There are great challenges facing surgeons and hospital trusts to assess their performance both in terms of clinical outcome as well as cost effectiveness.

“Evidence based Medicine” can sound like yet another jargon-based phrase that has a very little meaning. The reality is though that healthcare institutions are creating more data than ever before and when mined for information this data can be extremely valuable both in care of patients and in reducing costs.

Collection of data for audit and research is an essential part of this, also with the recent discussions regarding implant recalls and an increased emphasis on evidence-based medicine in fields like oncology and orthopaedics, outcome scores and patient reported outcome measures (PROMs) as well as quality of life questionnaires are becoming more and more of a necessity for an accurate gauge of patent care.

What problems do practitioners and institutions face when collecting this kind of data?


Problem: Data Capture

    Paper form filling means that the data has to be collected and manually entered. This is a significant overhead for any hospital or institution

  • Paper form filling by the patients or doctors can sometimes lead to ambiguity
  • Paper adds an extra step and often a research assistant is needed
  • Often there is not the time to enter the data when collected so sheets go missing

Solution

    KM MEDICAL’s iMedAudit suite of products is designed to manage clinical audit and patient data capture quickly and easily by a mixture of touch screen scores and cloud based collation. It allows:

  • Clinical precision during the audit process
  • Reduces pressure on the clinical audit team
Our clinical audit products offera suite of applications and solutions to suit differing infrastructural requirements and that can interact with any existing legacy system in a hospital.

iMedOrtho is a product that deals with a difficult problem in modern orthopaedics.

The Problem: how to capture, collate and report on orthopaedic outcome scores?

iMedOrtho harnesses the power of cloud computing and mobile health platforms to allow you to collect outcome scores for a large orthopaedic department or even a group of hospitals

iMedOrtho which is web-based and allows capture of outcome scores with an iPad app or a touch screen kiosk but can centralize a multi-site, multi-practitioner study. It allows researchers to create different studies, assign scores and set follow-up increments as well as email patients a secure link to enter patient related scores online. Here are some details on how this technology works and can be adapted to the needs of a hospital department.Below are the elements of the solution and how they work together

The web-based portal allows centralization of all surgeons in a hospital or group. Researchers or administrators can access all figures centrally, they can create study groups, assign outcome scores and how they are to be collected.

Surgeons can log into the portal and enter their own clinical data and look at their own patient outcomes. They can run reports on implants; age/gender and specific approaches used and get real-time statistics on outcomes.

How do we capture the data from the patient?
  • iPad/tablet interfaces
  • Touch Screen Kiosk in waiting rooms
  • Email patients follow up forms
We can brand the iPad app to any hospital, trust, clinic or company. Management of the scores is centralized.

The interface is specially designed to be easy to use for patients unused to computers. The interface is one question per page and takes one tap per question to answer.

The app will sync with theweb portal and give live reporting on all the data collected immediately. It immediately access the result of the score the patient has filled in the waiting room just before a consultation. These iPad interfaces can operate over WiFi in any location. The servers can be installed in the hospital or clinic to keep the data secure. Offline apps can also be used in an envoirnment with no WIFI that allow the data to be synced later.

Touch Screen Kiosks
In theiMedOrtho suite we can also provide branded touchscreen kiosks in waiting rooms or Outpatient facilities. These kiosks will boot automatically to a welcome screen. The administrator or secretary can specify from their own computer terminal the patient and what survey / score they are to fill in. The patient can then be directed to the kiosk where it will automatically greet them by name and invite them to start the survey. This information will then automatically sync with the main score database and is immediately accessible

Email Follow up
If the patient has email they may give permission to be emailed a follow up scores. After a certain time lapse the system will email the patient with a link to an online form. The patient can answer the online survey and submit the score. The results syncs immediately back to the main study database and alerts the administrator that the score has been completed.

Reporting
Practitioners and clinical specialists can now start looking at data as it appears in the system. Surgeons can view individual patients and their scores or they can look at groups of patients " And run bespoke reports.
  • Researchers can log in and look at live data
  • Run custom reports
  • Run anonymized Reports
  • Gender / Age analysis
  • Cox regression
  • Wald and Score tests to see statistical significance
  • Kaplan Meier statistical analysis
Integration and Export of data
Although the application suite has excellent reporting and analysis there are many occasions where it will be useful to export this data into existing hospital information systems and medical records. iMedOrtho can export this data in CSV or Excel format as well as generating" helpful reports in PDF format."

iMedOrtho can also be set up to send HL7 messages to any Patient management, EMR or Hospital information System meaning that this valuable information is not trapped in one piece of proprietary software.

Researchers have the option to create their own reports using any of the data entry fields.The intuative interface allows ad-hoc reports to be made quickly and stored.

This allows the software to change along with the changing requirements of a research institution.

In research studies there are always requirements for additional questionnaires and formsthat can supplement more established scoring systems. Our framework helps you build your own.

You can apply scoring and weightings to multiple choice questions and get patient and clinicianfree text input as well as date and time input. Our form builder allows the researcher to easily drag and drop form elements and bulk upload questions for quick and easy form creation.

Questions to consider?

Is touch screen data capture the answer?

Has there been any research in this area?

A study of 1348 patient scores collected by paper and then touch screen in Royal Cornwall Hospital, UK showed some interesting findings.
  • 91% correctly entered their hospital number and date of birth,
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  • he average time to complete the scores was 4.7 min rising with age.
  • Scores can be collected in very large volumes using a touchscreen
  • The method is acceptable to patients, independent of ageand computer experience
The main conclusion of the study was that with the touchscreen input

The accuracy was higher than for paper versions of the score

How Safe is it?
With this application suite we offer a range of different hosting and secutity options. If you run a small clinic or practice we offer private cloud hosting. This is a data centre which is ISO accredited and which is authorised to store medical data. Your data will not be stored with any other data and is monitored 24 hours a day in a highly secure data centre. All data is backed up to a second location and can be recovered if anything happens to our primary data centre.

On Site Hosting For enterprise customers in hospitals, trusts or large companies we offer the option to host " the application in the IT infrastructure of the customer "
we offer RSA authentication, Active Directory integration as well as many other enterprise level" security measures