Abstracts

Electronic health (eHealth) services have the potential to enhance epilepsy care by improving integration of health services. Electronic patient records (EPR) provide basic infrastructure for eHealth services. An EPR supports pre-service, point-of-service and after-service enhancements for all stakeholders [ndash] patients and their carers, clinicians, health researchers and healthcare managers. EPR[apos]s facilitate the continuity of patient care both within and across healthcare organisation boundaries as simultaneous and/or remote access by multiple users is possible. Data protection and security is enhanced with an audit trail of all accesses to the record which is role-based and limited to authorised and authenticated users. An EPR supports health service monitoring, planning, and health research as it provides ready access to large volumes of integrated, harmonised and consistent patient data. While the potential benefits of EPR[apos]s are clear, their design, development and implementation represent a socio-technical challenge.
The epilepsy programme at Beaumont Hospital aims to design, develop and implement a standards based secure EPR to support epilepsy clinical services and research activities. System design involved a qualitative study to determine user and domain requirements, data protection, security and training requirements, and to inform software engineers. Study subjects included potential users of the EPR [ndash] epileptologists, NCHDs, epilepsy nurses and the epilepsy clinic administrator. Data collection Multi-stage interviews following a Delphi technique were conducted with potential users; ethnographic fieldwork was conducted to observe users in the environment where the EPR will be used. Data collected were used to establish the granularity of field requirements for the EPR; process-mapping was conducted to illustrate the workflows that the EPR would support; a set of use-cases, or sequence of transactions, required for effective interaction between users and the EPR was determined The technical development of the EPR is based on international healthcare standards. It has two components, one which manages generic patient information and one that manages epilepsy specific information. The system architecture can therefore be applied to develop EPRs for the management of other diseases. The epilepsy EPR development is at an advanced stage. 16 of 30 use cases are complete. User acceptance testing commenced in April 2005 and we expect roll-out of phase 1 to the epilepsy out-patient service at Beaumont Hospital in Summer 2005. In this presentation we will demonstrate our experience with the project to date and the first phase EPR user interfaces. Building on this infrastructure we aim to further enhance the care of epilepsy patients by providing remote access to the EPR to healthcare professionals in other settings and to authorised patients. (Supported by the Irish Health Research Board.)