Next to THESIS and WIDE, Esprit supports yet another project involved with hospital management. The COBRA project represents an exercise in Core Business Re-engineering for which it builds upon the RICHE IT Architecture. This approach offers considerable savings by reducing duplication of work in hospitals. The IT solutions transform the clinical and administrative procedures in theatre and day surgery into efficient processes enabling the staff to improve the general performance and make more effective use of the existing facilities in these areas.
The COBRA concept utilises a three-tier architecture of client application, servers containing the business rules of the organisation and a relational database. Patients needing either a one-off or recurrent surgery are conducted through defined protocols or care pathways. They provide appropriate information for the patient at any moment with as minimum intervention as possible.
One of the key roles of the protocols is to identify patients who will deviate from previously defined of standard pathways for whatever reason. In this case, the protocol has to provide a decision support facility for the clinician in order to help him make a correct diagnosis. With the introduction of booking lists, patients no longer are placed on a waiting list to get a consultation or a operation.
The COBRA concept allocates "slots" for different operations, each with its own resource requirement profile. Theatre slots can now be booked much further in advance and not just when the next available space is free. Once a decision for surgical intervention has been agreed upon, the patient immediately is given an operation date and time. Theatre managers are able to plan and organise their resources more efficiently in this way.
To achieve an ideal functioning of the COBRA procedure, all necessary information and guidelines must be available at the appropriate time so as to allow decisions to be made as early as possible in the process. Under certain conditions, it is possible to insert more delicate information to support the patient's interaction in the surgical process. We here refer to criteria such as risk of death, likely outcome, complications, competence of the surgeon etc.
The COBRA server infrastructure has made it possible to develop protocol-driven applications which are process or department specific and to even permit clinicians in other hospitals to have access to all the offered facilities. For more COBRA news, please consult the Irish Medical Systems site on the web.