LOGBOOK USING THELOGBOOK USING THE WORLD WIDE WEB WORLD WIDE WEB

Dr R VermaDr R Verma

Consultant AnaesthetistConsultant Anaesthetist

Southern Derby Acute Hospitals NHS TrustSouthern Derby Acute Hospitals NHS Trust

rv2000@btinternet.comrv2000@btinternet.com

A SIMPLE IDEA - IA SIMPLE IDEA - I

• Log onLog on

• Enter dataEnter data

• Log offLog off

A SIMPLE IDEA - IIA SIMPLE IDEA - II

• Log onLog on

• Review/analyse data on-lineReview/analyse data on-line

• Produce any outputs from those on offerProduce any outputs from those on offer

• Printout resultsPrintout results

• Log offLog off

A SIMPLE IDEA - IIIA SIMPLE IDEA - III

• Log onLog on

• Review/analyse data on-lineReview/analyse data on-line

• Download dataDownload data

• Do what you like with the dataDo what you like with the data

• Log offLog off

PERCIEVED ADVANTAGES OF AN INTERNET PERCIEVED ADVANTAGES OF AN INTERNET BASED LOGBOOK IBASED LOGBOOK I

• Data can be input from anywhereData can be input from anywhere

• Software is web-basedSoftware is web-based– hence universal and centralisedhence universal and centralised

• Robustness assuredRobustness assured– Data integrityData integrity

– BackupsBackups

– Virus protectionVirus protection

– Data securityData security

• Software tweaks and upgradesSoftware tweaks and upgrades

PERCIEVED ADVANTAGES OF AN INTERNET PERCIEVED ADVANTAGES OF AN INTERNET BASED LOGBOOK IIBASED LOGBOOK II

• Password control of usersPassword control of users

• Hierarchy of level of accessHierarchy of level of access– IndividualIndividual

– College tutorCollege tutor

– Regional advisorRegional advisor

– Administrator(s)Administrator(s)

• Predefined reportsPredefined reports

• SQL user defined report facilitySQL user defined report facility

ANXIETY ISSUESANXIETY ISSUES

• Don’t want to write codeDon’t want to write code– Will take far too long (lonely hours in the loft)Will take far too long (lonely hours in the loft)

– Will have too many bugs (not robust enough)Will have too many bugs (not robust enough)

– Will never be as good as the professionalsWill never be as good as the professionals

– Got better things to doGot better things to do

• Buy in expertise BUTBuy in expertise BUT– Beware promise-ware versus softwareBeware promise-ware versus software

– Need some understanding of technical matters Need some understanding of technical matters

• FundingFunding

DATA PROTECTION ACTDATA PROTECTION ACT

• The DPA (1988) has been established to prevent The DPA (1988) has been established to prevent

misuse of individuals’ sensitive personal data, misuse of individuals’ sensitive personal data,

pertaining to an individual’s physical or mental health pertaining to an individual’s physical or mental health

or condition. Those storing information in an or condition. Those storing information in an

identifiable form are obliged to register with the Data identifiable form are obliged to register with the Data

Protection Registrar and take reasonable measures to Protection Registrar and take reasonable measures to

secure the data.secure the data.

Is your logbook legal. Ann R Coll Surg Engl Is your logbook legal. Ann R Coll Surg Engl (Suppl) 2003; 85: 88-89(Suppl) 2003; 85: 88-89

• High proportion (all grades) store patient High proportion (all grades) store patient

informationinformation

• Easily identifiable formEasily identifiable form

• Rarely password protected, largely unsecureRarely password protected, largely unsecure

• Only a small minority registerd with the Data Only a small minority registerd with the Data

Protection RegistrarProtection Registrar

THE PILOTTHE PILOT

• Supported by grants fromSupported by grants from

• Outcome TechnologiesOutcome Technologies– Formerly Formerly Weboutcome.comWeboutcome.com

IMPLIMENTATION - IIMPLIMENTATION - I

• Used the RCA logbook datasetUsed the RCA logbook dataset

– Well establishedWell established

– Small, concise with a track historySmall, concise with a track history

– Widely used by trainees hence ‘familiar’ and not Widely used by trainees hence ‘familiar’ and not

‘New’‘New’

