Electronic patient records (EPR) - I've seen some negative tweets recently about how cumbersome they can be...but EPR is here to stay so it's important to get them right

I'm fortunate to work somewhere with the most amazing EPR set-up...check it out!

A brief 🧵...
Our hospital's IT team have built 1 program from which we get all these options:

E-documents (clinic letters, memos etc)
Blood results
X-rays / scans
Drug chart
Request tests (bloods, imaging, micro, everything)
Link to primary care records
Observations (for in-patients)
There's so much more there too..."Outpatients" allows us to see what we have booked for upcoming clinics including procedural clinic lists like stress echo.

EDMS has the scanned records after hospital admissions

There's even a direct link to UpToDate!
Clicking on e-documents brings up the various specialities that letters are categorised by...and if you click on one division like 'Medicine', you can see the breakdown...so you know instantly where to look to find the letters you need
This is what the menu looks like...you can see if the document is a clinic letter, a MDT meeting entry, a record of a phone call with the patient, a GP referral, a test result (e.g. TTE or TOE) etc...so you can usually find what you want pretty quickly!
The eQuest system allows you to request almost any test, request a specialty consult from another team and also view requests already placed on the system, to avoid repetition / duplication
I know this is a rather unusual thread compared to my normal ones, but I see my wife struggle with her hospital's IT system - literally pulling her hair out at how clunky and difficult it is to navigate - and I realise that getting this right really impacts our working lives!
I've never met any of the @UHSDigital team, but a BIG thank-you from me (and I suspect almost everyone that works here) for a truly special IT system that definitely aids efficiency and facilitates patient care

Interested to hear experiences of others with EPR systems...

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More from @dr_benoy_n_shah

11 Dec 21
**VALVE CASE OF THE MONTH**
@BrHeartValveSoc

Last case of 2021!

If EVER you needed an example of why not to judge a 3-dimensional structure with 2-dimensional imaging...this it it!

I think you'll like this one...😁

#echofirst #cardiotwitter #MedTwitter
Male, late 60s, underwent biological MVR (29mm) 11 yrs previously for
Severe MR. Has permanent AF & VVIR pacemaker

Admitted to local hospital with breathlessness

This is admission chest x-ray
Treated with diuretics, offloaded successfully

Rpt CXR after a week - nearly normal
Read 19 tweets
11 Dec 21
The #NHS and GMC expect doctors to speak up whenever they have concerns regarding patient safety...

Yet 'whistleblowers' (WB) continue to be treated abysmally, almost as if they're the problem - see latest example here

A brief 🧵...

bbc.co.uk/news/uk-englan…
Probably the most famous WB is Stephen Bolsin, the cardiac anaesthetist that was highly concerned by very high mortality rates in paediatric ❤ surgery in Bristol in late 1980s / early 1990s

He had to leave his job & could not find another job in 🇬🇧

en.wikipedia.org/wiki/Stephen_B…
So he emigrated to Australia. The entire concept of 'clinical governance' largely originated due to his work and the subsequent Kennedy report
Read 9 tweets
18 Oct 21
Well, #EACTS2021 may be over...but I'm not done! 😆

One of the most important sessions was on Women In Cardiothoracic Surgery

I suppose I should clarify - not writing a 🧵on this for likes or 'virtue signalling' - my wife's journey through her training gave me some insights...
#EACTS2021
Opening talk on why @EACTS needs a womne's committee from @JolandaKluin - this was a great talk to set the tone for the session
#EACTS2021
Prof Kluin discussed the many challenges that can face women in medicine, in academic medicine, in surgery and in cardiac surgery
Read 25 tweets
15 Oct 21
#EACTS2021

This 🧵is related to Thursday's symposium on Edwards' Inspiris Resilia aortic bioprosthetic valve

The hospital in which I work used this valve for ~2yrs before stopping, so I was intrigued to hear the experts

A thought-provoking session!
@rafasadaba @GilbertTangMD
#EACTS2021

First talk from Prof Takkenberg, who needs no introduction to any of you. A very important talk in which she questioned the primacy of RCTs and spoke up on the importance of 'real world' registry data, often dismissed as poor quality
#EACTS2021

I learnt a new acronym today - GOBSAT!
Good Old Boys Sat Around the Table!
i.e. expert consensus, LoE - C! Love it!

She emphasised that a lot of our evidence, esp in VHD, is GOBSAT!

@mirvatalasnag @mrjzacharias
Read 29 tweets
15 Oct 21
#EACTS2021

Good morning everyone!

Spoilt for choice, unsure which session to attend but I am at Controversies in Transcatheter valve treatments

First talk is on TAVI in nonagenarians (>90 yrs old) - is there a survival benefit? by @RoxanneStL

Great and vital question!
#EACTS2021

If someone has already lived far past the average life expectancy in their country and is now into their 90s, can we *promise* the patient that TAVI will make them live longer?

In our centre, we feel that patients >90 need to be very motivated to have a procedure
#EACTS2021

Retrospective study looking at everyone age >90 that had TAVI & then matched them to the Quebec general population that are >90 years
Read 35 tweets
15 Oct 21
#EACTS2021

This is a 🧵all about Transcatheter Mitral Valve Implantation (TMVI). If you don't know a lot about this and want to learn more - read on! This is a summary of a great expert focus session

First talk from Dr Gry Dahle (Oslo), on why TMVI is not the same as TAVI
#EACTS2021

1st TAVI was done 10 years before 1st TMVI

TAVI has revolutionised treatment of aortic stenosis; TMVI is further behind largely due to anaromical complexity of treating the MV compared to the AV - the AV valves are much more complex than the semilunar valves!
#EACTS2021

Historical timeline of the TMVI journey (left) and the large number of devices still competing for approval in the transcatheter mitral space (right)

@GilbertTangMD @mrjzacharias @BISMICS @SCTSUK @BrHeartValveSoc
Read 25 tweets

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