Northern Lincolnshire and Goole Hospitals NHS Foundation Trust develops clinical portal using InterSystems Caché, delivering better patient outcomes by improving access to clinical data.

• Improved interdepartmental communications
• Faster diagnosis
• Better patient outcomes

Caché’s speed and performance help achieve wide-ranging business results
“The project first started when we wanted to speed up the availability of lab test results on wards,” explains Robin Howes, Client Services Technical Manager for Northern Lincolnshire and Goole Hospitals NHS Foundation Trust. “We knew we had to bring our various systems together to make them more accessible to clinical staff.”

Howes and his team met this challenge by using InterSystems Caché® , the world’s most widely used database system for healthcare solutions, to develop an in-house clinical portal they named WebV. “We evaluated the integration capability we had internally prior to commencement but we found that none of our existing systems were fit for the purpose of this task,” says Howes. “The successful completion of the project has only been possible because of the incredible speed and performance we were able to introduce with Caché.”

The WebV system currently provides pathology and radiology requests and full order communications. These are coupled with clinical alerting and observations with a feed from the patient administration system (PAS), which includes future and past outpatient appointments. Other modules on the portal include venous thrombosis and embolism (VTE) assessments, Web-based ward management and a bed status system.

Clinicians and ward staff benefit because they use one login process to access data from disparate systems, producing timely clinical information. Overall, the new portal is also helping Northern Lincolnshire and Goole to achieve:

• Better patient outcomes through quicker and more timely diagnoses
• Reduced risk of infection spreading through availability of real-time test result alerts
• More efficient bed management through the addition of the integrated ward management module
• More effective collaboration with specialists in other NHS trusts through Web-based portal access

Fresh data is the key to improving patient outcomes

Quicker diagnoses are being achieved because all the data on the new portal system is current. For example, as soon as a result is released on an analyzer in the hematology laboratory, the clinician can view it immediately. Grossly abnormal reports are highlighted to create alerts, enabling clinicians to act upon the information on a timely basis.

As the portal is Web-based it is simple to access on mobile devices at or near the bedside or it can be viewed remotely, even by an authorized user in another hospital or distant location. This is especially useful when a second clinical opinion is considered helpful during diagnosis or care planning.

“The benefits of the portal using InterSystems Caché mean we are already seeing improvements in results that are measurable,” says Howes. “For example, introducing an online VTE assessment audit as a module of WebV enabled us to hit the required standard of returning 90% of the assessments within a month.”

Integration with administration systems improves communication and efficiency

Communication with ward staff has also been improved by using the rapid application development capability of Caché to develop a ward administration module linked to patient observations. Ward staff can now view a topographical display of the ward, see which beds are occupied and view special requirements of a patient in a specific bed.

The successful completion ofthe project has only been possiblebecause of the incredible speedand performance we were able tointroduce with InterSystems Caché.

Robin Howes, Client Services Technical Manager
Northern Lincolnshire and Goole Hospitals NHS Foundation Trust

This is linked to diagnostic reports and observations for easy access. If a Patient at Risk (PAR) scoring is abnormal then the bed’ will change color. If the patient presents an infection risk, available from the real-time links to the microbiology/infection control systems, the system will also produce an alert.

The whole ward status can be displayed on a large screen, just like the whiteboards used on many wards. The overall current status of the hospital can also be reviewed at any time, so enabling more effective acute bed management. “The difference between this and many other systems is that the information is fully integrated and is built around the needs of patients,” says Howes.

Innovation that can be replicated

The Trust is currently developing a further module to help it go ‘paper light’ by ensuring that all clinical investigations are available securely and reliably on the system. This module will also provide a system that mandates all reports produced are viewed, so reducing printed waste and improving the accuracy of decision-making.

The Trust believes that the modules it is developing can be replicated by other NHS trusts, particularly the ward management system.

Aside from delivering functionalitythat benefits patients, we havealso been able to provide a proof of-concept that demonstrateshow simplified integration usingInterSystems Caché can reduce costs.

Robin Howes, Client Services Technical Manager
Northern Lincolnshire and Goole Hospitals NHS Foundation Trust

“The ward management module is a one stop summary display that could be of great benefit in other environments,” Howes explains. “Aside from delivering functionality that benefits patients, we have also been able to provide a proof-of-concept that demonstrates how simplified integration using Caché can reduce costs. These systems can be implemented for under 2,000 per ward, instead of implementation costs running up to tens of thousands for other similar systems.”

According to Jonathan Selby, Country Manager UK & Ireland at InterSystems, this sums up perfectly the value of the work that Robin Howes and his team have been able to achieve. “Northern Lincolnshire and Goole Hospitals NHS Foundation Trust’s WebV is an excellent example of how Caché facilitates the delivery of timely patient care. We are extremely pleased that the Trust has used its in-house development skills to produce this excellent portal. Caché is the core technology for all of InterSystems’ healthcare offerings, including the InterSystems HealthShare® strategic healthcare informatics platform and InterSystems Ensemble® rapid integration platform, enabling our customers to capture, share, understand and act upon all of their data in real time.”