KernPaeP – A Web-Based Pediatric Palliative Documentation System for

Home Care

Tobias Hartz, Dipl. Math.

Medical Informatics and Biomathematics

University Clinics Muenster

Background Information: Palliative Care and Scenario

  Pediatric Palliative Home Care   ~ 400 children each year (in Germany)   SA(P)PV – specialized (pediatric) palliative care in the community   PCT – palliative care teams   SAP(P)V is enforced by law since April 2007 (in Germany)

  Scenario (Needs)   new SAPPV structures   health providers with different professions, different institutions

involved   exchange of information between health providers essential   immediate access to newest patient data needed

  valid data for scientific research (data standards)

Background Information: Scenario

Palliative home care

Pastor

Physio- therapiest

Pharmacy

Medical & Home Health Care Supplies

Ambulant Hospice Service

Ambulant Nursing Service

Family doctor

SAPPV

Patient &

Family

Background Information: Solution to support PCT

  Solution (& our goal)   comprehensive documentation in digital form   data accessible by web browser for pediatric palliative patients

receiving treatment at home   on- and offline solution for documentation at site

helps saving time and improving the quality of documentation

Background Information: Preliminary Work

  Preliminary Work   PATE Project

  2001 – 2004 (project of the German Cancer Aid)   based on HOPE (Hospiz- und Palliativ-Erfassung Standarddokumentation)   Implementation of an Access based documentation tool

(KernPäP)   ongoing patient documentation

  evaluation of patient documentation data

Methods: Concept

  Project plan   2 year funding by the Krupp-Stiftung   cooperation with PCTs of Münster, Datteln & Dresden   project start April 2008

  Prerequisites   employment of most current techniques, in terms of security   separation of identifying and medical data (Data security concept of

the German TMF e.V.)   being reviewed by local governmental authority (data protection

officer)

  Goal   implementation of a web-based KernPäP system

Methods: 2 year timeline

  So far   evaluation of existing data   preparation of data security concept   implementation of web-based documentation system

  own MVC infrastructure (PHP, Smarty Template Engine, SQL Database)   testing

  Now   productive system of online version (October 2009)

  Ahead   implementation of an offline solution   data synchronization

Methods: Online version

  KernPäP – Online Systems   consists of 70 different forms

  structure   basic patient data   patient data at admission   patient history

  assessment medical | care | psychosocial

  treatment   time registration (with reminder)   closing

Methods: Online version

  KernPäP – Online Systems   medication plan (printout for parents)   individual printsheet for each PCT   hard and soft input check   patient administration   administration frontend for …

  user   team   roles   medication   form items   ICD 10

(International Classification of Diseases)

Online Solution: Screenshot – Symptoms

Online Solution: Screenshot – Nursing care plan

Data Security Concept: Data Classes handled in KernPäP

KernPäP handles different Data Classes:

  Patient Identification Data (IDAT)   Name   Date of birth   Sex   (…)

  Medical/Diagnostic Data (MDAT)   Assessment (Symptoms, pain localization, …)   Medication   (…)

  Administration Data (ADAT)   Role Model, Access Matrix, (…)

Data Security Concept: Maximizing Privacy by Separation of Data, as proposed by the German TMF society

  Technical concept will be introduced by Dr. Michael Spitzer on Wednesday (Oral Paper Session 35. Privacy and Security: Securing a Web-Based Teleradiology Platform According to German Law and “Best Practices”.)

Methods: Offline documentation & synchronization

  Documentation at site   small net books with surf sticks   offline documentation possible (only current history & base data)

  local server with secured SQL-Database

  Data synchronization   insert history data in central data base   user is informed by conflicting data (only base data)

Perspective: Goal

  First PCTs using KernPäP in October   Workshops for interested PCTs in November

  Yearly fee applies for PCTs

  Add-ons (features for a 3rd year)   comprehensive user-role-access management   automatic evaluation   Enhancements

  Goal: KernPäP as a nationwide accepted quality assurance instrument

Last but not least: Contact information

Thanks for your interest

Questions?

Contact: Tobias Hartz (hartz@imfl.de) Medical Informatics and Biomathematics

University Clinics Muenster