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Integrated PAS and clinical portal supports unified patient care pathway at Abertawe Bro Morgannwg

19 November 2014

Real-time updating and synchronising of patient data between the Patient Administration System (PAS) and a ward-based clinical portal is now taking place across all facilities within Abertawe Bro Morgannwg University Health Board (ABMU). This brings together into one coherent data pathway the two halves of the Board which merged in 2009 and supports a key aim of the merger of allowing patients to transfer to and from any Board facility. The integration, which was developed in-house using NDL’s awi SX application integration platform, has also avoided the resource-heavy process of manually re-entering an estimated half a million items of data a year.

The merger of Swansea and Bro Morgannwg NHS Trusts resulted in a mismatch in systems and created data quality issues. One area operated an in-house PAS with an integrated electronic clinical portal; the other had implemented the Welsh national PAS, Myrddin, but there was no clinical portal. A key aim of the merger - for patients to have unified care pathways across any facility in the Health Board - was only possible if it was supported by synchronised and real-time patient data.

Now, both Myrddin and an integrated clinical portal are operating across the entire Health Board. Staff can record real-time patient information in one system which is automatically updated in the other; this can then be presented to them at every stage in the patient journey at any facility, ensuring consistency of information across the whole organisation. This has also avoided the need for staff to double-enter into separate systems the 1000-plus items of data generated daily, enabling more time to be devoted to patient care; it also reduced the possibility of typographical errors, which can impact on patient safety.

The ABMU development team extended key PAS functions to the clinical portal, covering actions such as admitting elective or emergency patients, transferring patients internally or externally, discharging patients and undoing transfers or admissions. Critical to the success of the integration is that transactions are processed in the right order to preserve the integrity of patient records as they continue through their care pathway: this supports the aim of providing clinicians with the most up-to-date information.

Matthew John, ABMU’s Head of ICT Programmes who led the project, commented: “A PAS is the crux of the management of data in every hospital. If you want to bring the clinical world into the electronic world, you need to keep the PAS happy from admission to discharge. But bringing together the two different sides of our merged Health Board by implementing Myrddin and a clinical portal across the organisation presented us with significant integration challenges. It was only possible to achieve our aims by developing the solution in-house using NDL’s application integration toolkit: otherwise it would have been financially unviable.”

Matthew John believes that, without the integration, the Board would have had to retreat in its way of working: “We’ve been working electronically on wards in one half of the Board since 2005 but this would not have been able to continue. Without it, we would have needed an army of clerks to re-key all the data. Now we can take forward electronic ways of working, which helps with efficiencies across the organisation and gives clinical staff more time for patients.”
The new integrated system will also go live at a new outpatients unit in Swansea when it opens in 2015. This will use self-service kiosks for patient check-ins while referral to treatment information will be entered electronically by clinicians: all data will be transferred directly to Myrddin.

NDL Software Ltd supplies easy-to-use software toolkits to integrate disparate back-office systems and to develop offline, cross-platform mobile business applications. By radically simplifying these two key areas, NDL has given over 200 UK public sector organisations across local government and the NHS the ability to integrate and mobilise their systems. This has resulted in significant savings of both time and money, changing the way frontline services are being delivered. With a pedigree stretching over 30 years, NDL is a profitable UK company priding itself on both technical innovation and high standards of customer care.