Question

The Lewisham Hospital NHS Trust comprises University Hospital Lewisham, The Children’s Hospital Lewisham and Dunoran Home (a residential nursing home in Bromley). The Trust manages approximately 650 beds and currently employs around 2,500 staff.
The Data Quality Challenge
The south-east London hospitals were seen as having problems with fragmented patient records, particularly the difficulty of identifying whether a record existed for a newly-admitted patient. When patients were admitted to hospital, they were not always correctly identified as having an existing medical record, often due to a change of name or address; sometimes the patient’s state of health made it difficult to get accurate details and sometimes it is simply a case of a clerical error in not finding the patient on the system.
New records were then opened for them and their previous history lost to their clinical team. With approximately 150 ‘new patient’ registrations each day to be compared against the 930,000 existing records in the Lewisham Hospital NHS Trust database, the search for duplicate records was a time-consuming manual task, taking more than half a day. At one stage there was a six month backlog.
As Terry Walton, IT Manager at Lewisham Hospital, points out, “This is not just about meeting government targets and overcoming fragmented patient records. There is a clinical risk if a newly-admitted patient is not identified as having an existing record with us.”
Having clean, high integrity patient data is also an essential requirement for connecting to the Connecting for Health Local Service provider. In his quest to achieve a single patient view, Terry applied for funding from Connecting for Health. He organised a joint procurement for
©Al Tareeqah Management Studies - 2020 5
the Lewisham Hospital NHS Trust, Kings College Hospital NHS Trust and the South London and Maudesley NHS Trust.
Questions:
1. What in your understanding are the issues that Lewisham Hospital faces ?
2. What are the dangers to fragmented patient records for Hospitals providing healthcare? 3. What would be your suggestions to Lewisham hospitals as a HCIS consultant to maintain their
patient records safe?

Answer 1

Q.1 The main issue faced by Lewisham Hospital is regarding the data management. Their management information system is not very strong and efficient. For checking data of 150 new patients, consuming half day is not acceptable time. Their system should be such strong, that data should be matched immediately. They have taken name and address only as an identity factor for a customer as the case study shows. More number of parameters like main mobile number or alternate mobile number and email addresses may also be included to match new patient data with old patient data records. This will assist the hospital not only to treat new patients with existing data but also to check their previous health history to treat them better in the hospital.

Q.2 Fragmented patient records may create problems for patients. For example they may receive low or high dosages, conflicting medications etc. Especially the patients with chronic illness may face challenges as they have a strong need for the records to be coordinated for proper and consistent treatment. This may adversely impact the cost, quality and outcome in the treatment of the patient. Their healthcare expenditure may become unsustainable.

Q. 3 To keep the patient record safe, the hospital has to maintain strong MIS (Management information system of the hospital). The knowledge management software should be available to doctors or nurses or any medical staff at any location and at any time. This will speed up the integration process. New policies may also be designed to show clear health journey of the patient in electronic health care records. This will assist in providing proper treatment to the patients after looking at their old medical journey.