Disappointed to hear about problems in Plymouth
We use the HAS system for all ED medical notes and after the initial culture
shock of having to type it works well and has been well accepted by medical
staff. There is no evidence of a slowing in our system and our performance
compares well with othe centres in Australaia for timeliness. We are one of
the few (possibly the only) HAS users to have made this change
All of our ED notes back to early 99 can now be easily read from a PC
Have introduced and continue to make a number of modifications eg medical
notes now cannot be edited after entry to ensure they are "contemporaneous"
in a medicolegal sense.
The notes are transfered in entirety to the GP letters who can peruse our
complete consultation
Some may be surprised at this !
The system has only crashed twice in 2 years and then for only 2 hours at
most. Have the occassional planned shut down in the early hours for
upgrading. When the system is down there is no loss of data but the inabilty
to enter new data till it comes back on. Back to the old white board and
paper till then. Thankfully no major disasters in 2 years so far.
My main regret is that the nurses did not go "paperless" at the same time.
They still write their notes and observations and sign for medications on a
paper sheet. HAS EDIS could incorporate these functions with some
modification. They are coming round though...
Those non ED doctors who visit the department to consult need persuading to
use the system but as they get "younger" and more used to communicating by
keyboard in most aspects of life we are now finding they also are using the
system to access notes and make additions without decreasing fuss.
Radiology in our hospital is still 3-4 years away from a digital process
I have not written for about 2 years now and there is no going back....
To retrospectively scan written notes in has been done in some Australain
centres but scanning written notes seems a bit retrospective. An alternative
would be voice recognition for thos doctors who cannot cope with typing!!
HAS EDIS is not perfect but it is purpose built for ED practice following
the Australasian model and in particular the NTS triage system of
prioritisation and analysis of performance indicators in relation to this
JohnC
Ultimately it would be a nice idea if a whole hospital record or even health
service record system was paperless but difficult to get a system that suits
every department, becomes a huge undertaking with a lot of risk across the
whole organisation, especially if it proves to be a lemon...
Too long for an e-mail apologies
-----Original Message-----
From: lee.wallis [mailto:[log in to unmask]]
Sent: Wednesday, November 15, 2000 12:39 PM
To: [log in to unmask]
Subject: Re: Ruth's message
Unfortunately not yet a reality - we are still writing notes but printing
radiology forms and various other bits and pieces. The computer actually
slows things down tremendously, as you have to write notes the type it all
into the computer also.
Plans are afoot to introduce scanning of notes, followed by writing straight
onto the computer with one of those fancy light pen things. Hmmm.
We also have PACS installed, so the 2 computer systems together give 1. lots
of reasons for SHO's to sit around talking, and 2. lots of delays when the
drives are having a slow day (most days).
Anyone that wants to come and see, please feel free.
Lee Wallis
SpR Derriford A&E
----- Original Message -----
From: A S Lockey <[log in to unmask]>
To: <[log in to unmask]>
Sent: Tuesday, November 14, 2000 11:14 PM
Subject: RE: Ruth's message
> A year ago I did an option appraisal of various computer systems for A&E.
> Derriford in Plymouth had just installed HASS EDIS, which is capable of
> operating as a paperless system. They were still documenting on A&E cards
> but it was their intention to become totally paperless by early this year.
> If there is anyone on the list who works or has worked there in the last
> year they could maybe let us know if it has become a reality.
>
> Footman-Walker claim that they can adapt their latest package (Symphony)
to
> work as a paperless system but when I spoke with them last year they
didn't
> perceive a great demand for this.
>
> Finally, a representative from another major company, when asked about the
> possibility of their system being developed as a paperless one said, "The
> search for a paperless department is like the search for a paperless
> toilet!"
>
> I suppose the overriding worry with a paperless system is what happens
when
> it crashes. If there is no on-line backup or if that fails as well, what
> happens to the lost data? What happens if it has crashed when you
> desperately need to know about your patient's previous attendance last
week?
> (I appreciate that the counter argument is that paper records can and do
go
> missing).
>
> I am a self-confessed technophile with a love of gadgets. I am however
> sceptical of the benefits of a paperless department. For one thing, what
> happens when the patient complaint comes through and all you have to show
> for their time in A&E is a non-specific generic record. By having to write
> something, I am more inclined to think about what I am documenting rather
> than if I have a series of check boxes and a free text box.
>
> Andy
>
>
>
>
>
> -----Original Message-----
> From: [log in to unmask]
> [mailto:[log in to unmask]]On Behalf Of Laurence Rocke
> Sent: 14 November 2000 22:35
> To: [log in to unmask]
> Subject: Re: Ruth's message
>
> I'd also like to know about paperless systems.
>
> Rocky
> ----- Original Message -----
> From: "Ruth Brown" <[log in to unmask]>
> To: <[log in to unmask]>
> Sent: Tuesday, November 14, 2000 6:04 PM
>
>
> > Dear List, not really that academic but very interested if anyone can
help
> > me. DOes anyone out there have a truly paperless A&E record, ie no
paper
> > records, everything straight into the computer, downloaded at patient
> > bedside, image transfer and all?
> > If so, could you reply privately rather than clog up the list, thanks
Ruth
> >
> > Ruth Brown FRCS FFAEM
> > Consultant in Emergency Medicine,
> > King's College Hospital, London UK
> >
> >
> >
>
>
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