IT Innovation Contest

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PandO DB - SFGH Pain and OB Patients Database Application

Submitted by Oliver Radke on July 13, 2012 - 1:39pm Last revised by Web Producer on August 25, 2014 - 10:06am.
Proposal Status: 
Review Complete

The Pain and Obestetric Anesthesia Database (PandO DB) is a project of the Dept. of Anesthesia at SFGH to facilitate the management of block patients, pain patients and laboring patients at SFGH.

At SFGH we perform up to 50 regional anesthesia cases per week, both single shot and continuous nerve blocks. Additionally, we place epidural catheters for surgical as well as for laboring patients. All these cases patients need proper documentation and follow up.

What’s challenging about this is that the patients are seen by several different anesthesia providers. Our shift changes twice every day, and the patients are seen by different attendings and residents.

We are currently keeping track of the patients and the interventions by using multiple paper forms. It is difficult to ensure that all the relevant information is passed on, and that the anesthesia residents have access to the relevant information when they are paged. Additionally, we face potential PHI issues with paper notes, and we cannot analyze the data for quality assurance.

Aims

  • Replace current pain & OB cards to avoid PHI problems and improve i
  • Collect data for quality assurance
  • Facilitate follow-up by OB/Pain service and for in-house single-shot blocks
  • Optimize handover between providers
  • Replace current pain service forms
  • Hold all relevant data in terms of medical information, legal information and billing
  • Collect data to allow comparison with national and international pain benchmarks
  • Physically based on a secure server (HIPAA compliant) with regular backups and high availability
  • Web-based user interface, scalable for mobile devices (e.g. iPad, iPhone) and PCs
  • Compliant with HIPAA, JCHO, Pharmacy policies, MERP requirements
  • Allow export for further analysis
  • User authentication

Requirements

  • Physically based on a secure server (HIPAA compliant) with regular backups and high availability
  • Web-based user interface, scalable for mobile devices (e.g. iPad, iPhone) and PCs
  • Compliant with HIPAA, JCHO, Pharmacy policies, MERP requirements
  • Allow export for further analysis
  • User authentication
  • Optional: Interface to hospital databases to query patient data and store notes.

Deliverables

Web application, hosted on a secure server, that is accessible with both desktop computers and mobile devices (automatic scaling).

Impact on UCSF's mission and/or community

  • Improved patient safety and patient care
  • Improvement in inter-provider communication
  • Improvement in workflow
  • Increased protection of sensitive patient data
  • Generates data for quality assurance and potentially research

List of team members and their roles

  • Oliver C. Radke, MD, PhD, DEAA. Faculty at the Dept. of Anesthesia & Perioperative Care, San Francisco General Hospital: Conceptual design, UI design, Testing, Project coordination
  • Katja Radke, MD, PhD, DEAA. Faculty at the Dept. of Anesthesia & Perioperative Care, San Francisco General Hospital: Conceptual design, Testing
  • Jacobsen, Adam. Programmer/Analyst, Dept. of Anesthesia & Perioperative Care, UCSF: Database setup, Programming, Testing
  • Spinner, Jon. Programmer/Analyst, Dept. of Anesthesia & Perioperative Care, UCSF: Database setup, Programming, Testing
  • Dispensa, Brad. Programmer/Analyst, Supervisor, Dept. of Anesthesia & Perioperative Care, UCSF: Project coordination

Estimated time devoted by each team member

  • Oliver Radke: 2 work weeks + testing during clinical time
  • Katja Radke: 2 work days + testing during clinical time
  • Jacobsen, Adam. Programmer/Analyst, Dept. of Anesthesia & Perioperative Care, UCSF: Database setup, Programming, Testing
  • Spinner, Jon. Programmer/Analyst, Dept. of Anesthesia & Perioperative Care, UCSF: Database setup, Programming, Testing
  • Dispensa, Brad. Programmer/Analyst, Supervisor, Dept. of Anesthesia & Perioperative Care, UCSF: Project coordination

Comments

Vivek Swarnakar - July 13, 2012 - 1:55pm
We have developed a spine pain database application within QUIPC (quantitative image processing center) for the iPad. Would be great to determine if that could be leveraged to support this project as well. Might save time and money! (

Oliver Radke - July 19, 2012 - 11:04am
I'd assume that your database is aimed at *chronic* pain, while we deal with *acute* pain patients who receive invasive interventions and need a short-term follow-up.

Vivek Swarnakar - July 19, 2012 - 12:24pm
The application is fairly generic. It has an interface of the human body with relevant ROIs on which the person reports their pain. It would have to be modified for reporting Acute pain as you suggested, however the data capture, storage and interaction layers could be reused. Would be happy to show you if interested.

Enrique Terrazas - July 17, 2012 - 9:51am
The complexity increases greatly with the optional interface to hospital databases, however would be a more robust solution that would decrease manual entry errors. Overall a laudable goal and somewhat ambitious, but one that would seem to be widely applicable to other services seeking to keep a patient/procedure database with handoff capabilities that is not served by existing hospital systems. The goal of "Hold all relevant data in terms of medical information, legal information and billing" would need a secure, robust authentication mechanism that provides the equivalent of a digital signature.

Brad Dispensa - July 19, 2012 - 4:56pm
Enrique, thank you for your feedback. We agree the hospital interface causes complexity, and that's why we have already laid the ground work with the DPH to ensure data access for our project. Remember that we are aiming to replace the current paper based model used in the OR at SFGH with a digital model that reduces the risk of loss from cards being left behind as well as mistakes based on "hand writing interpretation". Since this data will flow into our departmental databases, a wealth of patient care related studies could be originated from our data. As Oliver notes, this project aims to reduce communication issues at SFGH, increase patient safety and develop a framework for evaluating patient care over longitudinal studies.

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