UK | OMS

We turned a highly specialised paper-based process into a secure online system that can be accessed any time, anywhere, on any device.

We had to deal with a large amount of specialised data and technical terminology and make sure that the system presented it in a way that was intuitive to the users.

The system needed to combine smooth workflow and clear presentation with the ability to scale rapidly as the business grows.

UK Orthopaedic Microbiology Services (UKOMS) was established in Sheffield in 2011 to provide specialist infection testing and advisory services to orthopaedic surgeons around the country.

Every year, around 15,000 people develop infections following hip or knee replacement operations. Surgeons have to perform a revision operation to take samples to uncover the cause of the problem. Surgeons download a form from the UKOMS website to send with their samples to UKOMS. The UKOMS lab carries out the testing to identify the infection and its resistance or susceptibility to different types of antibiotics.

Once the laboratory work has been completed, the UKOMS specialists respond with a detailed diagnosis and recommendations for treatment.

When we started, test results were sent back to surgeons in paper form by post. However, this process was slow and there was a risk of information being lost. It also made it difficult to keep surgeons updated on what testing was being done.

We decided that we wanted to find a way to replace the paper-based system with a secure online system. This would be much faster and would allow surgeons to see the progress of the diagnosis. It would also mean that all the information about a patient would be in one place and could be accessed on a range of devices, so that the surgeon could see all related information such as past diagnosis and action taken.

Nothing like this kind of system exists and so we needed to find a technical partner who could work with us to create it from scratch.

Rob Townsend — Clinical Director and Consultant Medical Microbiologist at Sheffield Teaching Hospitals NHS Foundation Trust

Security: to protect patient data, samples are anonymised when they are put into the system. Surgeons’ access is protected by a login and the surgeon controls who else can see particular records (eg a secretary or organisation manager).

Workflow: to understand what the system needed to do, we had to learn how the testing lab works and then work with the UKOMS team to reproduce and optimise the process. This involved dealing with a large amount of complex technical data, grouping information logically and keeping as close to the current process workflow as possible.

User experience: surgeons are used to having test result information presented in a particular way, so we made sure that the online experience reproduced what they were used to. We kept it simple and anticipated how surgeons would use the information; for example, by allowing them to search by patient (rather than by sample) and see all the records relating to a particular patient in one place.

Multi-device: the system is designed to work across devices, allowing both surgeons and UKOMS specialists to access it wherever they are. This also means that the UKOMS specialists can see results quickly and provide rapid treatment advice to surgeons.

Scalability: at the end of 2013, UKOMS had contracts with 8 hospitals across the UK and handled 275 patients in the last 6 months of the year. They are expecting very rapid growth and the system has been built to grow with them.

Surgeons are used to having lab results in close proximity. With this service, it’s like having the best lab in the country in your hospital. This is labour intensive, low volume, specialised testing and we now have a system designed specifically for the purpose of dealing with orthopaedic samples only. The system makes our service fast, secure and straight-forward to use.

It’s been a mutual learning process – we were taking a novel approach and we went along the path together. We expect to continue working together to make improvements as we continue to develop and the business grows.

Rob Townsend — Clinical Director and Consultant Medical Microbiologist at Sheffield Teaching Hospitals NHS Foundation Trust

The system makes our service fast, secure and straight-forward to use.