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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 FRCOG Honorary Consultant Obstetrician, UHCW (IT Research). Potential advantages of electronic records.

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Rupert Fawdry FRCS FRCOG Honorary Consultant Obstetrician, UHCW (IT Research)

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  1. Magic and Mayhem40 years experience with the problems of Shared Community/Acute Hospital IT in Maternity Care Rupert Fawdry FRCS FRCOG Honorary Consultant Obstetrician, UHCW (IT Research)

  2. 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

  3. The dream: a paperless office?

  4. Chasm of partially explored but virtually uncharted territory

  5. 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.

  6. Computers are • Extremely flexible in creation • Extremely rigid forever afterwards • Not Magic!

  7. “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

  8. “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

  9. 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

  10. Are we climbing the right mountain?

  11. Never forget that ifcomputers had been inventedfirst, and paper & pen later;the latter would probablyhave been regardedas the world’s greatestbreakthrough in the historyof Information Technology

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