ESP IT Consultancy was founded to fill a gap in the market for IT healthcare solutions that support the continuity of care at hand over to improve the delivery of care with better and shared information
Identify the types of information needed to support continuity of care between sectors.
Enable information flow to support patient journey across sectors
Support the patient’s journey through their illness and on their way to recovery through the health and social care system.
Relieve the bottlenecks on discharge in the acute sector
Get the right information to the right people at the right time
Reducing the “start again” approach to care between sectors
Currently there is no IT system that supports the process of emergency referrals from the community to the acute hospital setting and from the acute hospital to the community
ETPIER application will be the first to the Healthcare market that will deal with referral information in real-time across sectors and within the NHS Hospitals, as such there various constraints. These are as follows:
There is limited funding available
The application is dependent on the ability to search and capture data of various programming languages. The Department of Health has set the HL7 standard for inter-operability (XML)
This will be the first to market therefore uptake maybe slow
Cross sectional users with varying ability to use IT
The NHS is subjected to political changes to the health services
Due to sensitive data content security is of utmost importance
Different companies manages the different IT systems
Need to follow standards that are set by Connecting for Health for the Department of Health for IT developers.
Significant numbers of patients are referred directly to hospitals under the care of consulting physicians for urgent admittance by GPS, Walk-in Centre and other hospitals. These emergency or urgent referrals often bypass A&E and go directly to the accepting ward. The patients are greeted by other members of the team for example the nurses and the doctors. At this point problems are faced at all levels due to insufficient or the lack of information and handover.
At the operational level patients turns up onto the ward unexpected by the receiving junior doctors and nurses. The information that is handed over to the doctor or nurse by the patient is often:
A hand written doctor’s letter that is poorly written or may not have all the required details
A prescription print-out sheet, which does not have all of the patient’s vital information
The patient does not have any of the above.
With these emergency referrals there is often a problem for the receiving team to build up an accurate picture of the patient’s presenting problem and their social circumstances. Sometimes the patient is unable to answer questions about their presenting problems and the care they receive prior to admission to the hospital. This can lead to:
Ambiguity in the care received prior to admission
Delay with prescribing treatment on admission
Increased errors due to lack of information available
The purpose of ETPIER system is to have a communication and alert system that will enable the clinicians in the community to communicate with the clinicians at the acute hospitals and vice versa. The intended purpose is to have a system that will support the admission and discharge process for emergency or urgent referrals into and out of the acute hospitals.
Hand written referral letters and electronically generated prescription print-out sheets that are produced by doctors in the community and given to the patient to deliver
Hand written letters produced by doctors and nurses at the acute hospital and given to the patient to deliver.
An area where letters and reports are generated electronically using current details pertaining to that referral and search features to search for information that is stored in healthcare record/databases. In order to generate the letter the user must first identify the patient that needs referring. In the community patients are identified using the NHS Number and in the hospital the patient is identified using the Hospital Number. Once the patient is identified, the patient demographic information, medical history and current medications which are already stored in healthcare record databases are displayed. Information that is needed to complete the referral letter are the current information, these are as following:
Date and time of referral
Details of the person making referral & their location
Details of the person accepting the referral (the receiver), their location and contact details
Reason for referral
Present signs and symptoms
Results of observation & test completed within the last month
Social intervention that is in place.
An alert mechanism that alerts the receiving team that the referral details is waiting to be viewed with the referral
identification number (Referral ID)
Once the message is received, an area where the receiver can locate, view and accept the information. The intention
is that when the receiver accepts the referral the ETPIER system can then upload the information into the receiver’s information system where it can be reused.
The application must be able to:
Allow the referrer to enter into the ETPIER application during consultation
Use the patient’s unique identifiers to display the patient details, for example the patient’s NHS number when in the
community and the patient’s Hospital Number when in Hospital – When the referrer is in consultation to navigate to a Make a referral automatically displaying the referring organizations details the current patient’s details as listed previously
Allow the user to use the organizations’ existing username and password
Allow the user to select either: – Make a referral
A report must be displayed containing the “Referring Organization’s Details”, “Date and Time” of referral, the “Referrer Details”, the “Patient Demographic Details”
Allow the referrer to navigate back to edit the information displayed
Allow the user to save the information to the ETPIER system
Save a copy of the referral in the referrer’s system
Allow the user to submit the referral report into the ETPIER system
Alert the receiver that referral information is waiting to be viewed, giving the Referral ID
Allow authorized users to enter into the ETPIER System
Allow the user to enter in the referral ID
Allow the user to view the referral details
Allow the user to accept the details
Allow user to print the report
Allow the receiver computer system to upload the referral details
Allow the receiver to send back information in the form of a feedback to the referrer
Alerts the medical records at the hospital that a patient notes is needed on at a specified ward, giving medical record
patient NHS number, patient’s First Name, Surname, Date of Birth, Address.
Programming Language >> Asp.Net (version 3.5), C# language