Order entry in Radiology Our experience R Etherington Countess of Chester Foundation NHS Trust 25/3/11

Background 620 bed DGH 620 bed DGH 2 sites 2 miles apart 2 sites 2 miles apart exams/year exams/year New RIS in 1999 (Meditech) New RIS in 1999 (Meditech)

RIS – seconded a superintendent radiographer to IT for 6 months RIS – seconded a superintendent radiographer to IT for 6 months Extended to order entry in 2000 Extended to order entry in 2000

Are you going to do it? Big bang Big bang Slowly Slowly Terminology of ordering Terminology of ordering

General advantages Increased general familiarity with IT Increased general familiarity with IT –Important in the early days pre-PACS

Specific advantages No lost requests No lost requests

Specific advantages No lost requests No lost requests Audit trail Audit trail

Specific advantages No lost requests No lost requests Audit trail Audit trail Speed of transmission Speed of transmission

Specific advantages No lost requests No lost requests Audit trail Audit trail Speed of transmission Speed of transmission Legible Legible

Specific advantages No lost requests No lost requests Audit trail Audit trail Speed of transmission Speed of transmission Legible Legible Specify who can request/what can be requested Specify who can request/what can be requested

Specific advantages No lost requests No lost requests Audit trail Audit trail Speed of transmission Speed of transmission Legible Legible Specify who can request/what can be requested Specify who can request/what can be requested Define compulsory questions Define compulsory questions

Specific advantages No lost requests No lost requests Audit trail Audit trail Speed of transmission Speed of transmission Legible Legible Specify who can request/what can be requested Specify who can request/what can be requested Define compulsory questions Define compulsory questions Avoid printing and scanning Avoid printing and scanning

Problems Brevity Brevity

Problems No picklist so forced to use free text No picklist so forced to use free text

Problems Brevity Brevity No picklist so forced to use free text No picklist so forced to use free text Password abuse Password abuse

Problems Brevity Brevity No picklist so forced to use free text No picklist so forced to use free text Password abuse Password abuse Limited space for clinical information and limited user-defined options Limited space for clinical information and limited user-defined options

Problems Picking up a study heading that doesnt accurately reflect what is wanted Picking up a study heading that doesnt accurately reflect what is wanted –CT –MR arthrograms

Problems Picking up a study heading that doesnt accurately reflect what is wanted Picking up a study heading that doesnt accurately reflect what is wanted –CT –MR arthrograms Cant restrict studies for Radiology use only Cant restrict studies for Radiology use only –Calcium scoring, CT colonoscopy

Problems Picking up a study heading that doesnt accurately reflect what is wanted Picking up a study heading that doesnt accurately reflect what is wanted –CT –MR arthrograms Cant restrict studies for Radiology use only Cant restrict studies for Radiology use only –Calcium scoring, CT colonoscopy REQUESTING ON THE WRONG ACCOUNT NUMBER REQUESTING ON THE WRONG ACCOUNT NUMBER

Where we are now, 11 years later Hard to remember life before OE Hard to remember life before OE

Where we are now, 11 years later Hard to remember life before OE Hard to remember life before OE Every internal request is electronic Every internal request is electronic

Where we are now, 11 years later Hard to remember life before OE Hard to remember life before OE Every internal request is electronic Every internal request is electronic Most GP requests are typed and transmitted electronically and all are transcribed into the RIS/PACS Most GP requests are typed and transmitted electronically and all are transcribed into the RIS/PACS

Where we are now, 11 years later Hard to remember life before OE Hard to remember life before OE Every internal request is electronic Every internal request is electronic Most GP requests are typed and transmitted electronically and all are transcribed into the RIS/PACS Most GP requests are typed and transmitted electronically and all are transcribed into the RIS/PACS Rolled out to most of Pathology, CVD Rolled out to most of Pathology, CVD

Improvements Id like to see Ability to tailor it to our specific requirements Ability to tailor it to our specific requirements Direct link for GPs Direct link for GPs

Thankyou