Community Data, Information and the Omaha System within EMIS PCSweb

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Community Data, Information and the Omaha System
within EMIS PCSweb

• Janice Richardson
• Julie Haw
• Corinne Prescott
• Calderdale Primary Care Trust

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A brief history

• The concept of the Common Clinical Information
  System (CCIS)- a single electronic system,
  allowing the sharing of a single health care
  record across multiple agencies
• CCIS Procurement 2001 2003 - EMIS Chosen as
  preferred supplier
• Community nursing project commenced April 2003

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National Data Requirements

• Inform development of national policy
• Provide an overall assessment of the performance
  of the NHS as a whole

• Inform the development of local initiatives and
  the LDPs
• Enable comparisons to be made of the performance
  of provider organisations

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But

• It is essential that the data is relevant,
  complete, comparable, stable over time and
  readily available for these purposes in a timely
  way.
• Information for Health (1998) NHSE

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What about nursing data?

• Nurses represent the 2nd largest global workforce
• Only tiny proportion captured electronically
• Data collected on paper not turned into useful
  information
• Not available to other health care professionals
  at point of care
• So, how does this benefit the client/patient?

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Community Data Collection

• Quantity of care rather than quality
• Compelling evidence to abandon the use of
  statistical returns that do not flow naturally
  from the care process and are of no value in
  delivery of interventions to individuals (NHSE
  1998)

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Why do nurses need standardised terminology?

• If you cant name it, you cant control it,
  teach, research it, or put it into public
  policy.
• June Clark and Norma Lang (1992) Nursings
  next advance An International Classification for
  Nursing Practice. International Nursing Review.
  39 (4) 109-112 and 128

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Why SNOMED CT

• Preferred clinical terminology for the NHS
• Global clinical terminology
• Computerised language
• Includes nursing terms and concepts from the past
  25 years of research in USA

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Nursing Classification Systems in SNOMED

• NANDA (North American Nursing Diagnoses
  Association)
• NIC (Nursing Interventions Classification
• NOC (Nursing Outcomes Classification
• The Omaha System
• Home Health Care Classification System
• Perioperative Nursing Data Set

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Why the Omaha System

• History of automation
• Terms/definitions available at no cost
• Only community system tested in UK setting
• Terms and definitions familiar to UK nurses
• Long history of research and development
• Consistent with the nursing process assess,
  plan, implement and evaluate
• Provides an outcome management programme

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The Omaha System (cont)

• Problem Classification Scheme
• Intervention Scheme
• Problem Rating Scale for Outcomes
• (Essential to provide evidence/data within
  the present climate of reconfiguration,
  commissioning and change)
• Martin K (2005) The Omaha System A Key to
  Practice, Documentation and Information
  Management.
• 2nd Edition. Elsvier/Saunders.St Louis,
  Missouri.ISBN 0721601308

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Challenges!

• Adaptation of the Omaha System for use in the UK
  (terms/language)
• Limited nursing knowledge of clinical
  coding/terms
• Difficulty in comprehending the importance of
  standardisation in everyday practice
• Previous negative experiences of I.T.
• Present climate of change low moral in
  community nursing
• Lack of basic I.T. skills

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Positives!

• Nursing terms more meaningful to nurses
  (recognition of what they actually do!)
• Benefits to patients/clients, improved
  communication, information sharing and the
  contribution to public health data
• Purchaser/Provider information, accurate
  descriptors of nursing as a viable business

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Positives (cont!)

• Existing data collection tool replaced by a
  standardised terminology which accurately
  describes what they do
• Access to reports allows the organisation to plan
  staffing levels and resources more effectively
• Access to reports creates a clearer picture of
  demand and health need

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References

• NHSE (1998) Information for Health. National
  Health Service Executive. Page 70
• NOMINA Group (1998) The Nursing Information
  Research Project Final Report for the Project
  Board NHS Centre for Coding and Classification.
  May.
• Martin K (2005) The Omaha System A Key to
  Practice, Documentation, and Information
  Management. 2nd Edition. Elsevier/Saunders. St.
  Louis, Missouri. ISBN 0721601308

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Clinical Team

• Janice Richardson (IT Lead Nurse)
• Tel[phone] or 07899862670
• Janice.richardson_at_calderdale-pct.nhs.uk
• Julie Haw (School Nurse)
• Tel[phone] or 07795825130
• Julie.haw_at_calderdalecom-pct.nhs.uk

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SN Full Assessment
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SN Screening
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SN Height/Weight Template
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SN Online Centile Chart
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DN Full Assessment
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DN Skin Assessment
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DN Signs Symptoms (Omaha)
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HV Contact Screen
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HV 7-9mnths Assessment
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HV Signs Symptoms