Transcript The Humber IHE-XDS Multi Disciplinary Team (MDT) Project

The Humber IHE-XDS
Multi Disciplinary Team (MDT) Project
Dr. Richard Harries, Consultant Radiologist
Dr. Stephen Trowell, Head of Informatics
Northern Lincolnshire and Goole NHS Foundation Trust
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Humber XDS project initiation
Clinically led:
• Consultant Radiologist [Dr. Richard Harries] introduced IHE
compatibility to the Trust during a Radiology Information
system upgrade
• Engaged SHA in discussions around potential benefits to
the Local Health Community
• Identified potential benefits to XDS deployment within a
Multiple Disciplinary Team (MDT) meeting environment
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Humber Current MDT facilities
• Joint team meetings implemented
using video conferencing facilities
linking Hull and Grimsby
• Two large flat panel screens for
image display
– PC linked microscope
– PACS workstation
– Laptop
• Presentations by Radiologist,
Pathologist etc referring to images
shared on video screens
• Patient records other than images in
paper form
(some recent records are available
in electronic form, some only in
hardcopy form)
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Humber MDT meeting XDS enhancement
• Two objectives
– Proof of concept of XDS implementation in the UK
environment
– Enhancement of MDT meeting facilities by access to
selected documents during and after meetings
• Initial project: added functionality
– Rapid selection and display of Discharge Summaries,
Outpatient Clinic Notes and Operation Notes
– Availability of these documents following the meeting
• Follow on project: access to Reports e.g. CDA
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Document Access
• Document search and retrieval
– Centralised XDS Registry/Repository
• Document access from both Video conference rooms
• Video conference room PCs upgraded for XDS document
search and display (facility for panel monitor display of PC
screen exists)
• Document access from other locations?
• Continuous subsequent access to documents by
authorised staff
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Document preparation for MDT meetings
• Current process involves finding and collecting the record
folders for the patients on the list for that day
• Summaries and notes already in electronic from:
– Pull from local hospital store
– Convert to pdf
– Create metadata
• Some automatic
• Some supplied by operator
– Submit to XDS repository
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Humber XDS deliverables
Proof of concept will:
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Define suitable metadata tags for each document type
Define tag creation process for text records
Using tagged documents in XDS repository
Use of central document registry
Document retrieval will be demonstrated from
– Northern Lincolnshire and Goole Foundation Trust and
– Hull and East Yorkshire Hospitals Trust
• Access control will be established to ensure legitimate
relationship policies are adhered to
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Benefits to MDT participants
• Less risk of errors when matching records to patients.
• Greater probability that the entire relevant patient record
will be used to support clinical decision making.
• Facilitates ease of viewing key documents originating in
other health care provider organisations.
• Less manually resource intensive task to collate relevant
records prior to MDT meeting.
• During MDT meeting, more consistent and seamless
presentation of information – fewer interruptions whilst
looking for pertinent information.
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Benefits to the Foundation Trust
• Facilitates improved clinical decision making, thereby
reducing risk of incorrect conclusions being drawn.
• Facilitates a consistent, standard approach to MDT
meetings so easier for staff to sit on multiple MDT’s.
• Contributes to a culture of innovation.
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Benefits to patients and GPs
• Facilitates improved clinical decision making, thereby
reducing risk of incorrect conclusions being drawn.
• Potential to send a link electronically to GP and/or patient
so that they can access a file summarising the outcome of
MDT discussions.
(patient only has access to that specific document)
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Benefits to Local Health Community [SHA]:
• Demonstrates potential for cross-organisational sharing of
documentation – applicable to many areas beyond MDT
environment.
• Generates a local understanding of the benefits and issues
around IHE XDS technology.
• Continues to place the region at the forefront of health
informatics advances.
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Issues – implementation challenges
Despite good alignment with national and local NHS Quality
agenda…..
• Understanding of XDS in both clinical and informatics/IT
Trust departments is limited to a few individuals
• Engagement of Trust in IHE technology
– “We already have an Integration Engine and NPfIT
products – why do we need another method of
interfacing systems?”
• SHA supportive – potential benefits to the LHC
• Excellent support from IHE-UK, and commercial partners
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Humber XDS project summary
• The Humber IHE-XDS MDT project aims to develop local
understanding of IHE technology
• Through MDT’s, can demonstrate a proof of concept
• Easily scalable rollout, engaging many clinicians
– Suitable basis for future deployment
• Small scale [Trust based] proof of concept carries minimal
risk
• XDS is a method, not a product – it does not specify
everything that we need to make the project successful!
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Group Feedback
• Questions ?
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What else should the project team consider?
How does this relate to your areas?
What other potential applications are there for XDS?
How does the NHS agree standard metadata for
document classification?
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Humber XDS project – related projects
• Electronic Discharge summaries
– Joining Pharmacy records to ward-based clinical
records to create a single discharge summary
• PAS developments
– Clinical Viewer software could be configured to
generate pdf documents at source
• Electronic Document Management
– Digitising legacy paper records – XDS compatible?
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