1. Renal PatientView Sep 2008 Neil Turner

2. Shots from RPV, arranged as if you are clicking through it
Shots from RPV, arranged as if you are clicking through it. This is the screen you see at Click on ‘view a demo’ at the foot of the page …

3. Renal PatientView
RIXG
Organisations represented on RIXG

4. Sample Proton screens
First thing docs and patients asked about was could they see results online without having to ring up for them
Sample Proton screeens (these ones are from Edinburgh) showed that these figures were already in computers on units, patients said ‘that’s what we want to see’

5. And indeed this is what they see
And indeed this is what they see. Clicking on the Results tab takes you here. The heading of each column links to info about the test …

6. The heading of each column links to info about the test …

7. NHSnet The world Satellite unit Other hospitals Renal server
(e.g. Proton)
The world
Webserver
RPV solution. Red arrows mean data transfer is encrypted. Renal server sends daily (at the moment, could be more frequent) downloads of data from records of opted-in patients.
Satellite unit
Other hospitals

8. Aug 2008
8000 patients
33 units

9. Design principles Renal PatientView Internet: view anywhere
Open source engineering
Specification by patients, renal IT staff and clinicians
All would share same view
Implementation to require minimal extra work in units
Simple to use for patients
Opt in

10. This is what you see when you log in with your username and password
Now click on Patient Info …

11. Here is info arranged according to the patient’s diagnosis and treatment.
The links at the bottom (‘Further Info’) are shown for all patients. We may add ‘Additional info for children’.
The info linked from these has been selected by, but is not written by the RPV team. A multidisciplinary group is being assembled to review and update the info links provided (the RIXG Information Review Panel).
Here are some examples of info according to diagnosis, in this case diabetic nephropathy …

12. e.g. for a patient with diabetic kidney disease. From the NKF …

13. For a patient not on dialysis and not tranpslanted, this is one of the links (from EdRen). Down the page …

14. Treatment choices
Is info about the different treatment options, including Conservative Management

15. A link for a haemodialysis patient

16. Working along the tabs, here are results again
Working along the tabs, here are results again. There are 4 screens but could be more; they include tests of kidney function, anaemia, blood pressure, dialysis adequacy, and more.

17. Medicines are at the moment exactly as recorded in the renal unit’s computer system so a number of cautions are necessary at the top.

18. Although we were initially a little concerned about the possibility that letters might be the most sensitive elements of the record, they have been extremely popular and are the most requested item in units where they aren’t shown.

19. Now click on Patient Info …

20. Patient evaluation Renal PatientView
In essence – extremely positive (details available)
Tests are the things looked at most frequently
40% of patients have shared passwords with others and we know some are dependent on others for access
Little extra work to maintain

21. Formal evaluation Renal PatientView Barriers to use
64% non-users didn’t know of RPV
Gender profile same
45% of non-users over 66yrs cf 10.5%
Lack of computer/internet access the second most common stated reason
Little extra work to maintain

22. Impact on unit Renal PatientView
Not leading to extra consultation time
Or to increased patient anxiety
Anecdotes of info availability helping patients beyond simple confidence
Some improved compliance?
Effect on data quality – direct and indirect
IT people speak to patients more
Little extra work to maintain

23. Hidden cost? Renal PatientView RPV admin’s extra time
6 mins per enrolment
Lost passwords
More corrections (a good thing though)
Versus savings
Fewer phone calls about results
Data quality
Better compliance with treatment?
Little extra work to maintain

24. Availability through other portals
Renal PatientView
What next?
More units
More items
Graphics
Availability through other portals
Mention more data, more units

25. Patients send feedback to unit, clinician Primary care integration
Renal PatientView
What next?
Patients discuss
Patients enter data
Patients send feedback to unit, clinician
Primary care integration
Your ideas

26. [Caption competition]
Renal PatientView
[Caption competition]
Beach scene
Further info