An early view of Lorenzo - Introduction

1. An early view of Lorenzo - Introduction Philip Gunn CSC Account Executive

2. Single Instance Discussion Mike Dyer CSC Chief Technology Officer

3. Reliability We think it is technically more reliable to have a single instance that grows over time Basis of that is that the same engineering and development must take place for medium size instances as large Having a single database to manage is much easier than several due to single schema, etc.

4. CPU vs Response CPU/ Response CPU/ Response CPU CPU Response Response No of Users No of Users Worst Case – Non-scalable System Ideal Case – Scalable System • The more users the worse the response time • CPU usage is linear • Response remains the same as more users added

5. Scalability First two year volumes are not significant in regards to scale 200GB initial plus 200GB per year for a large Trust (GM) After one year we will reevaluate the use of SQL Server iSoft has dual-database development with Oracle/SQL Server The size of 6 Trusts by that time is estimated at 2TB The engineering for the end state scalability will be built into the data model for R1 and will not change whether we have single or multiple instances Partitioning – also needed for DB load Data Load Model for both transformation and load General database problems have little to do with size of DB in practical purposes once you get over 100GB

6. Versions The application layer provides the resilience mechanism for deploying multiple versions of the software in an incremental fashion Multiple concurrent versions add one level of complexity Adding in multiple database will significantly add complexity

7. Lorenzo Regional Care –An Introduction to Release 1 Chris Orme - Director of Clinical Governance CSCA

8. This Presentation • Introduce the look and feel of Lorenzo Regional Care - Release 1 • Provide an overview of Release 1 clinical functionality • Focus on the key elements of the Core EPR • Introduce clinician task management • Highlight clinical benefits

9. Lorenzo Regional Care – Overview of Release 1 and the core elements of the clinical record Clinical Data Capture Requests and Results Clinical Noting + +

10. Our scenario • Mrs Jane White age 71yrs admitted as an emergency with suspected acute pneumonia under the care of Dr DiSilva. • Mrs White is a diabetic and has hypertension, she has had previous admissions to hospital • Using a series of screen shots relevant to Dr DiSilva we will see how the clinician is able to: • access Mrs Whites care record to view her history, allergies and alerts • record semi structured free text using the “medipad” • record clinical information using structured forms • review results and request investigations and services • manage and plan his work using the “my work” facility

11. Retrieving and viewing Mrs Whites clinical record

13. Recording clinical information using structured forms

25. Release 1 - Clinical Benefits • Improved communication between clinicians and clinical teams and across care settings as information is collected in real time and is at once readily available to all who have a legitimate need • Promotes safe and effective practice through the use of structured data collection, pre defined order sets, alerting and authorisations • Promotes more efficient use of resources by reducing the time spent on indirect care activities • Improved patient satisfaction as less need to duplicate information collection