MEDinsight

MEDinsight was developed in response to clinicians’ requirements to carry out quality assurance of patient examinations and treatment, as well as to cover researchers’ needs for storage and collation of research results. By making systematic use of good research and quality registers, researchers and clinicians can evaluate the process and results of patient treatment, which furthermore can help with the understanding and patient-focused management of patient treatment and research.

Overview

MEDinsight is used today as a quality register in the clinic and replaces in many cases quality registers which are no longer functional. Data from old registers are converted to MEDinsight databases (SQL), which contribute to secure data access for historical data.

MEDinsight makes it possible to register self-defined parameters, gather information from other systems, cross-check information, as well as retrieve relevant parameters from other systems were it is necessary. This is in conjunction with securing good data quality and data security.
MEDinsight has a role filter enabling the user to only see data they have legal access to.

A patient explorer is the base structure in the application. Here the patients are in focus and the information is shown resembling an explorer in MS-Windows. The explorer provides health personnel and researchers an overview of the logical connection between patient data for the different databases. A timeline shows patient progress in chronological order with both historical and planned events. Together, this provides a comprehensive and more complete picture of a patient’s illness history and development. Data from the individual patient is used as a template to define reports for groups of patients. The reporting function is a primary function in MEDinsight. It is used, among other things, in the generation of data for quality indicators.

Reports and Statistics

It has previously been hard to obtain access to reports with special extractions from patient and research data. With MEDinsight it is easy for health personnel and researchers to take their own reports and statistics from systems and databases they have access to, without the help of database specialists. This is done by defining criteria, indicated by fields which are included, and produce lists from the system. In the next version, these will be transferred to statistical tools such as SPSS or Excel or in a text handling tool such as Word etc. This will allow one to look for a pattern and common features across databases, to better follow up and quality assure patient handling. Based on reports and statistics of relevant cases, one can quicker see what treatment has previously been utilized. MEDinsight will therefore be a useful tool to gain insight into volumes of historical data.

Quality Indicators

The Health and Custody Department is posing a requirement for enterprises to document the quality of their services in the form of a quality register and quality indicator. There is a need to define quality indicators which are more specific for diagnosis and treatment. MEDinsight, in this context, is a good tool for use in identifying and reporting such quality indicators.

Data Quality

Data quality is a buzz word in MEDinsight. This is a critical task for health personnel and researchers. The data registered in the system must be unambiguous, correct and precise so the extractions and reports will have an optimal value.
The treatment program leaders will participate in defining criteria for the quality indicators that are included. Physicians, other health personnel and researchers are responsible for registering data according to the defined criteria.

Better Treatment

Each quality indicator is considered a link in the systematic work to secure and develope quality in treatment. Our responsibility is to identify and define specific quality indicators which naturally enter into our treatment, and which will be registered in our own operation systems. Many of these should also be included as national quality indicators for all hospitals which offer equivalent diagnostics and treatment. In this way, we can gain an overview of the different types of treatment with corresponding results.

Better Research

Focus on quality indicators is also important in connection with raising the quality of our research. In addition to supporting expert credibility by focusing on data quality, it also creates a good reason for research. The hospital has as a goal to develop the role as the country’s best medical research institution and to focus on strategic research. We must clearly bring out the benefit of MEDinsight, also for use in research and translational research.

Gathering base data requires a lot of time when completing a research project. MEDinsight provides access to gathered clinical data to all working on a research project. In this way, MEDinsight secures effective use of research resources and should be emphasized as an advantage in recruiting the best researchers. The data set is in the system and one can use time on research and not on logistics.

Better Economy

The hospital’s reality is a tough one and we have tough economical conditions. We deliver highly specialized services and we know that our quality is competitive with the best in the world. To report on quality, it is necessary to maintain this position. MEDinsight is a tool for regular reporting of quality with respect to medical parameters.

Since the introduction of DRG-points per treated patient, it is crucial to register the right data on the patients so the correct number is entered every time. Correct and complete coding is obtained when someone reviews the data afterwards. Medical coders will work to quality control data entered into MEDinsight so the data in the diagnosis register are always correct.

Information Security

Information security will be an important issue with regards to the quality register, and it is important to be familiar with the Health Register and the Personal Information Law. In MEDinsight, access to data is controlled by a role-based user filter. The access level is linked to each user’s unique username.

A user with case processing privileges will have access to the relevant data in the processing area. There are thus strict rules for what and who will have access to patient identifiable data. In research databases, the data is anonymized so no personal information can be traced back to the patient. The system makes extractions where all identifiable personal information is removed, so that one can create reports and process these in external programs. A collocation thus occurs anonymously.

MEDinsight uses existing user accounts which all of the users use when they log into the hospital network. The access level in MEDinsight is connected to these accounts. The access is based on work tasks, project association, role, position, and department. As a user, one has access to all data one might need for work/research. The security in MEDinsight is equivalent to the hospital network. The network is closed for external access and one can exclude certain users if necessary.

Technology

We are developing our solutions in program modules with common structures so that portions can be recycled in situations we still have not yet identified. All other systems will benefit by improvement in one system. The databases will be integrated with the help of a presentation group. The portal will provide direct access to the data from our application, clinical, and research databases. Examples of this are PAS, Visir, PAiS etc. The solution is being developed on the .NET platform which retrieves data from these databases, which again are in different formats such as SQL Server, Sybase, Oracle etc.

Access

MEDinsight is made as an installable Windows program which is automatically upgraded centrally. Each user will find it under Programs/MEDinsight in the Start menu in Windows when the portal is ready and the user has obtained access.

MEDinsight toolbox

A creative and long term collaboration with clinicians at the Radium Hospital has resulted in many good general functions. We call these functions the toolbox. They are specially customized for the needs encountered in the hospital environment. Because MEDinsight is module-based, the futureís new tools will become old and new applications will benefit.

Patient Explorer

The main navigation element is the patient explorer. It has the same look as a file explorer in Windows and shows which schemes are defined (and to which access is granted). The purpose is to provide a quick total overview of the information volume and to give direct access to all of the schemes, regardless of where it is defined in the information hierarchy. The explorer is assembled with specially designed icons which represent different information types. Other databases use icons and structure which, to the clinician, provides the best overview. An icon corresponds to a scheme and often a scheme represents a case where the date for the case is together with the icon.

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