Abstracts

Rationale: Advances in medical science and technology have led to improved health outcomes for many chronic diseases including epilepsy. An associated increase in diagnostic and therapeutic complexity is causing a burgeoning strain on health care systems. To maximise the benefits of medical science while minimising the burden on healthcare systems, there is an international move to transform the way chronic disease is managed which recommends shared care that is integrated across organisational boundaries and is supported with information communication technology (ICT). Electronic patient records (EPR) facilitate information sharing and exchange and can promote a continuum of healthcare services for the benefit of the patient. The aim of the research and development programme described here is to design, develop, implement and evaluate an epilepsy EPR. Methods: Experts in the provision of epilepsy care at a specialist centre in Ireland defined the requirements from which a comprehensive EPR application which includes: demographics, social history, anti-epilepsy drug (AED) history, epilepsy history, allergies, vagal nerve stimulator, investigations and clinic visit modules. The EPR has been implemented within an epilepsy service and its impact on service delivery, patient care and clinical research is being evaluated. Results: There are 22 users of the EPR (epileptologists, nurses, researchers and administrative staff) which contains the records of over 700 individual patients. The following are examples of the impact of the EPR on healthcare process. Create once, use often Instead of each clinician in different parts of the service having to record the same information, a central EPR can be accessed and updated if required. Finding information in a complex medical record Navigating through a traditional paper record is time consuming and may not produce the required information e.g. all prior AEDs, diagnostic investigation results, allergies. A few clicks of a button can lead the clinician to the desired information. Improved communication Clinical information stored in different modules of the EPR is pulled into an automatically generated letter and if required additional comments can be added. The letter can be reviewed via an electronic portal by the referring clinician or sent by post in hardcopy format. Interrogating the EPR Lists of patients who meet particular criteria can be generated. This facilitates epilepsy research and service monitoring activities. Telephone advice service The EPR makes the telephone advice process more efficient, the patient’s record is accessible to the nurse during the call and if further advice from the epileptologist is required, they can both simultaneously review the record at their individual desktop PCs. Conclusions: Application of the EPR in an epilepsy service in Ireland is resulting in improved processes of care and a refocusing of resources into more value added activities. The ultimate benefit is improved quality of care for patients. Acknowledgement: This work is supported by a grant from the Health Research Board in Ireland