Case Studies...
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Main Hospitals
Lister Hospital
Background
In 1997, the Lister Renal Unit (LRU) had used Di-Proton for several years but was unable to support the system. RenalPlus was engaged to maintain the system.
By 1999 it became clear that this version of Di-Proton system was not year 2000 compliant so it was decided to tender for a new system.
All of the main renal systems were thoroughly evaluated. When it came time to make a decision the LRU found that none of the systems had the functionality of RenalPlus as RenalPlus is one of the most function rich renal applications available.
We would like to thank all of LRU staff for their ideas, contribution, explanations and help, without their input RenalPlus would not be the excellent product it is today as the LRU is one of the most advanced units in the country.
Royal Shrewsbury Hospital
Background
In 2001 The Royal Shrewsbury Hospital (RSH) was looking for a renal system which provided more functionality than a typical patient administration system (PAS).
The system needed both clinical and administrative data on renal patients receiving dialysis and associated support both in hospital and in the community. Most patients embark on a long “career” of treatment, which will take many different forms and directions over the years. The renal system collects a lot of detailed and unique information on patients over a very long period of time. This is fundamentally different to most other areas of the hospital, which collect standardised information on patients over a short time.
For these reasons, standard hospital databases are unsuitable for the requirements of renal units, purchasers, regulatory national bodies and regional organisations. Specialist systems also mean less work for these organisations as well as the renal unit in organising and collecting queries and periodic datasets.
Requirements
The RSH Renal Unit prepared a set of requirements
- Relational clinical patient data base specific to renal dialysis.
- Simultaneous analysis of multiple variables specific to dialysis and nephrology.
- Quantitative dialysis prescription (urea kinetic modelling or UKM for short).
- Standardisation with other renal units.
- Direct link to hospital’s PAS and pathology systems.
- Compatibility with regional / Renal Registry / EDTA conventions for reporting.
- Compatibility with existing renal management and business systems.
- Potential for link to specialist external systems such as Baxter Adequest, Poet and Janssen Cilag anaemia database.
- Compatibility with hospital’s morbid admissions systems.
The new system needed the ability to simultaneously examine variables such as diagnosis, symptoms, modality, kinetic studies, pathology and clinical events essential to effective and efficient renal patient management.
A pathology system would not provide a facility for the clinical management of maintenance dialysis patients as renal patients are not managed by pathology results alone.
Why RenalPlus?
RSH considered all of the main systems and options including managing with the existing PAS and Pathology systems and writing their own system.
No alternative system was found to offer the same level of functionality as RenalPlus and RenalPlus was found to offer the best value.
RSH gave us the following reasons why they chose RenalPlus:
- RenalPlus is workable, practical and available immediately.
- RenalPlus requires no server or big expensive databases to be installed.
- The configuration of RenalPlus is made much simpler with the provision of choices for fields, we were able to delete options that were not applicable and add our own specific entries.
- The RenalPlus PC installation procedure takes a minute and documentation is provided so that IT dept. can add new users in the same timescale.
- RenalPlus enables the RSH Renal unit to manage ever growing numbers of patients.
- RenalPlus is supported by the suppliers and our own IT department.
- RenalPlus is flexible and easy to use and the design has been influenced by staff experienced in renal dialysis and renal management.
- RenalPlus satisfies all clinical requirements and offers some that RSH had not even considered. Most importantly, it offers the mandatory requirement of being able to simultaneously analyse multiple variables both for individual patients and for selected groups.
- RenalPlus also satisfies existing and future audit requirements.
- RenalPlus offers immediate benefits for the units management requirements.
- RenalPlus interfaces directly with regulatory bodies and this service is provided as standard.
- RenalPlus is compatible with the hospitals IT infrastructure and uses industry standard protocols, middleware and systems.
- RenalPlus interfaces to PAS and pathology systems.
New developments
RenalPlus is unique among renal systems in that it is the users that determine what new developments made. When RSH started using RenalPlus they suggested some developments that would add new features and make RenalPlus able to cater for additional options used by other Hospitals.
These developments were in three main areas, Dialysis orders, CAPD and Batch Update. Once implemented these features became optionally available to the all other RenalPlus hospitals.
On-going partnership
Since RSH started using RenalPlus the relationship with the Renal Unit has continued to develop. In our unique position we are able to offer advice and obtain resources to help in training new staff about subjects like UKM.
Like the Lister, RSH has provided a unique insight into the way different Renal units operate. We are very grateful for all of the input thus far and look forward to many years of continued partnership.
Satellite Units - Case Study
In September 2001 a brand new state of the art Renal Unit was opened at the Luton and Dunstable Hospital (LDH).
All of the systems were fully operational on the day the unit opened.
The Luton and Dunstable Hospital was our first Hospital to use the automatic generation of Test Requests feature in RenalPlus which allows the users to print off the paperwork to accompany patient samples sent to the pathology dept. This has provided a huge cost saving as RenalPlus prevents staff from re-ordering tests that have already been ordered by the previous shift. Duplicated pathology can account for up to 40% of total pathology costs.
Staff no longer need to find and print labels as all of the patient details are taken from RenalPlus.
The pathology test request form is designed around your existing manual form and gives you and your pathology department final sign off.
Outreach Clinics - Case Study
We were asked to provide access to RenalPlus for doctors running nephrology outpatient clinics at a remote hospital and to bring pathology from the remote hospital into RenalPlus. This enabled patients to have their tests at the remote Hospital and again saved having to make special arrangements for patient samples.
The benefits of the RenalPlus NHSnet delivery model really come into their own when you need to run RenalPlus in an outlying clinic. This was achieved at the remote Hospital by simply completing the following tasks:
- Opening up a connection in the firewalls
- Creating an icon on the PC desktop that pointed to our servers which are located inside the NHSnet.
Doctors no longer need to refer to the patients Hospital record as everything they need is in RenalPlus. This saved a huge amount of time (and costs) in taking the files back and forth every time there was a clinic at the remote Hospital.
Multiple Pathology Laboratories
Our most modern link collects Haematology, Biochemistry and Microbiology data every 20 minutes and imports it into RenalPlus. The import process also updates electronic flow sheets. We have been connecting to numerous different laboratories and systems since 1997.
Equally important is the ability to use a strict process to import the data based on matched demographic information. RenalPlus does this and automatically removes data that does not match based on criteria that can include Name, Surname, DOB, Hospital Number and NHS Number.
RenalPlus also provides a pathology management function, this allows the RenalPlus Application Manager to release data that has been incorrectly unmatched due to spelling errors. RenalPlus also remembers these errors so you only have to do it once, this saves time and gives the clinicians access to the data they need.
Working from Home
More and more doctors are requesting the facility to access patient information from home, but this presents many concerns about security.
Hospital Trusts have various options from providing a dial-up service to the hospital network with an RSA key to allowing Broadband users to connect via a VPN. RenalPlus can be delivered over whichever service has been implemented without a requirement for additional hardware or software. RenalPlus uses a very low bandwidth and so it will run at a very reasonable speed on a dial-up connection and a very fast speed over a VPN.
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