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The Nexus EPR solution is not one system but consists of a number of interlocking systems and modules which can be implemented over time to suit each hospital.
A nation wide system where every patient can be booked into any hospital for any kind of care with their records instantly available electronically wherever they are. A pipe dream? Not in Northern Ireland where Nexus EPR was implemented - on time and on budget.
Newgate’s Nexus EPR (Electronic Patient Record) solution was chosen as the system to provide patient administration, booking and theatre functions in a nation-wide solution for Northern Ireland.
The Nexus system links all hospitals and can maintain an Electronic Patient Record for the processes from GP Referral, through the initial consultation, pre-assessment and theatre episode to discharge.
It processes Referrals, schedules Consultations, books pre-assessments, books theatres and records everything which happens to the patient electronically. The information is then stored as an electronic patient record centrally and can be accessed from any hospital in Northern Ireland.
Nexus enables patient records for all patients to be linked to their Health & Care Number (the Northern Ireland equivalent of the NHS Number). So, if a patient has a number of different hospital records because they have visited different hospitals, Nexus enables these to be linked together to form one overall record. Crucially, for each patient, Nexus also keeps a record of all hazards and all past episodes of care. Northern Ireland chooses Nexus EPR.
Core EPR System
Nexus links, via a number of methods but predominantly HL7, to an existing patient database and replicates the data within the Nexus core. It can also receive messages, such as a referral, from the existing hospital system thus any legacy P AS type system can remain in place with the hospital still being able to utilise the many benefits Nexus brings.
Patient Choice Booking
As described previously, Nexus allows a patient who is willing to travel to be booked from their local hospital into any other hospital thus minimising patient wait times and maximising the use of operating theatre time. This would be almost impossible if the Nexus EPR was not available and localised checking of resources were not possible.
Through the Nexus Resource Centre, staff or equipment is monitored so that warnings are provided at point of booking if resources are unavailable due to usage in another theatre or being out for maintenance. This is crucial when cross hospital booking is being done for patients.
Quick and Easy Input in Theatres
Within Theatres, Nexus Touchscreen terminals enable staff to quickly and easily complete information about the patient's journey. Pre-assessment and pre-op information is instantly available and progress of the patient through the anaesthetics room, theatre and recovery is recorded merely by the touch of onscreen buttons. Through a web based module, wards and departments can also view, in real-time, the progress of the patient through theatre and receive post-op information in advance of the patient leaving recovery.
Sterile Services and Third-Party System Integration
Although Nexus Sterile Services is a complete SSD solution in its own right, the Nexus system also enables, for the first time, complete integration of third-party, non-Newgate, systems such as those providing sterile services tracking. This is intended to make cancellation of procedures due to non-availability of theatre instrument trays a thing of the past. The system monitors the location of every tray and pack allowing S SD and Theatre staff to quickly search for any particular item.
The Nexus Surgeon’s Assistant and Endoscope Assistant module also enables clinicians to easily and quickly complete their theatre notes by touchscreen including the use of freehand diagrams, digital images and even voice notes.
What does having a Nationwide EPR mean in practice?
If a patient is referred to Belfast City Hospital and a decision is made that they require a procedure then the consultant can instantly see that they can be offered a theatre slot in Belfast City in, say, six weeks time. Nexus, however, will also indicate to the consultant that a slot is available in Altnagelvin Hospital the following week. The patient can then immediately be given that choice and can then choose to travel to Altnagelvin.
The patients pre-assessment, however, can still be done in Belfast because the information will be available electronically to the staff in Altnagelvin. Of course, if the patient subsequently undergoes surgery in Altnagelvin, staff at Belfast City have immediate access to their operating theatre records including staff and procedure notes etc.
Not only does this provide excellent patient choice and service which is known to reduce DNA’s but, as a consequence, it helps to maximise theatre utilisation not just in one hospital but, in fact, country wide.
Because a complete Nexus solution can be implemented over time and can exist alongside a hospital’s existing patient record system there is no need for the “big bang” process necessary with many Patient Administration Systems, many of which, unfortunately, fail to deliver.
This approach means that a long term implementation strategy can be undertaken thus minimising disruption to hospital processes and bringing with it considerable staff, administration, management and financial benefits...