P0539 / #801: DEVELOPING CLINICAL INFORMATION SYSTEM IN A PAEDIATRIC INTENSIVE CARE UNIT – SIMPLICITY AND EFFICIENCY MATTER FOR PHYSICIANS

Abstract

Aims & Objectives: Clinical information system supports electronic health record, computerized physician order entry, clinical decision support, and data science application. We described its early development in a paediatric intensive care unit. Methods: A case study and qualitative analysis of a unit as part of a new children’s hospital. Period was from opening on 27th March to 31st December 2019. Physician’s team included 8 seniors and 2 rotating residents. Bedspaces expanded from 4 to 6. Metavision (iMDsoft) was used, and integrated with the medication ordering function of the hospital’s clinical management system. The feedbacks, monthly updates, and meeting notes were reviewed; and the process was summarised. Results: The first phase focused on fine-tuning with daily workflow. Effort to improve the comprehensiveness of physician order entries, and incorporate computerized entry into doctor’s routine. Graphical representation and trending was promoted to facilitate data interpretation. The second phase focused on addressing doctor’s acceptance, as cases grew in complexity. Entries that were inefficient were replaced by free-text. Frames were re-positioned to reduce time lag. Education was prioritised, as rotating residents showed low incentive to familiarize and were stressed by the system requirement. The third phase focused on improving quality of documentation, as the system was simplified. Redundant notes from “copy and paste” were discouraged. The next steps were: develop clinical decision support for specific conditions, and start automated data extraction for audits. Conclusions: A simple and efficient system for documentation and orders appeals to new users. However, clinical information system’s potentials are to be fully utilized through development of clinical decision support and data science application.