Deirdre Keown, RGN, MSc Health Informatics
KDCPMS Overview
Now and into the Future
28 November 2014
Beaumont 3rd Annual Transplant & Nephrology Conference
Presentation Overview
KDCPMS
“Kidney Disease Clinical Patient Management System”
 Past
Background
CAWT Renal Project
 Present
Where we are now
 Future
Challenges
Reality
Benefits
CAWT Renal Project
 August 2008 the cross
border collaborative
health services project
won a prestigious
‘European Health
Forum Award.’
 It was developed with
funding secured by
CAWT from the
European Union
INTERREG IIIA
programme.
 The project enabled
six hospitals in the
border region to
install common
specialised
information systems
so that they could
share data to assist
them in the treatment
and care of patients
with kidney disease.
Beaumont 3rd Annual Transplant & Nephrology Conference 28 November 2014
Background to KDCPMS

National Renal Strategy Review (NRSR)
1.

Identified the development of a Renal Health Intelligence
system as a key requirement.
2.
Proposed establishment of a National Renal Registry.
3.
Formation of a National Renal Office (NRO).
AIM
“A dedicated Kidney Disease patient management system that
will facilitate the clinical management of all patients with
kidney disease, from first presentation to a renal centre right
through to renal replacement therapy.”
KDCPMS Project Objectives
The chosen ICT System must be :
 COMPREHENSIVE : Electronic medical record of patient medical history and events
 MULTIRELATIONAL : Interface in real-time with existing hospital PAS & LAB
systems and HD Machines
 SHARED CARE PLANS : Improved access to the care plans for renal teams:
Nephrologist, Renal Nurse, Dietician, Transplant Co-ordinator
 SEAMLESS : Easy transfer of patients between Units
 EFFICIENT: Enhance efficiency of current resources by avoidance of unnecessary
tests and reduce dependency on paper based records
 REGISTRY ORIENTATED: Establish a core information framework to support the
development of a National Renal Registry.
The Journey of KDCPMS Begins..

August 2010: Contract awarded to Mediqal Health Informatics Limited
(M.H.I) for the supply, installation and maintenance of a Kidney Disease Clinical
Patient Management System (KDCPMS) at 16 Renal Units in Ireland.


The application is referred to as “eMEDRenal”
November 2010 : Mediqal appointed Ms Yvonne O’Reilly as RoI National
Project Manager to oversee this contract.

Contract includes :
- A Single Database & Multiple Instances
- Delivery of PAS & LAB Interfaces on each site
- Irish Standard Build (90% Std, 10% Local)
- Full Audit Traceability
- Delivery of HD Machine Interfaces where MHI have developed the technology
to communicate with Suppliers machine software. (FMC)

2015 : Contract with MHI will be extended to include


Dublin Contracted Satellite Units (initially)
St James Hospital
KDCPMS Project Governance
HSE Board/CEO
NHO Director
ICT
Steering
ICT Director
Project Board
Dr. Liam Plant
(Executive Chair)
NHO
Steering
Project Team
Dr. Austin Stack
Change Control
Board
User Groups
(Clinical Director)
Vincent Jordan
(ICT Programme Manager)
Anne McCahill
(Project Manager)
16 sites
Deirdre Keown
(Business Implementation)
Implementation
Process
Local
Implementation
Local Teams
Implementation
Teams
Geographic Scope
16 Public Renal Units
Phase 1
Cavan General Hospital
Sligo General Hospital
Letterkenny General Hospital
Merlin Park Hospital, Galway
Mayo General Hospital, Castlebar
Cork University Hospital
Kerry General Hospital, Tralee
Waterford Regional Hospital
Midland Regional Hospital, Tullamore
University Hospital Limerick
St Vincent’s University Hospital
Beaumont Hospital (Pending)
2015+
AMNCH, Tallaght
Mater Hospital, Dublin
Children University Hospital, Temple St
Our Lady’s Children Hospital Crumlin
Phase II
Contracted Satellite Units
St James Hospital
KDCPMS Current position:
Actively used in patient care in 11
Chronic Renal Units.
Beaumont going live early 2015.
All HD and Home Therapy patients
recorded. Most run Transplant
Follow-up clinics.
Moving to all units recording all
end-stage patients.
Some units documenting CKD
patients.
Most have laboratory information
directly integrated into patient
record.
Ongoing lifetime of the Solution:
 eMEDRenal Go-Live is the Starting Point
 Ongoing Leadership is Key :

Drive enhancements at a local level
 Interfaces (HD, PAS, LAB)

Ensure there is participation in
 User Groups (UAT of new Releases)
 Change Control Board &

Sustain a focus on data-driven improvement in patient
care
 National clinical audit initiatives
Resulting in Enhanced Care Delivery at a Local Level
Renal System Administrator .. Pivotal Role










System Manager duties
Account Management
Configuration Management
Staff Training
Application review of eMEDRenal
Kt/v Management
New Version Testing
Data Gathering
Report Management
Updating of Patient Admin
Beaumont 3rd Annual Transplant & Nephrology Conference 28 November 2014
27th September 2013
MH1 Annual User Group Meeting
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Complexities/Challenges
Technical Challenges
Cultural Challenges
Organisational Challenges
Regulatory Challenges
Beaumont 3rd Annual Transplant & Nephrology Conference 28 November 2014
Challenges of using eMEDRenal effectively
 Data completion is challenging.

Crucial to get patient classification correct: Clinical
Supervision, Treatment Location, Modality
 The eMEDRenal Reporter will provide a
framework for performance monitoring.

Standard Operating Procedures & Guidelines are
required for effective use
 Why do it?

Allows for immediate reporting of important markers
of performance
Beaumont 3rd Annual Transplant & Nephrology Conference 28 November 2014
Census Reporting Proposal for 2014
1. All units review and validate their records. Start
with lead Nephrologist and Renal System
Admin (RSA) checking classification and lists
2. NRO issues a “% completion” report on 1st
December for all units (missing data)
3. Lead Nephrologist and RSA complete the
minimum dataset for all patients before
Christmas break
4. NRO extracts report @ 23hrs 31st Dec 2014
The Future …
A National Renal Registry
Beaumont 3rd Annual Transplant & Nephrology Conference 28
The KDCPMS Journey
What we’d like to build
What we have to build
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