Roger,
Could you look at TTOs in particular?
In the one I reported, this concerned an  infant under 3 months.
There were two medications (ranitidine and domperidone) with no form or 
strength - simply name of drug, and dose in mg (one to 2 decimal 
points..) no volume or dose per kg: one (nystatin) in what appears to be 
an almost correct format (Nystatin 100,000 units/gm) but in a form 
(ointment) which I cannot locate, and two (beclomethasone and sodium 
chloride nose drops) as one would expect (beclomethasone eye/nose/ear 
drops 0.1% etc.). - and no space for the amount given to patient,
The whole thing is puzzling: the majority of the letter has obviously 
been drawn directly from ICE (which we could download: I am more 
interested in what was/should be done about abnormal results than a full 
print out of the reports!) with no dates for the investigations - so 
what has happened about the TTOs? Especially the ones the GP needs to 
continue!
It certainly appears that there is no drug database in use or if there 
is, it stores some medications but not others in the correct forms.
Ranitidine and domperidone have a wide therapeutic margin: what happens 
when it comes to digoxin?

It looks as though it is the same system: do you agree it poses a threat 
to patient safety?

BW

Mary
PS I'd talk to TPP about where these are filed - quite agree, you need 
to find letters in the same place for clinical safety: a GP systems and 
clinical governance problem rather than a PCT IT one!
I don't know the system: is the problem with Read Coding dependant on 
where the message is stored?

In message <[log in to unmask]>, 
Roger Gardiner <[log in to unmask]> writes
>Hi Mary
>
>we're getting them in SE Essex
>
>two problems so far - though no-one in IT seems concerned - 
>
>1 is that normal letters get scanned into 'communications' on System
>1 but these get filed into 'letters' so you now have to look in two
>places for hospital missives.
>2 when you read code these events (and remember they all involve
>an in-patient stay so are likely to be significant) you can't put the read
>code directly into the patient summary
>
>Roger
>
>
>
>-----Original Message-----
>From: Mary Hawking <[log in to unmask]>
>To: [log in to unmask]
>Sent: Thu, 9 Jul 2009 20:24
>Subject: electronic discharges
>
>We received a few new format, electronic discharges last week : I
>have serious concerns (which have been reported to everyone I can
>think of!). 
>The system was activated last week, and does not extend across all
>units in the trust from which they were received. 
>I have been told (my informant was passing my concerns on and not
>involved directly) that this system had been mandated by TPTB
>across the region, and that the local staff in that department shared
>my concerns and were pursuing the problems.. 
>Has anyone else received any of these? If you have, is there any way
>of identifying the system apart from internal analysis of the content? 
>If you agree with me (or if the IT program generating the electronic
>discharges is generating Excellent, Good, Mediocre or dangerous
>discharges) , could you tell me what is going on? 
>At the moment, I don't know what is going on - but check medication -
>especially paediatric for clues.. 
>These are early days - not received sufficient material for full
>analysis! - but I consider the patient safety risks too great to wait for
>further damage! 
> 
>Mary 
> 
>PS who commissioned the software - had they checked functionality
>and output - and do they understand the issues? 
>unshareable comments off-line please! 
>-- Mary Hawking 
>Click here to get the very best of AOL, including news, sport, gossip,
>lifestyles updates and email.

-- 
Mary Hawking