As a follow up to “Fertility under the Microscope”, Professor of Reproductive Medicine at Newcastle’s International Centre for Life, Alison Murdoch, discusses her collaboration with Silverlink Software, a specialist clinical software provider, to develop a robust and comprehensive fertility management solution. Prof Murdoch, now in the final stages of testing and implementation, talks through the process of designing the system for the benefit of patients and Trusts alike.
Despite more couples in the UK undergoing IVF treatment than ever before, the overall success rate across the key age groups has remained constant at around 25 per cent for the last decade at a cost to the NHS in excess of £60.4 million every year, according to the Human Fertilisation and Embryology Authority (HFEA).
Paperless puts the patient first
This growing demand for fertility services and increase in expenditure to the NHS was one of the drivers for Prof Murdoch to look at how technology could transform their services and approach Silverlink Software with a technical spec. “We started with the cost-savings that a single electronic system could deliver in terms of improving efficiency,” said Prof Murdoch. “Being able to call up a patient file quickly to deal with any query saves enormous time and effort in comparison to the workload associated with a manual paper-based system.”
“we already collect all the necessary HFEA and clinical data, but having it all in a single IT system means that it can be accessed and analysed much more effectively,”
“Having electronic records also has numerous residual benefits for the centre and the patient but cost savings alone are a reason to implement the system simply to save money in the medical records department and put it into services for patients,” said Prof Murdoch.
Beyond the goal of cutting administration costs, Prof Murdoch believes that a comprehensive digital system is a powerful mechanism for enabling personalised, patient-centred treatment plans because it allows treating clinicians to harness individual patient data to more accurately predict the success of IVF or ICSI treatments. For both clinicians and fertility scientists, knowing who is most likely to get pregnant can focus efforts, streamline costs and ultimately, improve success rates.
“As a large tertiary clinical service we already collect all the necessary HFEA and clinical data, but having it all in a single IT system means that it can be accessed and analysed much more effectively,” said Prof Murdoch. In light of the new HFEA data requirements, due to be announced in 2016, Prof Murdoch went onto to outline the impact that a specialist software solution would have on the NHS as a whole in delivering fertility treatment.
“The amount of data collected by most clinics is not sufficient to do very complex, multi-variant analysis over a reasonable period of time. There’s also been a shift by the national regulator, the HFEA, to amalgamate the data faster. If all the individual parameters of each treatment cycle are entered accurately across the 60,000 IVF cycles done each year, then a much more in depth analysis can be done in a relatively short term to understand patients’ likely outcomes and decide how best to treat them,” explained Murdoch.
Designing for change
Prof Murdoch believes that the negative experiences that specialist departments like fertility have had in implementing digital health systems is due to the fact that they’ve been caught up in a the top-down approach when rolling out EPRs. “There’s been a lot of money spent and wasted on systems that don’t work for what we do. The starting point for designing the new system we’re working on has been to focus on patient data and then make it useful it for clinicians,” said Prof Murdoch.
“In a top-down approach, data is often collected retrospectively after the patient has had their treatment. But there are numerous points where errors occur because the data gets re-transmitted and re-organised multiple times before it is sent to Trust’s data repository,” said Murdoch. She believes that one way the systems she’s working on will address that issue and ensure more accurate information is by allowing clinicians and surgeons to enter data directly into a single database as and when they choose to.
This sort of close clinician engagement when designing a specialist system was one of the reasons she chose to work with Silverlink Software. Having a long standing reputation within the NHS as a provider that develops tailored solutions around clinician and patient requirements, Prof Murdoch said, “My choice to work with Silverlink Software was based on a combination of their understanding of the requirements, their commitment to the process of getting it right and their experience in creating solutions that actually solve problems – not create them.”
When asked why she didn’t opt for an existing solution she added, “I chose to work with Silverlink Software to build an entirely new system because current fertility solutions available on the market are too limited in their scope and failing to keep up with the changing regulatory requirements.”
The final stages
Prof Murdoch and her team, consisting of administrators to embryologists, are currently running simulations with the system in the last stages before they roll-out in their live environment. By inputting anonymised patient records into the new software they can see that all the fields they require have been included and glitches have been fixed, and the system is safe for patient care.
“I chose to work with Silverlink Software to build an entirely new system because current fertility solutions available on the market are too limited in their scope and failing to keep up with the changing regulatory requirements.”
“We’ll be using a combination of paper and digital records for a transition period of the implementation process, because it’s impossible to suddenly transfer a large quantity of different patients’ ongoing records onto a digital system,” said Murdoch. “It could take some time before all the records are completely transferred into the digital system, but at that point we will see significant cost and time savings related to admin efficiency.”
Murdoch expects the system to go live in the first quarter of 2016 once it has been successful integrated with the Trust’s existing PAS system. “Silverlink Software have been a responsive partner every step of the way in designing this system and are essential to the success of a project this size,” said Prof Murdoch.
Once the fertility solution is live, Murdoch believes her team will have better and quicker access to analyse complicated data in addition to automatically capturing the HFEA data. “In the end, this system will serve the patient because we can use it to more accurately predict who is more likely to get pregnant. There are so many factors that influence the success of IVF, so if we see a change in quality indicators or key performance indicators, we can use that as a basis to go back and interrogate the data and pinpoint what happened and how we can use that to influence greater success.” concluded Murdoch.
“Offering fertility specialists a much-needed benchmark for capturing high-quality data.”
Professor Alison Murdoch
Newcastle Fertility Centre @ Life, Newcastle-upon-Tyne Hospitals NHS Foundation Trust