1. Neonatal Database
Open Source Integrated Clinical, Audit and Followup Neonatal Database Dr Ian Callander, Dr Martin Kluckow & NICUS Group (Neonatal Intensive Care Unit Study – NSW & ACT Australia)

2. National Perinatal Data System Planning Workshop convened by Perinatal Services Network (NSW) in June 2004
No single existing system was ideal
Duplication across AHS and States
Features of the Ideal Neonatal Database are as follows ….

3. Data
OHIO principle (Observational, Historical, Investigations, Outcomes) Observational rather then interpretative data
Based on a common core data fields with national data dictionary definitions where available
Real-time completion
Accuracy and Completeness by use of Mandatory fields, cross validation of fields and assessment of data

4. Ideal features - Clinical Utility
Clinical management system including alerts, links to standards, pathways and policy relevant to the clinician entering the data
Discharge summaries and admission/transfer notification
local hospital data collections supported
A standard suite of reports as well as the ability to perform ad hoc reports
Ability to collate summary statistics
In-built graphing tools

5. Ideal features - Connectivity
Integrate with obstetric data
Links with other hospital systems (diagnostic reports, order-entry and prescribing systems)
Integrate with electronic health record when developed
Links with other healthcare providers (Hospitals, GPs, Community Midwives)
Connectivity with maternal and national neonatal data collections

6. NSW NICUS Database subcommittee
Recommended Option
Develop a purpose built database using industry standard software (Microsoft SQL Server 2000 – or free MSDE) with familiar front end (MS Access 2000)
Economic & Flexible
Robust security and data integrity
Maintain familiarity - Already a lot of experience with MS Access within NICUS group
Full Expandibility and Connectivity
Web-based front end could be developed later

7. INTERNET NSWHealth Intranet Central SQL Server Obstetrix PC Web
Area Health Service (2007 achievable)
Tertiary Hospital
PC Web
PC Web
PC MSAccess
PC MSAccess
Local SQL Server
Central SQL Server
Obstetrix
Non-tertiary Hospitals
Obstetric currently unable to have central server for NSW – separate server in each AHS (except SSWAHS & ACT using other systems)
PC MSAccess
PC MSAccess
NSWHealth Intranet
(much politics required to allow direct connection across AHS boundaries – may send individual patient information by using XML data packets as interim solution
Local SQL Server
Local SQL Server

8. Relationship between main patient tables tables (PMI = Baby)

9. Datetime Patient data is entered into PMI dependant tables (1-many) - relationships can be deduced between these tables using datetime analysis

10. Dropdown list items are stored as integers that relate to a _like named lookup table

11. Dropdown list is pulled from the appropriate lookup _table, and is specific to the baby’s date of birth and whether an audit of clinical item (allows list to change over time)

12. Neonatal Database Audit Module Replaced Old NICUS (CRS) on 01/01/2007 throughout NSW & ACT Clinical Module beta tested at Liverpool Hospital since March 2007, and currently rolling out to NSW perinatal units (8) Reporting Module available since November 2007 – evolving suite Followup Module under construction – expected mid 2008

13. Live Demonstration of Neonatal Database

14. The future National Infection Audit
Level 2 Units connected to Level 3 units with same AHS (aim to increase network connections – ideally NSW central server)
Level 1 units using an obstetric data collection to allow a true denominator
Web – based input/Central server
CERNER/eMR and relationship to new NICUS database – linkage, amalgamation etc
Linkage to the “New ANZNN Database” (new concept)
Host Prospective research projects
Data Mining to detect statistical associations and suggest prospective research

15. Clinical Module requirements SQL Server or PC with MSDE available on hospital network with a designated administrator (administrator rights required on the database or PC) Arrange a day for installation and setup The designated administrator should be available for the whole day. Contact Mobile If you wish for an Obstetrix interface, you should liase with a member of your IT department familiar with this program. Each client PC will need to have this function installed (for further information see Martin Kluckow)