From clinicians: Real world use cases please

[rossjones]

From @davidmiller on November 3, 2014 15:18

... for dynamic triggers

/cc @gabpoll @drcjar @michaeledwardmarks

Copied from original issue: openhealthcare/ddd#24

[rossjones]

From @GabPoll on November 4, 2014 0:18

Infection control: alert organism test positive - e.g. C diff toxin positive, send alert to infection control team.

HIV test - all patients? only patients with certain conditions - TB? pneumonia? Pre-transplant? If positive, alert the Immune team.

Research - if patient matches eligibility criteria, alert research nurse.

[rossjones]

From @davidmiller on November 4, 2014 7:18

@GabPoll :

Ace!

Infection Control - I think they want the patient in an IC list on e.g. elCID, and an email "push notification" that a new patient has arrived, with say... a list of diagnoses? What should the email notification say?

HIV tests were only a subset of conditions - @michaeledwardmarks had a list?

Re. Research - do you have any precise criteria for studies that might be going on at UCLH early 2015

Wasn't there one related to antibiotic resistance ?

[rossjones]

From @GabPoll on November 6, 2014 8:49

One research scenario.

• any patients on elCID with diagnosis LRTI, email research nurse. Seems very simple, but there is a study specifically looking at recruiting these patients (not RiD-RTI).

The email to the research nurse can just say "a new patient with diagnosis of LRTI have been added to this team list". No need for demographics - they can search once log into elCID (small number of patients)

[rossjones]

From @GabPoll on November 6, 2014 8:56

Infection control, we have to be clever. Hospital systems already have alerts associated with individual patients known to be MRSA positive for example. Therefore, the angle here should be new infection control issues driven by a) results from lab or b) advice given by ID/micro doctors. Even then, infection control have access to Winpath, so they already have alerts coming from there. The selling point then has to be patient safety and communication by unifying medical and nursing workflow, minimise duplication and advice clash.

In addition, Winpath has no clinical information. So if the alert came through elCID, the email to infection control could alert them of the organism in question - e.g. MRSA / C diff and then either contain a clinical summary of the patient or perhaps a link to that individual's single patient entry, so that at the drop of a hat they know the patient's clinical history before phoning out the result - i.e. they know the context easily & rapidly. This is often what takes the most time on the phone.

[rossjones]

From @GabPoll on November 6, 2014 8:57

Infection control alert organisms

• MRSA
• C diff (antigen positive)
• ESBL producing organism
• Carbapenem resistant organism (big issue)

Email - "This patient xxx has a new result of this alert organism. Link to patient record here....". Then just let them get on with what they know best.

[rossjones]

From @GabPoll on November 6, 2014 8:58

elCID should then automatically tag these patients with infection control tag, so that a virtual ward round of infection control active patients can occur at any time. Need to filter on the infection control alert organism.

[rossjones]

From @davidmiller on November 6, 2014 9:19

@GabPoll These are great - thanks :)

(&& Keep 'em coming as you think of them ! )

[GabPoll]

@davidmiller, please let me know when you’re thinking of testing some of these functionalities. Have just re-read my pearls of wisdom – clearly some simpler than others, but crucially, some may be tested in real-world more easily than others. Have enquired a little and will let you know. Thought that may help you prioritise what to push for in first iteration.