Tallaght hospital: Tallaght hospital's rapid diagnostic breast unit has cut the cost of carrying out clinical audits by 43 per cent and says it is able to offer patients assurances about quality of care following the introduction of a new computer system.
The new system means that all patient data - from arrival at the outpatient clinic to prognosis, treatment and outcome - is stored electronically rather than on paper charts.
As a result, clinical audits can be carried out in a matter of hours rather than days or weeks.
The rapid diagnostic clinic provides a same-day diagnostic service for women who discover a lump on their breasts.
"We see over 1,200 new patients a year with breast symptoms," said James Geraghty, consultant breast surgeon in Tallaght hospital. "The issue for us is that we have to have the ability to guarantee the quality of service we have to offer. Without the electronic system, we would have to review 1,200 paper charts."
With the new system, a specific report can be produced in as little as two or three hours using software from French software company Business Objects.
The tool enables users to choose different sets of data and run analysis on it in a much more efficient manner than using spreadsheets or other manual tools.
The application, which stores the electronic data about patients, was developed inhouse over a six-month period, according to Michelle Atkinson, ICT/cancer project co-ordinator in Tallaght hospital.
When assessing a patient, the system guides the doctor through the consultation and ensures all relevant questions are asked.
All of the fields on the patient records are mandatory so a doctor cannot submit the details without asking all the questions.
"When the patient is changing for the examination, it only takes a minute to enter the data onto the system because it makes use of tick-boxes and drop-down menus," said Mr Geraghty.
"Because the fields are mandatory, it forces you to ask all the relevant questions. The audit loop is completed with the system. The audit was always the problem, because we see such a large number of people," he said.
"If we are not getting something right, we can change our protocols based on the result of the audit."
The new data assists in the management of care for cancer patients. It gives clinicians the information they need to plan and develop the services their patients' need, monitor their progress and optimise hospital resources to ensure patients receive the best possible care available.
"We installed the cancer audit system in theatres, enabling the surgeons to enter their data directly after completing surgical procedures on cancer patients," said Ms Atkinson. "Entering the data in real time is accurate and eliminates the need for a third party to try to interpret complex handwritten operative notes at a later date," she said.
Tallaght hospital also operates a follow-up clinic for women diagnosed with breast cancer, a breast reconstruction unit, and a family risk assessment unit for women whose family history suggests they may be at risk of developing breast cancer.
Mr Geraghty said they were developing similar electronic systems for these clinics which would be introduced later this year. Computerising the family risk assessment unit presents particular challenges as electronic models of family trees will have to be produced.