Oxford Clinical Intranet: Providing clinicians with accessto patient records and multipleknowledgeba

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Oxford Clinical Intranet Providing clinicians
with access to patient records and
multiple knowledgebases, using Internet
technology
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Organisation

• Population 630,000
• Academic hospital on four sites
• 1,500 beds
• 112,000 admissions / year
• 400,000 outpatient attendances/ year
• 10,000 staff
• 90 General Practices

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Objectives

• Provide a single portal to patient records and
  knowledge resources
• Decrease the fragmentation of care between
  primary and secondary care
• Promote knowledge-based medicine and
  evidence-based medicine
• Save staff time
• Improve the patients journey across the
  healthcare system

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Principles of our approach

• Use existing systems, adding other systems as
  they become available
• Use existing technology, industry standards, eGIF
  compliant
• Incremental, modular development
• Understand the needs of healthcare professionals,
  evaluate and redesign repeatedly

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Current state

• Over 2,000 clinicians across primary and
  secondary care
• can access information about their patients held
  on multiple remote disparate computer systems.
• can access support and advisory information,
  developed both within the organization and
  collected from other sites and projects.
• are automatically notified of support information
  that is contextually appropriate to the current
  task.

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Benefits

• Improved continuity of patient care
• Reduced unnecessary repetition of investigations
• Faster patient management.
• Fewer phone calls
• Improved security and confidentiality
• Promotion of evidence-based clinical practice
• Low support costs

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Patient records

• Laboratory medicine (5 departmental systems)
• Radiology reports
• Discharge letters to GPs
• Patient Administration System
• using the CaseNotes product from CSW Health

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Advisory and support information

• Local handbooks and guidelines, linked to
  external resources
• Directories
• British National Formulary
• Bandolier
• Reports from the Cochrane Collaboration

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Advice and guidelines found in one general
practice...
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Advice and support

• can be accessed by indexes and searching
• and contextually according to the task the user
  is carrying out, eg when viewing a laboratory
  report the user is notified that advice on
  interpretation is available

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And with one more click...
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Benefits

• Improved continuity of patient care
• Reduced unnecessary repetition of investigations
• Faster patient management.
• Fewer phone calls
• Improved security and confidentiality
• Promotion of evidence-based clinical practice
• Low support costs

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Current developments

• Enhancements to increase usability, in response
  to user comments
• Adding more departmental systems, including
  cardiology and diabetes management
• Improved knowledge management
• Increasing links to the UK National electronic
  Library of Health
• Trials of wireless-networked handheld computers

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Knowledge Management

• Current state 2,000 users. Can add resources
  cheaply and quickly.
• Large volume of support and advisory information
• Need to improve accountability, traceability,
  local control eLABook
• Promote evidence-based practice
• Remove duplication of effort by accessing remote
  resources

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The team

• The Oxford Clinical Intranet was developed by
  Dave Nurse and Jonathan Kay, and the Knowledge
  Management work is now led by Christos Bountis.
• Collaborators included David Sackett, Sharon
  Straus, Brian MacDonald, Douglas Badenoch, John
  McVittie, Kevin Paddon, James Penn-Dunnett, Ian
  Bowler, Kieron White, Ken Nicholl, Paddy
  Phillips, Chris Bunch, Ian Mackenzie, Nick
  Atkins, Sonja Decker, Herb Parker, Chris Pipkin,
  John Skinner, Louise Read, Pauline Hurley, Janet
  Knowles, Thomas Lamandais, Anne Ecobichon and
  Alistair West.
• Content contributors included Ian Mackenzie,
  Aram Rudenski, John Keenan, Brian Shine, Janet
  McIlroy, Niki Meston, Frank Geoghegan. Vian
  Anber, Elaine Murphy, Andrew Silverman, Sue
  Standing, Steve Justice, Christos Bountis and
  Jonathan Kay.

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