– Probably needs a re-vampProbably needs a re-vamp

IMPLIMENTATION - IIIMPLIMENTATION - II

• Testing the concept of an Internet based Testing the concept of an Internet based

logbooklogbook

• Nothing moreNothing more

• Nothing lessNothing less

• No ambition to enhance, modify, improve the No ambition to enhance, modify, improve the

datasetdataset

IMPLIMENTATION - IIIMPLIMENTATION - II

• Short time scaleShort time scale

• Hence expected the product to be limited Hence expected the product to be limited

bearing in mind its potentialbearing in mind its potential

• Bought in technical expertiseBought in technical expertise

SPECIFICATIONSSPECIFICATIONS

• RCA datasetRCA dataset

• Access via the internetAccess via the internet

• Assure security, integrity of dataAssure security, integrity of data

• Input with adequate error checksInput with adequate error checks

• Varying levels of access to the dataVarying levels of access to the data

• Ability to download one’s own data in different Ability to download one’s own data in different

formatsformats

• Few pre-designed outputs e.g. RITA formFew pre-designed outputs e.g. RITA form

THE PILOT - ITHE PILOT - I

• Http://www.alogbook.comHttp://www.alogbook.com

THE PILOT - IITHE PILOT - II

• ConsultantsConsultants == 5757

• SpRSpR == 2323

• SHOSHO == 1414

• Assoc. Spec.Assoc. Spec. == 8 8

• Unknown Unknown == 1 1

• Less ApologiesLess Apologies == -6 -6

• Less e-mail failureLess e-mail failure == -3 -3

----------

9494

FOLLOW-UP QUESTIONNAIREFOLLOW-UP QUESTIONNAIREPreliminary resultsPreliminary results

• Registered Registered == 104104

• Not used yetNot used yet == 44 44

• System usedSystem used == 64 64

• Feedback Feedback == 36 36

Do you use the RCA logbook regularly?Do you use the RCA logbook regularly?

10

24

0

5

10

15

20

25

Yes No

Do you or have you used the following versions of the Do you or have you used the following versions of the RCA logbookRCA logbook

11 11

16

0

2

4

6

8

10

12

14

16

Paper PDA/Handheld PC based

Did you find the RCA software?Did you find the RCA software?

1

16

32

0

2

4

6

8

10

12

14

16

Easy Fairly Not Easy Difficult

How did you find the the use of this Internet logbook?How did you find the the use of this Internet logbook?

8

11 11

2

0

2

4

6

8

10

12

Excellent Good Fair Poor

How did this compare with your previous use of How did this compare with your previous use of logbooks?logbooks?

67

11

0

2

4

6

8

10

12

Better Same Worse

Did you have problems with …..Did you have problems with …..

4

30

6

26

9

21

0

5

10

15

20

25

30

Registration Logging Entering

Yes

No

Did you have problems with …..Did you have problems with …..

3

19

9

1

7

23

0

5

10

15

20

25

Retrieving Data Retreiving RITA

Yes

No

Didn't Bother

Did you have problems with …..Did you have problems with …..

5

21

0

5

10

15

20

25

Yes No

Speed of Access

Where do you update your logbook?Where do you update your logbook?

9

11

14

0

2

4

6

8

10

12

14

Theatre Work Breaks Home

Do you have Internet access …Do you have Internet access …

14

11

28

18

30

0

5

10

15

20

25

30

Theatre Op Suite Dept Library Home

Did you access the internet logbook from …Did you access the internet logbook from …

1413

9

0

2

4

6

8

10

12

14

Hospital Home Both

What internet connection do you have at home?What internet connection do you have at home?

22

11

0

5

10

15

20

25

Dial-up Modem ADSL/DSL Broadband

Would you like to see the concept of an Internet Would you like to see the concept of an Internet logbook developed further?logbook developed further?

21

8

0

5

10

15

20

25

Yes No

FUTURE DEVELOPMENT- AcademicFUTURE DEVELOPMENT- Academic

• Improve datasetImprove dataset– e.g. d.o.be.g. d.o.b

• Enhance existing datasetEnhance existing dataset– e.g. were the blocks effective?e.g. were the blocks effective?

• Revalidation dataRevalidation data• Appraisal dataAppraisal data• C.M.E points registerC.M.E points register

FUTURE DEVELOPMENT - TechnicalFUTURE DEVELOPMENT - Technical

• Improve user interfaceImprove user interface

• End users need ‘training’ in using the softwareEnd users need ‘training’ in using the software

• On line or other help linesOn line or other help lines

FUTURE DEVELOPMENT - TechnicalFUTURE DEVELOPMENT - Technical

• Modules for PDAs/HandheldsModules for PDAs/Handhelds

– One click synchronization (possibly wireless)One click synchronization (possibly wireless)

• Modules for stand-alone or networked PCsModules for stand-alone or networked PCs

– One click synchronizationOne click synchronization

• Integrate with Hospital IntranetsIntegrate with Hospital Intranets

– Eliminate duplicating data entryEliminate duplicating data entry

Thank YouThank You