Post on 16-Jan-2016
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Renal Unit Activity
Specific Opportunities for Information Support
YORKSHIRE CENTRE FOR HEALTH INFORMATICS UNIVERSITY OF LEEDS
Tom Crocker
medtcro@leeds.ac.uk
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Case study of St James’s renal unit and the information system
• Models and diagrams
• Identifying processes and opportunities for information support
• Plans for the future
Overview
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Renal pathway - purpose
Understand theactivity of a renal unit
Renal pathway diagram
{Want a simple and clear walk throughwith extra information on theimplications for the patient available}
{Want a depth of information they can rapidly assimilate}
{Want a model that is accurateand unambiguous to identifyopportunities for support}
Explain the activityof a renal unit
GP / other clinical staff
Renal expert IT specialist
Patient / family member
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• I have modelled areas of St James’s renal unit using the Unified Modelling Language
• UML syntax helps to make diagrams clear and unambiguous
• 13 types of diagram1. Use-case diagrams – show purpose
2. Activity diagrams – like flow-charts
Models and diagrams
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Patient care - purpose
Have health statusreviewed
Have care planreviewed
Enable informeddecisions about care
Receive treatment
Be educated aboutrenal and associated health
Get clinicalcorrespondence
Refer patient tounit
Be cared for
Renal unit
Patient
GP
Consultation - purpose
Have health statusreviewed
Have care planreviewed
Enable informeddecisions about care
Be educated aboutrenal and associated health
Attend consultation
Patient
Renal unit – consultation
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Clinic visits for each patient
SecretaryPathology LabClinic TeamInformatics Team
Prepare patient list and synoptic sheets
for clinic
Clinic visits for each patient
Enter changes to Proton
Correct errors in returned results
Check abnormal results and take
appropriate action
Test samples and return results
Type out consultation letter
and distribute
Organising Consultations
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Consultation
Patient PhlebotomistConsultantNursingReception
Book in patient
Attend clinic
Take blood pressure and weight
Consultation
Take samples and send for testing
Agree next appointment time and
book patient out
[Yes] [No]
Patient tohave tests?
A clinic visit
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ConsultantPatient
Selective review of patient history
Examine, interview and inform patient. Infer and
deduce needs
Agree future investigations / treatment / consultations
Record consultation outcome
Call patient in
Enter consultation
Leave consultation
A Consultation
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Renal IS - purpose
Information System
Review patienthistory
Consultant
View graphical displayof test result trends
View tabulardisplay of results
Discover estimate oftime to renal replacement
therapyReceive guidance
from a protocol
<<include>>
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Informatics-based procedural loop
Clinical Staff Informatics group Consultant
Input information andprepare summary
Reviewinformation
Makedecisions
Returndecisions
Returnresults
Followprotocols
Reviewactivities
[see consultant][see clinician]
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PROTOCOL JUDGEMENTcomputer
results decisions
Computer-based procedural loop
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PROTOCOL JUDGEMENTcomputer
results decisions
Medical staff Transplant Co-ordinator
Computer-based procedural loop for transplantation
SpecificationCalibration
Characterisation
Specialty Panel
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• Models can aid understanding by:– Simplifying reality– Making our ideas explicit
• UML is a particularly useful tool
• Drill-down example from patients’ needs to staff needs of an information system
• Generic patterns and variety can be identified
Summary
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• To improve the understanding of processes within renal units
• Examine process variety (e.g. for anaemia management) across different units
• Compare with outcomes data• Identify generic patterns • Research solutions from other disciplines• Intended PhD – consultation with units and
Renal Registry
Future work
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?
Questions
Renal Unit Activity
Specific Opportunities for Information Support
YORKSHIRE CENTRE FOR HEALTH INFORMATICS UNIVERSITY OF LEEDS
Tom Crocker
medtcro@leeds.ac.uk
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Shifting the balance to the left
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Lemniscate of Booth
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