A Western Cape surgeon developed an online clinical tool that has single-handedly improved clinical administration in the Surgery Department of Worcester Hospital.

Head of the Clinical Unit in the Department of Surgery at Worcester Hospital, Dr Riaan Duvenage, realised the necessity of a clinical management system in 2006 when he was the hospital’s sole surgeon. “I wanted to organise the department’s clinical notes in a more efficient way; this led me to Googling how to make a website and my brainchild quickly progressed from there,” said Dr Duvenage.

Dr Riaan Duvenage - EHN

Dr Riaan Duvenage

Worcester Hospital’s Surgery Department admits approximately 200 patients a month, half of which undergo operations. The volume of patients against limited resources formed the basis for Dr Duvenage’s determination to improve the clinical workflow. “There’s a fundamental need to develop a solution that improves communication while ensuring adherence to clinical guidelines,” said Dr Duvenage.

“Surgery has special needs, so I wanted to create a system with a basic design that ensured accurate data collection and supported the clinician through the process of referring them for surgery. The most essential thing however was to lessen the workload of clinicians, not add to it,” continued Dr Duvenage.

The system’s custom design is aligned to processes within the Surgery Department and with the surgeon as the central focus; it allows users  to download all the operations they did, thereby offering a digital alternative to the conventional log book, and also creates operation and discharge reports. “The system caters for all aspects of surgery; from referral tools and clinical guidelines to outreach and support, as well as streamlining the referral process,” said Dr Duvenage.

“Since the system’s been implemented there has been a tremendous change; clinicians are now more organised and communicate better,” said Dr Duvenage. The uptake has been extremely positive and everyone has gotten over their initial scepticism, “it definitely helps that staff are tech-savvy from using smartphones and similar technology,” Dr Duvenage added.

Dr Duvenage has developed and implemented the system free of charge; all that was required from the facility was to provide Internet connectivity and computers for the doctors. The system has also enabled the department to become paper-light. Even though all the data is accessible online, the system has printing functionality so notes can be printed out and given to patients and also stored in paper files, which is required by law.

“I’ve taken immense steps to secure the data; there are a number of anti-hacking and security systems in place.” Users in the Surgery Department are required to log in with a unique username and password, and to access actual patient data an additional login is required.

While Dr Duvenage is optimistic about the contents of the Western Cape 2030 strategy and is a firm believer in establishing eHealth standards, he noted that “I believe it’s more sensible to establish norms, standards and a minimum data set instead of developing a uniform system.”

Dr Duvenage is currently working on fully integrating the system with the Worcester Hospital’s PAC system, as well as making it more mobile friendly because “tablets are the way to go.”

Due to the system’s success, it is being duplicated to provide a similar system for the Obstetrics and Gynaecology, Internal Medicine and ENT Departments at the hospital. Beyond that, it is also getting recognition from other regional hospitals that have shown an interest in implementing the system at their own facilities, including the Surgery Department in New Somerset Hospital.

“The system is still a work in progress and will probably keep me busy for the rest of my career,” concluded Dr Duvenage. “I believe it has the potential to be implemented nation-wide, which will mean it’ll no longer be a one-man show but require buy in from Government and even the private sector.”

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