Transforming deteriorating patient care with a digital and sustainable rapid response system developed in the open

该项目旨在研究和实施一种新的概念验证、开放标准、数字启用的电子观察(EObs)解决方案，用于日益恶化的患者护理。它将解决NHS中一个主要的未得到满足的需求，在NHS中，很大一部分患者仍然经历着不佳的护理，导致不良的临床结果，如计划外的ICU入院、紧急手术、心脏骤停和死亡。据估计，7%的住院死亡是可以预防的。(NCEPOD急诊入院)。对病情恶化的患者护理不力的核心原因可能与目前基于纸质(和数字)的患者观察和管理系统无效有关，导致缺乏对病情恶化的认识。现有的专有数字系统缺乏互操作性，提供非常低的价值和不可持续的高成本，以及提供改善结果和推进临床进展所需的实用程序所需的迭代和发展障碍。我们的愿景是以数字化方式转变医疗流程，并克服NHS面临的与专有IT系统相关的障碍，这些系统无法轻松或低成本地迭代以满足临床医生的要求和最佳实践操作程序。我们将通过使用转化医学中常用的方法创新医疗过程信息化设计来实现这一点。在考文垂大学的帮助下，我们将分析两个NHS信托基金(伦敦南部和莫德斯利、柴郡和威拉尔伙伴关系)的当前做法，设计一种最佳方法，并在考文垂大学的模拟NHS医院环境中与医疗从业者进行试验(这是CU在英国最先进的模拟实验室的第一个主要项目)；一旦得到证实，我们将与我们的两个NHS信托基金合作伙伴进行实际试验。通过与Apperta和Open UK的合作，将确保治理、安全和标准。我们项目的成功将带来可衡量的改善患者结果，因为更好的eObs患者观察系统具有从精神健康到生产力的广泛结果，并减少了进一步临床干预的需要。与手动管理相比，直接的好处将包括减少员工时间和减少人为错误。采用开源和标准方法将消除令人望而却步的年度软件许可和适配成本，同时提供可随时适应个人NHS信托需求的灵活公共资产。我们的方法与国家卫生部门Matt Hancock对NHS的数字转型愿景(2018年10月)独一无二地一致，并将作为一种工具，通过创新使用数字技术来改变中小企业的市场准入，以发展英国数字医疗行业。

This project seeks to research and implement a new proof-of-concept open standard digitally-enabled electronic observation (eObs) solution for deteriorating patient care. It will address a major unmet need in the NHS where a significant proportion of patients still experience suboptimal care leading to adverse clinical outcomes such as unplanned ICU admissions, emergency surgery, cardiac arrest and death. An estimated 7% of in-hospital deaths are preventable. (_NCEPOD Emergency Admissions_).Core reasons behind poor care of deteriorating patients can be linked to current ineffective paper-based (and digital) systems of observation and management of patients leading to lack of recognition of deteriorating conditions. Incumbent, proprietary digital systems lack interoperability and deliver very low value with unsustainable high costs, plus barriers-to-iteration and evolution required for utility needed to deliver improved outcomes and to advance clinical progress.Our vision is to transform the care process digitally and also to overcome the barriers the NHS faces over proprietary IT systems that cannot be easily or cost-effectively iterated to meet clinician requirements and best practice operating procedures.We will deliver this by innovating the care process informatics design using an approach commonly used in translational medicine. With Coventry University's help, we will analyse current practice at two NHS Trusts (South London and Maudsley, Cheshire and Wirral Partnership), design an optimal approach and trial it with healthcare practitioners in a simulated NHS hospital environment at Coventry University (the first major project for CU at the most advanced simulation lab in UK); and once proven, trial it for real with our two NHS Trust partners. Governance, safety and standards will be assured through working with Apperta and Open UK.Success with our project will bring measurable improved patient outcomes due to a better eObs patient observation system that has wide-reaching outcomes from mental health to productivity, and reduced need for further clinical intervention.Immediate benefits will include reduced staff time and reduced human error compared with manual administration. Adopting an open source and standards approach will eliminate prohibitive annual software licensing and adaptation costs while delivering a flexible public asset that can readily be adapted to individual NHS Trust needs.Our approach is uniquely consistent with secritary of state for health Matt Hancock's vision for Digital Transformation (October 2018) for the NHS and will serve as a vehicle to transform market access for SME's to grow the UK digital healthcare industry through the innovative use of digital technologies.