Volume 5. A draft set of Questions and all allowable Answer Options which gives "Logical Priority" to "Individual Care"

Volume Editor:  Rupert Fawdry

To see a sample page   Click here

Discussion Links:  http://eepd.org.uk/?p=438

 

"If electronic records are to fulfil their potential,

we need the best wording, and timing,

for every electronic Question

and every allowable Answer Option"

needs to be documented once and properly"

 

Summary 

It is clearly impossible to agree internationally (or even nationally!) immediately on the electronic standardisation of every potential question and every potential answer in all of maternity and neonatal care.

The task is too great.

But one must start somewhere if Electronic Patient Records are to fulfil their full potential, since without such bedrock standardisation it will never be cost effective: 

 

a)   to write the complex computer programs which will provide both immediate, individualised, on-screen timely information about both a “Prognosis of Risks” and, more important, any appropriate “Action Suggestions” based on single or groups of “Trigger Data” 

 

b)      to create high quality individualised computer printouts.

 

c)  incidentally to provide internationally standardised detailed and reliable complex data for analysis, audit and benchmarking and

 

d)   to allow standard sets of data to be transferred from one electronic system to another e.g. from a primary care system to and from a maternity system (see Volume 15. S.IN.B.A.D.S: Standard INterprogram Bundles of Associated Data   http://fawdry.info/index.php?&id=35 

 

        Until there is adequate standardisation staff will continue to waste time filling in independent computer systems for different purposes together with a multitude of different paper proformas e.g. Hydatidiform Mole Registrations, Adoption Proformas, Post-Mortem requests, Health Visitor Records, UKOSS forms etc.  - neglecting the mothers and babies under their care because of so much time spent on paperwork.

 

Primary Data Standardisation first

 

Standardisation is proposed as a FIRST priority ONLY for those items which would seem to be of value in the care of individual (expectant) mothers and babies (“Patient-Centred IT care“) whenever there is a “Four Guaranteed Places“ Maternity & Neonatal EPR Computer System.

 

A FOUR PLACES Perinatal computer system being defined as one where Terminals & Printers are always reliably available:

 

a)  whenever Scans are done

b)  in the Delivery Suite

c)  in all Maternity Wards

d)  in all Neonatal Care Units.

 

This emphasis has led to the “Logical Priority“ Draft International Perinatal Data Definition Proposals.

 

THE TWO CRUCIAL CONCEPTS IN THE EEPD

 

This draft chronologically-based, flow-patterned data-set is one of the two most crucial concept in the EEPD.

 

The second crucial concept concerns the need to accept a hybrid system of paper records and electronic records with full documentation of what should happen at each maternity or neonatal RIO (Realistic Input/Output Opportunity)  see the EEPD Volume V.  http://fawdry.info/index.php?&id=26

 

IMPORTANCE AS A SPINE FOR OTHER DATA

This chronologically-based, flow-patterned data-set not only helps to prioritise the massive amount of work involved; but also provides a clear “spine” into which it becomes easier to fit any proposed additional data items. 

(Updated 23 Aug 2010)

 

Introduction

Volume 5. The draft chronologically arranged, flow-patterned

”Logical Priority” set of questions and all allowable answers,

 is, by far, the most important part of the EEPD website project.

It is, as far as I know, unique in the following.

1. The first U.K. (anywhere?) attempt known to me to provide, in draft form, openly available a complex documentation with the following characteristics:

a. Chronologically Arranged

b. Flow-patterned

c. Openly Accessible on the web for worldwide viewing and feed-back

d. as a result, with the Potential for International Standardisation.

This being the essential foundation for further progress in maternity computing

e. Complex Enough to be useful in all maternity and neonatal electronic records.

f. yet the Minimum which facilitates a functioning Individual Patient-care Orientated perinatal computer system

g. suggests a full list of All Allowable Answer Options,  

h. with “Other (free text)” always allowing free text option whenever appropriate.

i with “Unknown (free text)” always available if appropriate

2. The only maternal or paediatric dataset so far seen which uses a logical (workload / cost), rather than the current arbitrary basis (i.e. a whole series of incompatible short term expert advisory committees) for the selection of items for inclusion or exclusion.  This basis is summarised in the following link:  www.fawdry.info/eepd/00_ima/poster/12_RFClassif.pdf√

3. The only project which, not only documents what has been included, but also, through the EEPD Volume IV. (The Resource Document), those data items which, for what I have described above as a Phase 1 system, have been excluded or not so far been prioritised, and why.

Until we standardise on the kind of foundation which the “Logical Prioritisation” dataset now provides electronic patient records created by different organisations or commercial companies will remain incompatible. This will not only limit their use for statistical purposes; but much more importantly, without much more standardisation,it will make it much more difficult and expensive to use the power of IT to encourage a better quality of care for individual patients.

Two Crucial Foundation Concepts in the EEPD

This draft is an attempt to provide a standardised, chronologically-based, flow-patterned set of data definitions both for the wording of the question and for the allowable answer options.

It forms one of the two most crucial parts of the EEPD website.

The second crucial concept concerns the need to accept a hybrid system of paper records and electronic records with full documentation of what should happen at each maternity or neonatal RIO (Realistic Input/Output Opportunity. For further information about RIOs see the EEPD Volume VI.

Essential Spine for Additional Data Items

The “Logical Prioritisation” chronologically-based, flow-patterned set of draft question and answer definitions not only helps to prioritise the massive amount of work involved; but also provides a clear “spine” into which it becomes easier to fit all future proposed all additional data items.

Any Feedback very welcome

Rupert Fawdry (Updated  8 Aug 2010)