RealTime Product Roadmap beyond R2

1. RealTime Product Roadmap beyond R2 • Still focused on key goal of reducing LOS through improved clinical and operational process • Increased depth on clinical tool to support doctor and nurse processes • Extending RealTime beyond the acute hospital wards, e.g. ED, multi-site care delivery • Moving RealTime closer to the patient

2. The RealTime Software stack

3. Performance monitoring CQC CQUIN Monitoring Readmission tracking Dashboards Infection Tracking Reports KPIs Clinical Alerts ED Nurse Assessments Charting and EWS VTE Clinical Handover Discharge summaries Clinical modules Patient Flow Discharge Planning Safe Discharge Social Services ED DTA Site Mgt RealTimeBase and Integration PAS ED LAB Clinical EPR Directory Services

4. Since the last User Group (r2.*-3) • Readmission Tracking • Nursing Assessment module • Clinical Handover, patient allocation • Filter based patient lists • Discharge Summaries • ED interface into inpatient flow • Report Scheduling • Single Sex compliance • Cancel Discharge • Ward Visibility • Nurse observations, charting and EWS alerting • Patient lifeline • Operations/Site report

5. Readmission Tracking • Tracks all re-admissions within 30 days • Sets a unique Alert on the patient • Readmission qualification form disables alert once completed • Re-admission report exports full dataset to enable integration of billing data

6. Nursing Assessment Module

7. Nursing Assessment Module • Inpatient Assessment form (for all patients) • Comprehensive assessment including:admission details, patient alerts, infection preventions, test results, initial obs, patient consent/property, medication, pain assessment, elimination, oral hygiene, breathing, safe environment, mobilisation, skin, washing, communication, sleeping, death & dying and eating & drinking. • Using sophisticated form controls for ease of use: section navigation, incomplete section alerting, pre-population and summary of who to notify and referrals needed based on previous answers. • Form triggering mechanism

8. Nursing Assessment Module • Review Forms – triggered by IA • These include: Bed Safety Rails, Falls Care Plan, DIAG, Derby Nutritional Score and Waterlow • Guidance page • Initial assessment (pre-filled from IA) • Additional Assessments (with automated scoring) • Care plan section (with dynamic task creation) • Sign/date stamped

9. Clinical Handover - RCP • Communication at patient handover should be written. • In a study simulating handovers using fictional patient scenarios, junior doctors given verbal handovers forgot 67% of the information after the first handover and 97% by the fifth handover. • Structured handover form increased information retention from 73% (plain paper notes) to 93%.

10. Clinical Handover in RealTime • Standardised templates that follow the patient. • Sophisticated automated and manual alerting. • Supports most handover scenarios: • Weekend Handovers • Specialty Handovers • Ward shift handovers • Patients for allocation • Patient handover tracking

12. Discharge Summaries • Integrates TTO process with clinical alerting • Advanced form features ease authoring • Automated pre-fill, within form dynamic updates, rapid drug searching • TTOs sent in advance of completion • Pharmacy TTO lists ease processing, automated refer back to doctor on processing • Electronic communication to GPs

14. 3.0 features

15. Dynamic Patient lists • Enable doctors to drill down via the ‘Handover’ screen and filter based on their consultants (groups), and specialty groups. • Display and print the list with handover information • Dynamically build a virtual list of patients based on ‘contact’. Provide the ability to manage and merge this list.

16. Nursing Charting, EWS and event lifeline • A model for patient observation and charting • Charting protocol; parameters; frequency; EWS • Integrated with the patient’s lifeline (USP) • Shows the actions taken in response to an EWS Alert • Alerting when a charting point has been missed • Automatic escalation / notification to Patient physicians via there patient list view and via paging systems to ‘outreach teams’.

17. RealTime by the bedside Giving RealTime teeth by the bedside and on the move !

18. The Goal • An advanced handheld RealTime application to support activities that take place by the bedside to optimise patient flow and link key elements of business process: • Consultant rounds where each patient is visited in turn • Physician assessments • Nursing assessments • Nurse / HCA charting • Escalation pathways • Physician alerting • IC Risk assessment and alerting

19. Technical goals • Enable the RT application to port to market leading tablet and mobile devices • Apple OS; iPAD, iPhone, iTouch • Android • ? Other • Implement first on the Apple OS – the current market leader…

20. Consultant rounds • EDD review • Discharge pathway – Safe discharge checklist • Barriers to discharge • Actions – change to the discharge plan • Tools • My Patient list; Ward view; Whiteboard; Handover

21. Physician assessment • VTE Assessment • Handover information • Review vital signs • Tools • My patient list; Forms; Charts; Handover

22. Nurse Assessment • Inpatient Assessment & Review forms • SAP Risk Assessment, S2 and S5 • Charting • Tools; Ward view, Forms, Charting

23. Charting and MEWS • A model for patient centric charting • Charting protocol; parameters; frequency; EWS • Integrated with the patient’s lifeline (USP) • Shows the actions taken in response to an EWS Alert • Alerting when a charting point has been missed • Automatic notification to Patient physicians via their patient list view.

24. My patient list

25. Patient chart, showing integrated lifeline

26. Viewing the lifeline event

27. The End !