Sickle
  Cell)

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Project Challenges

• Project Challenges
• Minimise the need for manual data entry and
  duplication of information by extracting data
  from existing systems and loading into the
  screening system automatically via electronic
  interfaces.
• Proliferation of existing IT systems and business
  processes across GGC maternity services. Each
  Maternity Unit using different IT systems and
  processes.
• Maternity services are currently undergoing a
  redesign to a hub and spoke structure which is
  not yet finalised.
• Planned move of QMH maternity services from
  Yorkhill.

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Application Users

• Key Application Users
• Midwives
• Community Midwives
• Ultrasonographers
• Doctors
• Health Records
• Public Health Screening Unit
• Public Health Protection Unit
• Child Health
• Laboratories

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The Application

• The application -
• is Web based (Microsoft .NET).
• developed in-house by GGC HIT
• can be accessed via the Clinical Portal
  application.
• uses role based security to ensure that users
  only see the information they need to do their
  job.
• provides a number of Data Entry screens to
  support manual data entry when required.
• has interfaces to SCI store to retrieve
  electronic referrals and screening test results.
• has an electronic interface to Scottish Birth
  Record (SBR) to retrieve details of GGC births.
• provides Public Health Screening Unit with KPI
  reports .
• provides clinical staff with control and planning
  reports.
• provides a facility to batch print screening test
  results letters.
• provides a clinical alert mechanism to highlight
  process issues e.g. overdue test results.

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Key System Interfaces
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Screening Episode
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Referral
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Screening Registration
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Booking Visit
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Routine Bloods
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Dating Scan
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Communicable Disease Screening
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Fetal Anomaly Scan
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Fetal Anomaly Scan
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Outcomes
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Patient Contacts
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Registration Management
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Patient Management
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Alert Management
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KPI Reports

• KPI reports have been developed to monitor the
  success of the screening programme in NHS GGC.
  Reports include-
• Total number of women offered screening.
• Total number of women accepting screening.
• Total number of women receiving high
  risk/abnormal/positive screening test.
• Total Number of women accepting further
  diagnostic testing.
• Total Number of women with low risk/normal/negativ
  e screening test who went on to have baby with
  Downs syndrome or a fetal anomaly. False
  Negative.
• Total Number of women with high
  risk/abnormal/positive screening test who went on
  to have baby without Downs syndrome or a fetal
  anomaly. False positive
• Total Number of women receiving results of
  screening tests out with the Clinical Standards.

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Control Reports

• Control reports have been developed to highlight
  issues with the screening programme. Reports
  include-
• Patient screening summary report.
• Screening programme summary report.
• Positive/abnormal test results summary report.
• Overdue results summary report.
• Unrecorded outcomes.
• Alert summary report.
• Booking visit DNA report.
• Screening test summary report

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Project Milestones

• Key Project milestones-
• Aug/Sep 2009 System Testing
• Oct/Nov User training for Clyde based staff
• Nov/Dec Go live in Clyde (IRH, RAH, VOL)
• Jan/Feb 2010- User training for Glasgow based
  staff
• Jan/Feb 2010 Go live in Glasgow (SGH, PRMH)

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NHSGGC Bowel Screening

• Main features
• Integrated to SCI-Gateway
• Imports Positive Referrals
• Generates letters to the patient, the GP and to
  SBoSC
• Records Pre-Assessment Administration data
• Imports Patient History
• Records Pre-Assessment Data
• Records Colonoscopy Data
• Tracks Patient Progress through the Process
• KPI Reports

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Teaser Letters
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Health Informatics?

• Information science
• Computer science
• Health care
• Medical knowledge
• Project management
• Change management
• Courage
• Leadership