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Implementing Clinical Context Management at Great Ormond Street Hospital

Context Management at GOSH. Implementing Clinical Context Management at Great Ormond Street Hospital HL7 UK Conference – 22 nd November, 2007 Presenter: David Bowen EPR Programme Manager Great Ormond Street Hospital for Children. How CCOW works. How It Works

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Implementing Clinical Context Management at Great Ormond Street Hospital

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  1. Context Management at GOSH Implementing Clinical Context Management at Great Ormond Street Hospital HL7 UK Conference – 22nd November, 2007 Presenter: David Bowen EPR Programme Manager Great Ormond Street Hospital for Children

  2. How CCOW works How It Works The user sets the context using any CCOW-compliant application—for example, he or she selects a patient of interest. The application then tells the CCOW-compliant context manager that it wants to set the patient context, and provides this context manager with an identifier that indicates the context subject, which in this case might be the medical record number for the patient of interest. The context manager then notifies the other applications that the context has been changed, and each application obtains the patient’s identifier from the context manager. Each application then adjusts its internal state and data display accordingly. Taken from: http://www.hl7.org/special/Committees/ccow_sigvi.htm

  3. Benefits • Efficiency • Governance • Patient Safety

  4. Context Management at GOSH • ~1,500 users • Sentillion’s Vergence software • Single Sign On • Clinical Context Management • LaunchPad • Citrix-published desktop (“the GVD”) • Applications in first phase • i.PM (patient administration) • JAC (prescribing, medicines administration, pharmacy) • MedCouRier (pathology results browser) • GroupWise (email etc.) • Level of CCOW compliance • Middleware ✔ • Applications ✘

  5. Next Phases … immediate: • More applications • Smartcards • National Programme deployments … further out: • More finely grained context management • Roaming sessions • Business Process Management/SOA

  6. Lessons learned so far • Don’t underestimate the value of domain expertise. • Patient identifiers – clean? • Think carefully about thin client – pros and cons. • Do as many applications as possible. • Close the back door!

  7. A suggested CCOW maturity model

  8. CCOW dependent applications OCRR PAS patient id order id LIS

  9. D I S C H A R G E CREATE DISCHARGE SUMMARY DATA AGGREGATION TRANSFORMATION TRANSFORMATION CDA COMMITTMENT TO RECORD CDA DATA SOURCES TEMPLATE DESPATCH

  10. Mixed SOA – conventional A2 A1 Portal A3 S2 S3 S1 S4 S5

  11. Context Sessions Explicit context switching A1 Portal Portal A2 S3 S1 S2 S2 S3 S1 S4 S5 S4 S5 S6 S7 S8

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