"The requirements for the Trust were to provide a solution to consolidate key patient based clinical reports into one central repository and allow the easy distribution of this information to the clinicians and managers who needed a complete overview of activity, Patient status, throughput and demand. If this could be achieved then the Trust would be more effective and efficient and improve its resource utilisation."

 

Since the mid 1990's the NHS Executive has been pioneering an Information Management and Technology Strategy to ensure that systems and processes are installed that allow clinical information to be easily accessible at every level of the service. The ability of the NHS to share patient information is mission critical to the efficiency of the services provided and key to the continuous improvement of patient care and treatment.

Simplistically, the more information that can be shared about patients, then the planning of both clinical and support services can become both priority and resource driven. If the net effect enables the NHS to have the resources and vision they need to provide efficient and responsive patient care then areas of public concern, such as waiting lists and bed shortages, should reduce.

Said Paul Kitchen, Medical Director at Essex Rivers Healthcare NHS Trust; "Individual patient-specific information is still only accessible via departmental systems such as the pathology labs. It will be necessary to link these systems in such a way that the users will be able to gain rapid access to information they require for patient care without going in and out of different systems. Once this is achieved I envisage a move to routine use of computers by clinicians for such tasks as ordering investigations, prescribing drugs, making referrals, recording clinical information and so forth." Concluded Paul Kitchen; "The possibilities are limited only by the extent of our imagination and of course the investment in terms of time and money required to develop the systems."

The challenge to the Trust is vast, many departments running different and proprietary databases, a Patient Administration System (PAS) on a VAX system connected to the resident MUMPS infrastructure and specialist applications such as CaseMix that were proving to be difficult to administer. In short the problems facing Essex Rivers Healthcare NHS Trust was one of information chaos, too much information flowing without any real structure or control, not easily accessible and often in a format which, to the end-user, was unusable.

IMPROVED RESOURCE UTILISATION AND COST EFFICIENCIES

The requirements for the Trust were to provide a solution to consolidate key patient based clinical reports into one central repository and allow the easy distribution of this information to the clinicians and managers who needed a complete overview of activity, Patient status, throughput and demand. If this could be achieved then the Trust would be more effective and efficient and improve it's resource utilisation.

As with most large NHS Trusts in the UK today, Essex Rivers have a significant number of IT vendors supplying hardware, software and netware but none were offering the comprehensive solution which Datawatch International Limited were able to deliver with Monarch|ES.

Monarch|ES is a comprehensive Enterprise Reporting solution. The key advantage of Monarch|ES is its ability to interface with existing systems which are generating raw data in report format and provide one single point of storage, a report repository. Furthermore Monarch|ES can supply a distribution mechanism to end-users who can easily access indexes and report models to pull-down the data they need to their desktop.

OPERATIONAL DATA FOR MANAGEMENT ANALYSIS AND FORECASTING

The implementation is a phased project reflecting not only the requirement of the initiative laid down by the NHS Executive but also the way IT is distributed throughout the organisation. The structure of Monarch's central repository has been constructed to accommodate 12 departmental databases and the PAS system.

Phase 1 data from the PAS is now being consolidated and distributed to Directorate Managers. The first phase stage took just 5 days to implement with user and administrator training taking a further 8 days. In under 20 days of being "live", principle users have structured quality data which they can use and IM&T have a solution which can liberate even the most stubborn of captive data. This was most evident when running Monarch|ES against a departmental database written in a DOS development environment called Advanced Revelation. The database runs automated routines and spools scheduled reports for hardcopy printing but there was no longer anybody left in IM&T with the skills to convert the report data into usable desktop information. By running the report files through Monarch the clinicians can now access and manipulate the database in Microsoft Access. Advanced Revelation is not a redundant database system but the skills to administrate it are scarce and expensive and Monarch|ES has provided the platform to extend its usage.

CONSULTANTS AND DOCTORS SHARE EASY-TO-UISE CASE LOAD VISION AND IM&T ACHIEVE LOWER COST OF OWNERSHIP

Similarly, and common to most NHS Trusts, is CaseMix, an application designed to assist Consultants and Clinicians, to understand the profile of their workload by providing the vision needed to plan resources and priorities against activity targets. Monarch's ability to cross reference operational data and cut reports against an infinite number of selections (by Consultant, Department, Speciality, Operation Type etc.) has superceded CaseMix due to its easy report modelling and analytical properties as well as a lower cost to install every required end-user. The Trust had a long term commitment to CaseMix of five years, the fact that Monarch provides a more intuitive solution to CaseMix management at a lower cost means that the Trust can move away from a proprietary solution thereby releasing resources for other purposes.

ESSEX RIVERS REALISE TOTAL INFORMATION DELIVERY MECHANISM

By choosing Datawatch, Essex Rivers has taken the first steps to achieving the objectives of their Medical Director, Paul Kitchen and the NHS Executive. The benefits they were seeking in terms of better quality data to provide effective operational information in the clinical departments and wards is already in evidence. The quality of the operational data is also proving to be of substantial use to other Senior Managers and Department Heads who know they have a solution that will provide better business knowledge to run the Trust efficiently. So what next?

With so much information available next phases of the project will scope and execute web delivery mechanisms so standard reports such as waiting lists and Patient's Charter performance can be scheduled, generated and delivered by Datawatch's Monarch|ES Web solution over the Trust's Intranet. Once all GP Practices are connected to the NHSNet even the most remote General Practice or Nurse Practitioner Clinic will be able to provide better patient care based upon better operational information.

By consolidating the Trust's back-office systems and applications Monarch|ES is providing a central repository for operational information that will positively impact upon corporate efficiency.

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