By using an optical mark reader from Kendata Peripherals, the intensive care unit of the University College London Hospitals Trust has been able to make a significant reduction in the amount of time its junior doctors spend entering patient data into the ICU's computers.
At the same time, the quality of the information gathered has improved to such a degree that it can now be used as the basis for the unit's invoicing system.
With a total of 22 beds on two sites, the ICU has been collecting detailed clinical information on all its patients for several years, primarily as an aid to management decision-making. Each night, a junior doctor would sit at the computer and tap in the details of all the medical and nursing interventions that had been carried out on each patient during the day. Although this data-entry task was facilitated by the use of a database with
multi-level choice lists, it still required many keystrokes on the 'down arrow' and 'return' keys, and sometimes took nearly an hour to complete.
With the recent reforms in the health service and the consequent need to invoice other departments or hospitals for treatment given to their patients, UCLH ICU took a close look at the information it was collecting and discovered that it was not accurate enough to be used for billing purposes.
"Part of the problem was that at the end of the day the doctors keying in the data were unable to remember the exact details of the treatment given to all the patients in the unit," said the ICU's research officer, Steve Batson. "Eventually we decided that the best solution would be the Kendata system, which consists of 'multiple-choice' data-entry forms together with an optical mark reader to scan them into the computer."
Working closely with Batson to ensure that the unit's requirements were met, Kendata produced a carefully designed form, split into 14 different sections covering a total of 113 possible treatments. "Because the form is well laid out and uses simple yes/no questions, there is very little that can go wrong with the system," commented Batson.
Although the junior doctors still have responsibility for the data collection task, the forms are actually filled in by each patient's nurse, since she is in the best position to know exactly what treatment has been given during the course of the day. The doctor then gathers up the completed forms and simply feeds them into the OMR, enabling the daily data collection task to be carried out far more accurately and far more quickly than was previously the case.
18th July 1996 Ref. KE4/2