Rupert Fawdry FRCS FRCOG Honorary Consultant Obstetrician, UHCW (IT Research)
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Transcript of Rupert Fawdry FRCS FRCOG Honorary Consultant Obstetrician, UHCW (IT Research)
Magic and Mayhem
40 years experience with the problems of Shared Community/Acute Hospital IT in Maternity Care
Rupert Fawdry FRCS FRCOGHonorary Consultant Obstetrician, UHCW (IT Research)
Potential advantages of electronic records
• Easier access to previously recorded individual patient data
• Faster transmission of letters, reports, memos
• Reduced duplication in recording of data
• More reliable communication
• Reducing medical errors
• Better quality data immediately available
The dream: a paperless office?
Chasm of partially explored but virtually uncharted territory
Some reasons for – and results of – the Chasm
• 1984 Booking clinic printed items.– 42 UK teaching hospitals generated 571
printed history data items, of which• Only 12 items present in >75% of case records• Only 52 items present in >50% of case records
• 2005 Analysis of C-section Proformas– 8 UK hospitals generated >280 printed items,
of which only 3 items had (nearly) identical wording.
Computers are
• Extremely flexible in creation
• Extremely rigid forever afterwards
• Not Magic!
“Paperless” records? When…
• Hand-held and not reliant on wiring, power etc.; Crash proof & Virus proof
• User-friendly, reliable way of entering free text
• Portable but theft-proof / not worth stealing
• Open source, not reliant on proprietary systems
“Paperless” records? When…• Easily readable by any authorised person,
including the patient
• Easy for authorised person to make context-sensitive amendments any time, any place, anywhere
• Easy access without complicated password procedures
• As secure as paper record held only by individual and health provider
And When…• A single chronologically-arranged, flow-
patterned set of every question and every allowable answer option is– Internationally standardised– Takes full account of all interested parties– Workload/cost classified and logically
prioritised
Are we climbing the right mountain?
Never forget that ifcomputers had been invented
first, and paper & pen later;the latter would probably
have been regardedas the world’s greatest
breakthrough in the historyof Information Technology