B.o.a.d. Regional Analgesia and Anaesthesia in Obstetric Patients

LOGBOOK USING THE WORLD WIDE WEB Dr R Verma Consultant Anaesthetist Southern Derby Acute Hospitals NHS Trust [email protected] A SIMPLE IDEA - I

Log on Enter data Log off A SIMPLE IDEA - II

Log on Review/analyse data on-line Produce any outputs from those on offer

Printout results Log off A SIMPLE IDEA - III

Log on Review/analyse data on-line Download data

Do what you like with the data Log off PERCIEVED ADVANTAGES OF AN INTERNET BASED LOGBOOK I Data can be input from anywhere

Software is web-based hence universal and centralised

Robustness assured Data integrity Backups Virus protection

Data security Software tweaks and upgrades PERCIEVED ADVANTAGES OF AN INTERNET BASED LOGBOOK II

Password control of users Hierarchy of level of access Individual College tutor

Regional advisor Administrator(s) Predefined reports

SQL user defined report facility ANXIETY ISSUES Dont want to write code

Will take far too long (lonely hours in the loft) Will have too many bugs (not robust enough) Will never be as good as the professionals

Got better things to do Buy in expertise BUT Beware promise-ware versus software

Need some understanding of technical matters Funding DATA PROTECTION ACT The DPA (1988) has been established to prevent misuse of individuals sensitive personal data, pertaining to an individuals physical or mental health or condition.

Those storing information in an identifiable form are obliged to register with the Data Protection Registrar and take reasonable measures to secure the data. Is your logbook legal. Ann R Coll Surg Engl (Suppl) 2003; 85: 88-89 High proportion (all grades) store patient information

Easily identifiable form Rarely password protected, largely unsecure Only a small minority registerd with the Data Protection Registrar

THE PILOT Supported by grants from Outcome Technologies

Formerly Weboutcome.com IMPLIMENTATION - I Used the RCA logbook dataset Well established

Small, concise with a track history Widely used by trainees hence familiar and not New Probably needs a re-vamp

IMPLIMENTATION - II Testing the concept of an Internet based logbook Nothing more

Nothing less No ambition to enhance, modify, improve the dataset IMPLIMENTATION - II

Short time scale Hence expected the product to be limited bearing in mind its potential Bought in technical expertise SPECIFICATIONS

RCA dataset Access via the internet Assure security, integrity of data

Input with adequate error checks Varying levels of access to the data Ability to download ones own data in different

formats Few pre-designed outputs e.g. RITA form THE PILOT - I Http://www.alogbook.com

THE PILOT - II Consultants SpR = = SHO = Assoc. Spec. 14

23 = Unknown Less Apologies = Less e-mail failure ----94 57 8

= 1 -6 = -3 FOLLOW-UP QUESTIONNAIRE Preliminary results

Registered = 104 Not used yet = 44

System used = 64 Feedback = 36

Do you use the RCA logbook regularly? 24 25 20 15 10 10 5 0

Yes No Do you or have you used the following versions of the RCA logbook 16 16 14 12

11 11 10 8 6 4 2 0

Paper PDA/Handheld PC based Did you find the RCA software? 16 16 14 12

10 8 6 3 4 2 0 1 Easy

Fairly Not Easy 2 Difficult How did you find the the use of this Internet logbook? 12

11 11 10 8 8 6 4 2 2 0

Excellent Good Fair Poor How did this compare with your previous use of logbooks?

11 12 10 8 7 6 6 4 2

0 Better Same Worse Did you have problems with .. 30

30 26 25 21 20 Yes 15

9 10 5 0 4 Registration 6

Logging Entering No Did you have problems with .. 25 23 19

20 15 Yes 10 5 No 9

7 3 1 0 Retrieving Data Retreiving RITA Didn't Bother

Did you have problems with .. Speed of Access 21 25 20 15 10 5

5 0 Yes No Where do you update your logbook? 14 14

11 12 10 9 8 6 4 2 0

Theatre Work Breaks Home Do you have Internet access 30 30

28 25 20 15 18 14 11 10

5 0 Theatre Op Suite Dept Library Home

Did you access the internet logbook from 14 14 13 12 9 10

8 6 4 2 0 Hospital Home Both

What internet connection do you have at home? 25 22 20 15 11 10

5 0 Dial-up Modem ADSL/DSL Broadband Would you like to see the concept of an Internet logbook developed further? 25

21 20 15 8 10 5 0 Yes No

FUTURE DEVELOPMENT- Academic Improve dataset e.g. d.o.b Enhance existing dataset e.g. were the blocks effective? Revalidation data Appraisal data C.M.E points register FUTURE DEVELOPMENT - Technical

Improve user interface End users need training in using the software On line or other help lines FUTURE DEVELOPMENT - Technical Modules for PDAs/Handhelds One click synchronization (possibly wireless) Modules for stand-alone or networked PCs One click synchronization Integrate with Hospital Intranets Eliminate duplicating data entry

Thank You

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