Beaumont Hospital

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Minister Launches Innovative Electronic Patient Record to Aid Chronic Disease Patients

Thursday January 21, 2010

The Minister for Health & Children, Ms Mary Harney TD, today (Thursday 21st January 2010) launched an innovative approach to managing chronic disease through the use of Information Technology.

The secure, web-based, electronic patient record (EPR) is already helping to provide seamless care for more than 1,000 people with epilepsy who attend Beaumont Hospital. Funded by the Health Research Board,  the EPR has been developed by Beaumont's Epilepsy Team and IT Department in association with Trinity College Dublin.

The EPR improves both the quality and safety of care patients receive compared to traditional paper-based records, allowing one or more users to access and appraise the information at the same time and in a variety of ways, irrespective of location. It is intended to extend its use to manage care of epilepsy patients nationally and also to explore its potential in the management of a range of other chronic diseases. 

According to Dr Norman Delanty, Head of Beaumont's Epilepsy Team, the EPR now in daily use in the hospital ensures that clinicians have access to timely and consistent information.

"In the future we would like to further exploit this enabling technology by extending access to the web-based epilepsy EPR to authorised clinicians (community nurses, general practitioners, epileptologists) beyond Beaumont Hospital and to authorised patients," he says.

"The EPR has the potential to become a central hub linking healthcare services to healthcare constituencies - patients and healthcare professionals at any location - and facilitate information sharing and exchange.  It could promote a continuum and cost effectiveness of epilepsy care by improving quality, safety and efficiency of services and promoting shared care networks both within and across healthcare agencies."

Mary Harney EPR Conference

Front row, l-r: Norman Delanty, Consultant Neurologist; Professor Jane Grimson, Centre for Health Informatics, Trinity College Dublin; Mary Harney, TD, Minister for Health and Children; Mary Fitzsimons, Principal Physicist Epilepsy Programme, Beaumont Hospital; Back row l-r: Professor Charles Normand, Department of Health Policy and Management, Trinity College, Dublin; Professor Dipak Kalra, Centre for Health Informatics and
Medical Education, University College London.

Mary Fitzsimons, Principal Physicist with the Epilepsy Programme, points out that learning from this project can be extended to other similar complex chronic diseases. She notes that advances in medical science and technology are leading to better outcomes and greater life -expectancy for people with chronic illness.

"Associated with these advances is an increase in diagnostic and therapeutic options for managing many conditions. This is leading to a burgeoning demand on health services that the current fragmented models of healthcare are struggling to meet.

"For example, there is poor integration of primary care services with hospital-based healthcare services. This is leading to an international move to transform the way chronic disease is managed. Among the recommendations of international chronic disease management models is a call for shared care that is integrated across organisational boundaries and supported by information and communication technology. " 
The electronic patient record (EPR) developed by the Beaumont-based team has been shown to provide a robust solution which can be extended to help link healthcare services to healthcare constituencies - patients and healthcare professionals at any location.

At present, it is estimated, epilepsy affects up to 37,000 people in Ireland. A secure web-based EPR stored centrally has the potential to ensure that patient information is available when and where needed so that clinicians at any location will have access to the same single record for an individual patient. This results in benefits such as speedy liaison across all sectors (community, primary care and hospital) and shared decision making in relation to an individual's care.

In the Beaumont epilepsy programme, for example, it can greatly reduce the time needed to review complex medical records taken over years when optimising anti-epileptic drug therapy, it supports the epilepsy nurse telephone advice line, helps identify patients meeting the criteria for clinical research studies and greatly improves communication with referring clinicians.

Research indicates that in addition to delivering significant benefits for the patient, an efficient ICT-based approach to management of a chronic condition yields important financial savings for healthcare providers by improving productivity, eliminating unnecessary investigations and reducing the length of time patients spend in hospital.

It is estimated that unnecessary admissions to Irish hospitals because of seizures and misdiagnosis of epilepsy currently costs the Irish Exchequer in the region of Euro 7 million a year. In addition there are further costs related to inappropriate use of Emergency Department resources and anti-epilepsy drug prescription.

Over the course of this HRB funded R&D programme the team at Beaumont Hospital has also learned important lessons about the barriers and facilitators to implementing the technology in healthcare. Achieving successful implementation of an EPR is complex requiring attention to the technology as well as the human and organisational setting into which it is being introduced.