News
Salisbury commissions trust-wide clinical information system
2 June 2008
Salisbury NHS Foundation Trust has commissioned a new trust-wide
clinical information system (CIS) to enable it to develop a fully
configurable clinical database to support its clinicians working within
a live hospital environment.
Providing general acute and emergency services to over 200,000 people
across Wiltshire, Dorset and Hampshire, and clinical specialist services
extending to a wider population of more than 3 million people, the new
system will support the monitoring and management of information to
facilitate accurate clinical reporting and improvement of the patient
journey through the process of care within the hospital.
The Trust has selected AxSys Technology to supply, implement and
support the CIS which will be based on AxSys’ Excelicare solution.
Functioning within the Trust’s existing IM&T framework,
implementation of the system will be phased across clinical departments
and specialties to enable the collection of data in the form of custom
datasets.
This will be used to assist in the automation of a range of tasks
from clinical audit, specific research projects and refining patient
care, through to providing data for patient management, outcome
measurement, and feeding financial analyses.
The system will also facilitate the completion of mandatory reports
for the Department of Health as well as reports required by the Trust
and local health authorities. The new system will also be able to
communicate, through HL7/XML integration, with other IT systems
throughout the Trust.
“The aim is to improve the quality and accuracy of data gathered and
to ensure that the Trust has full control over the content, usability
and functionality of its CIS,” comments Mark Newton, the Trust’s
Clinical Databases Manager, Information Services Department, and project
manager for the implementation.
“From patient assessments through to diagnosis and treatment,
clinicians will be able to track and manage patient information and
records, improving the process of patient care. As the system
facilitates the sharing of clinical information this will also promote
greater efficiencies in multidisciplinary collaboration.”
This change has come about as a result of an 18-month, evidence-based
review process undertaken by the Information Services Department and
driven by the Trust’s Clinical Information Group, to clearly define the
needs and requirements that the new system had to deliver against. The
review process also included a thorough evaluation of products available
that would meet the requirements. The application of the Excelicare
solution means the Trust will be able to replace its internally
developed multiple departmental solutions and provide additional
functionality.
Newton explains, “It was clear that our existing software was
struggling to cope with the increasing demands and needs of the
clinicians who were very much the driving force for change. They also
became involved in the process of defining the specifications and
criteria required for developing the new CIS.
“After a rigorous procurement process Excelicare was selected because
of its ability to cover all clinical specialties and the flexibility and
the reporting prowess of the system was critical. It will give us the
ability to design the CIS specifically to suit the working processes of
each department and to generate relevant information for completion of
all necessary reports. The additional functionality through the ‘special
forms’ means we are in the ‘driving seat’ in terms of setting field
criteria and building in process controls which gives us the ability to
respond quickly to any changes in user requirements.
"The scalability of Excelicare means it can expand inline with the
expected growth in the number of patient records, which is predicted to
rise by 4% year on year over the next three years. I think the fact that
AxSys understand clinician’s language and that they take a collaborative
approach has also been key.”
Implementation and training began in April 2008, with deployment of
the system planned for summer 2008. Excelicare will run in parallel with
the existing system, with full migration expected within an 18-month
timeframe. This staged approach will accommodate the various strategies
and levels of IT development each department is at.
Once fully operational, there will be 100 users consisting of
clinicians and support staff. Because of its intuitiveness and the
configurability of the look and feel of the user interface, this means
that staff at all levels of skill will be able to use the system.
“We expect to achieve significant benefits from the new CIS,” Newton
further explains. “Clinicians will have a system that has been designed
to suit their own clinical practice processes, which means they will be
able to view information to help with clinical decision making. Critical
will be the ability to generate information for national and regional
performance reporting, analysis and audit purposes and as the system
will enable the recording against pre-agreed coded categories and
national datasets this will provide assurances that all information is
accurate, quantifiable and auditable. The guaranteed consistency of data
will also support corporate and clinical governance compliance.”
Interaction with other databases will be possible, including the
ability to import demographic data from the PAS system and export
information to the Trust’s datawarehouse which can be used to support
research and analysis.
Laurence Arnold, Head of Corporate Development, said: “The new CIS
means that once fully implemented the Trust will have a reliable and
flexible clinical system that can be utilised across the Trust
departments. This development is a further reflection of the Trust’s
commitment to continue to provide the highest standards of healthcare
service. It will enable us to share information and communicate more
effectively to improve the management of patients. As a consequence this
will support the timeliness and consistency of patient care that the
Trust delivers. It will also help the Trust continue to meet national
targets and meet the business needs of our NHS foundation trust status.”
Dr Pradeep Ramayya, CEO AxSys Technology added: “Deployment of a
single clinical information system can enhance the delivery of
patient-centric services and it is because of the innovative approach at
Salisbury that they have grasped the benefits of this concept. By
facilitating the delivery of accurate on-demand information, clinicians
and other healthcare staff will witness performance improvements, better
management of patients and the ability to share information throughout
the Trust within a secure, confidential environment. The flexibility of
the Excelicare toolkit will also allow the system to expand and change
as users increase the systems scope and capability thereby providing the
Trust with a future-proofed solution.”
The CIS designed for Salisbury has been developed using Excelicare’s
powerful Designer Toolkit, meaning that all information is captured at
each patient event and allows clinical care pathways to be defined
ensuring that correct treatment protocols are followed.
The system will provide clinical and administrative staff access to a
single database containing all patient records including medical and
social history information, referral details, ongoing clinic visits,
test, diagnosis, treatment and discharge data. Information will be made
available on the desktop where and when required, or can be accessed
remotely, and data collection occurs in real-time via intuitive easy to
use Windows based screens.
Excelicare’s Report Manager enables clinicians to generate tailored
reports and provides a constant record of what stage the patient is at
in their treatment plan. ‘Failsafe’ reports can also be generated
automatically to ensure mandatory timescales are met.
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