Improving Care for Diabetes Patients
A team at George Eliot Hospital in England finds success in Lorenzo adaptation.
Serving a population of 300,000, George Eliot Hospital National Health Service (NHS) Trust in Warwickshire, England, uses CSC’s Lorenzo Electronic Patient Record (EPR) to improve and transform the way services are delivered to patients. Recently, the hospital developed an EPR solution that optimizes care for an important group: diabetes patients.
People with diabetes often receive care from several departments, physicians or specialists. Ideally, information from all visits is kept in one place to support long-term healthcare needs, but this doesn’t always happen. A pilot program at George Eliot set out to achieve this.
by Dr. David Lee
Collecting and storing patient data
The diabetes team developed an electronic system to collect the same patient data wherever the patient was seen — be it the emergency department, outpatient clinic or in a ward. The new system, called Lorenzo-Diabetes, is user friendly and supports the creation of a patient-centered record that can be shared effectively, whether with the patient’s general practitioner (GP), podiatrist, nurse or other specialists.
The solution makes use of Lorenzo EPR. Consultants now collect standard patient information, such as blood pressure, eye health and prescription drug use, putting data directly into Lorenzo-Diabetes. Nurses who see patients in the outpatient clinic have instant access to this information. Health professionals who need to follow up with patients can also see the record.
Once captured, data can be added to standard letters for GPs and patients, using Lorenzo’s Clinical Documentation capability. Patients can go home with their clinic letters on the same day, and GPs’ letters are ready by the end of the clinic. GPs and patients can follow up on clinic recommendations without delay, and patients now have electronic documents that set out their “year-of-care” plans.
Related: Benefits of Agile Health
The system helps in other ways, too. A real-time audit gives clinicians insight into why patients are attending clinics and makes sure patients’ needs are met. Patients who are willing to take part in research can now be easily identified, which has increased participation in clinical trials.
Engaging patients in their care
Dr. Vinod Patel, consultant in diabetes, says, “Patients feel more engaged [because] they can see information is captured about them electronically and will be shared with their GPs and used in future consultations or wider treatment. They also value that this information is available to them at the end of their consultation.”
Health professionals and patients aren’t the only ones benefiting. Medical secretaries no longer have to type up handwritten notes. Within the first week of implementation, the secretaries’ workload was cut by 50 percent. The department is now “paper lite,” with GP letters and patient letters no longer produced on paper.
As Dr. Patel says, “The key to our success in achieving benefits from our EPR for this patient group was the multidisciplinary engagement, including medical secretaries and outpatient healthcare assistants, along with the nurses and doctors. This ensured a ‘bottom-up’ approach as well as buy-in from all the stakeholders.”
Dr. Ponnusamy Saravanan, associate clinical professor and honorary consultant physician in diabetes, endocrinology and metabolism, sees the systems as a case study other hospitals can adopt.
“We are keen to share the learning. Trusts that already have Lorenzo or trusts that are in the process of implementing Lorenzo or thinking of deploying it are very welcome to visit us and view the pilot firsthand,” he says.
With the success of the diabetes care solution, CSC’s approach of working with care teams to develop technology solutions has potential for a large range of clinical scenarios.
It’s All About Transformation
The work at George Eliot Hospital to improve diabetes care illustrates an important point about e-health optimization: For healthcare providers responding to shifting demographics, advances in medicine and changing patient expectations, incremental change isn’t enough. It’s all about transformation.
Successful IT-enabled transformation in healthcare organizations requires a clear purpose expressed as an achievable outcome, and a focus on change rather than on technology. Ultimately, that purpose is going to be linked to clinical outcomes and operational efficiency, and it needs to be expressed in terms that resonate with patients, clinicians and hospital staff.
As an example, a clear purpose might be improving the experience of care for a patient with a medium-severity respiratory condition, who may require up to 90 interactions with healthcare providers over a year. As part of their digital journey, healthcare organizations need to think about optimization in at least three areas:
- Making rich clinical and contextual data available at the point of care, wherever and whenever that may be
- Coordinating clinical care pathways across multiple care providers inside and outside of the immediate organization
- Improving the efficiency of routine operational processes everywhere across the organization and beyond
And they need to keep asking the question, “What’s in it for the patient?”
Dr. David Lee is medical director at CSC.