Abstract

SO.19.08

Web-based electronic patient record as an instrument for quality assurance within an integrated care concept

Händel A.¹, Jünemann A.¹, Prokosch H. U.³, Beyer A.², Ganslandt T.³, Grolik R.³, Klein A.³, Mrosek A.⁴, Michelson G.¹, Kruse F. E.^1 
1Department of Ophthamology, ²Medical Center for Information- and Communication Technology, ³Department of Medical Informatics University of Erlangen-Nuremburg, Erlangen, ⁴Siemens Medical Solutions Health Services, Erlangen

Objective: Prerequisite for integrated care programs is the implementation of a communication network meeting quality assurance standards. Due to this background the main objective of the integrated care project between the university eye hospital and the health insurance company “AOK Bayern” was to evaluate the potential and the acceptance of a web-based electronic patient record in the context of cataract surgery.
Methods: Standardised modules for capturing pre-, intra- and post-operative data on the basis of clinical pathway guidelines for cararact- and retina surgery have been developed. There are 6 data sets recorded per patient (1 pre-operative, 1 operative, 4-6 post-operative). For data collection, a web-based communication system (Siemens Soarian) has been chosen which meets the high requirements in data security, as well as being easy to handle. This communication system and the embedded electronic patient record are independent of the software used by respective practices and hospitals. Data transmission and storage are carried out in real-time.
Results: At present, 88 ophthalmologists in practice take part in the IGV-contract with the university eye hospital. This corresponds to a share of up to 50% of all ophtalmologists in the region. In the period from Jan 1st 2006 to Dec 31th 2006, 1,583 patients were entered overall. Expressed in percentages, the fluctuations within a complete data entry per patient averaged at 12.2% (3.2% - 31.6%) within this period of time. For the evaluation of this data, a multidimensional report- and analysis-tool (“Cognos”) is being used. The post-operative development of the visual acuity, for example, showed a rise from 0.5 at the first post-operative control onto 0.8 at the fourth one.
Conclusions: The demonstrated web-based patient record is accepted by the connected ophthalmologists. However there are still concerns against the medical data exchange via the internet. Nevertheless the web-based patient record is an essential tool for a functional integration between the ambulatory and stationary health care units.

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