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August 1, 2013 - Cohesion Medical Psoriasis Solution - Featured in Abbvie Spark Newsletter

Highlighting the advantages of new technology in Dermatology


Professor David Burden of the Dermatology Department, Western Infirmary Glasgow (NHS GGC) highlights the advantages of using new technology provided by Cohesion Medical to help manage his Psoriasis Clinic in the summer feature of SPARK's newsletter sponsored by AbbVie.


Real-life experience of setting up a bespoke psoriasis database by Professor David Burden


The safe and effective management of psoriasis in the modern era requires easy access to large amounts of information about individual patients. We now routinely modify patient management based on serially recorded information in areas including patient demographics, symptoms, disease severity, quality of life, pattern of psoriasis (and psoriatic arthritis), co-morbidities and their treatment, previous therapeutic responses etc. All of this needs to be done in a consultation, the duration of which is determined more by historical norms than by comparison with consultations of similar complexity in other medical specialities.


Excellent record keeping in an easily retrievable format is therefore essential. In the Glasgow severe psoriasis clinic over the past 10 years we have used paper-based datasets held separately from the main hospital record, which have served their purpose well but with limitations.


Over the past two years we have commissioned a computer database designed to assist in all aspects of the daily management of psoriasis patients and also academic and commercial research projects. IT-literate readers may wish to stop reading now as you may otherwise be disappointed in my lack of interest in the technical specification, which I am happy to consider as a black box. I can provide few insights into the shell or framework, let alone coding software and integrating calculations. What I can tell you is that the system (PsoriaCal) is modular allowing future developments, and is scalable for larger numbers of patients and clinicians. PsoriaCal runs on its own server, is delivered by the hospital intranet and permissioned access is from a standard web-browser. My main concern has been that the system should be intuitive and user-friendly with an ergonomic dashboard.


The main advantage of the system to the clinician is the provision of an 'at-a-glance' summary of co-morbidities and previous treatment responses, which provides a robust framework for decision making that is particularly helpful in the long-term follow up of complicated patients. Patients also appreciate consultations with a dermatologist who is familiar with the precise details of their case and this in turn increases their confidence and perhaps adherence to the treatment decisions.


The system also has extensive search functions allowing aggregate patient information to be analysed. This can be used for audit purposes, to provide data for other purposes such as 'freedom of information' requests and to satisfy commissioners, for those who are subject to these requirements. It is also proving useful in identifying, for clinical research organisations, the number of potentially eligible patients for clinical trials, and equally for a wide variety of non-commercial research projects.


The development of this system continues to be iterative, as our requirements are refined and database technology and software improves.The problems we have experienced in providing a service for severe psoriasis patients in a large population will have been shared to some extent by other departments around the UK, each of which will be finding their own solutions that may include the use of purpose-built disease-specific computerised databases.










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