LETTER TO THE EDITOR
Year : 2010 | Volume
: 21 | Issue : 3 | Page : 535--537
Computerization of hemodialysis records: A new era explored
Consultant Nephrologist and Head of Nephrology Department, The Indus Hospital, Korangi Crossing, Korangi, Karachi - 75190, Pakistan
Consultant Nephrologist and Head of Nephrology Department, The Indus Hospital, Korangi Crossing, Korangi, Karachi - 75190
|How to cite this article:|
Alam A. Computerization of hemodialysis records: A new era explored.Saudi J Kidney Dis Transpl 2010;21:535-537
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Alam A. Computerization of hemodialysis records: A new era explored. Saudi J Kidney Dis Transpl [serial online] 2010 [cited 2020 Jul 5 ];21:535-537
Available from: http://www.sjkdt.org/text.asp?2010/21/3/535/62714
To the Editor,
Information technology has recently entered in almost every aspect of health care, including the medical records. However, when we talk about real-time entry of hemodialysis records of the patients in the computer, several questions definitely arise in our mind like what should be the ideal format? How live data entry can be accomplished? How the confidentiality of patient record can be maintained? We have developed technical solutions to such questions in the light of our own experience and implemented such a system in our hospital. The system has been developed exclusively by our MIS (Management Information Systems) department with necessary inputs and advices at every required stage from the Department of Nephrology. We are a paperless hospital where registration, patient medical record, lab investigations, and anything one can require to run a hospital is computerized. Therefore, when we thought of developing a computerized record keeping system for hemodialysis, we hardly required investing anything additional in terms of computer hardware. On the other hand, if one thinks of establishing only the dialysis facility with the computerized records, the initial investment in terms of computer hardware may be significantly less.
Our hospital management information system (HMIS) is oracle based, both front-end and back-end. However, any suitable computer language can be used.
The initial step in developing the dialysis module was to work out in detail which type of data would be entered. We simply tried to translate the data entry at different stages of patient movement in the dialysis unit into electronic computer screens. The developed screens included dialysis patient registration (access is permitted to a limited number of personnel), the diagnosis (type of renal failure, blood group, ideal dry body weight, hepatitis serology, status of the patient, and schedule for maintenance dialysis), dialyzer issue and reprocessing, pre- and post dialysis record (the vitals including the weight of the patient before and after dialysis), intra-dialysis record (is used by the dialysis technicians while performing the actual procedure of hemodialysis with their names saved), vital signs and dialysis parameters, doctors record (remarks to that session either in physician order or patient progress accordingly using a unique username and password to enter record, [Figure 1], investigations, medication order, and dialysis summary (for a quick review of the pre- and post-dialysis blood pressures, weight, UF done, dialysis duration, etc. in different dialysis sessions). By a double click on the respective session, the complete dialysis record is also available [Figure 2].
The actual success is not only the design of the module, but also the implementation of such software, which includes training of endusers. We developed a proper training program of five to seven days for staff on the program before the access to the computerized database is permitted.
There is a long list of the advantages of computerization of dialysis records such as completeness of records (For example dialysis sessions cannot be opened if patients are not registered and so on), accuracy of records, privilege assignment (different health care personnel have different privileges to access the different screens of the modules, e.g., a technician cannot enter data in a field designated for doctors only), computerized calculations, fast data retrieval, easy patient management, research activities, and statistical reports. The cost of the use of computers is definitely far more as compared to the manual record keeping system, but when one takes long-term benefits into account, the computerized system is definitely more valuable and dependable.
In the end, it is necessary to emphasize that developing a computerized record keeping system is an on-going process and there is always scope to improve. Many more similar modules can be developed in different countries.