The BCS System for Cochlear Implant Programmes

The BCS administrative system for cochlear implant programmes is widely used in cochlear implant programmes throughout the UK and Ireland. The heart of the system is a patient information database and an appointment scheduling module which are fully articulated with the capture of assessment and rehabilitation records. Further modules of the system allow control of programme resources including stock, staff, equipment and locations and analysis of outcome measures.

The BCS system is a database application based on Microsoft's SQLServer. Users access the system through distributed workstations using a client application hosted by Microsoft Access. The application is fully intergrated with the Microsoft Office suite, allowing data such as appointment letters, research data, assessment results and reports to be published through Microsoft Excel and Microsoft Word.

Patient records include personal details, contact addresses including local professionals and family, implant history, history of diagnosis, and association with specialists.

Patient details can be imported from centralised hospital patient details repositories (such as PIMS, HISS or other hospital or clinic specific systems).

The appointment schedule enables a cochlear implant programme to manage a patient's assessment, implantation and rehabilitation and the programme's use of time, staff and resources.

The outcomes of an appointment booking include printed letters implemented through Microsoft Word to the patient and other interested parties such as school teachers or local health professionals. Appointments are also entered in the diaries of the programme's staff.

The BCS system decomposes a cochlear implant programme's protocol for assessment, implantation and rehabilitation into a number of intervals, actions and assessments. The results of each intervention, such as a 3 year TOD rehabilitation appointment, or the implantation operation itself, are recorded in the BCS system. Details of the assessments and events recorded for each speciliaty are available, grouped by speciality in the menu on the left.

The BSC system provides an easy and reliable interface for input of assessment results. Data is validated at input. A comprehensive online help system is available for users of the system. Context-dependant help can be accessed on screen by pressing the F1 button whenever the user feels they need help.

Once assessment and event data have been input to the BCS system, the results are available for analysis and reporting. Results can be output as printed reports, graphed information, or bulk data can be output to a Microsoft Excel spreadsheet for research purposes. The BCS system provides the tools to define patient populations on various attributes, such as duration of implant use, aetiology, or age. For example, NPCIP's published outcomes were produced using the BCS system. Another example of output from the BCS system is the ability to view on screen, save and print audiograms from audiometric data.

A patient's record of assessment, implantation and rehabilitation can be audited at regular itervals to establish the compleness or otherwise of that record.

The audit may be formatted to indicate areas needing further work by individual specialist staff, at the level of speciality or grouped by assessment. That is, the audit can be used to support statements such as "Mr Brown is a TOD and has 96% completion of his caseload." or "The TOD speciality have 85% completion its caseload" or "Our programme has 99% completion of records of cochlear implantation".

The stock management module provides complete control over all stock items including return for repair, serialized stock, association of accessories with a specific make and model of processor, and full history and valuation reports.

The BCS system can be extended into subsidiary areas, as required by specific cochlear implant programmes. For example the National Cochlear Implant Programme at Beaumont Hospital required an aditional module to cover the provision of ear moulds. The module is fully integrated with the core BCS system, using the same patient details, appointment system and user interface.

Representative users of the BCS system are:

• The Emmeline Centre for Hearing Implants, Cambridge, UK
• Great Ormond Street Hospital for Children Cochlear Implant Programme, London, UK
• National Cochlear Implant Programme at Beaumont Hospital, Dublin, Eire
• Nottingham Cochlear Implant Programme, Nottingham, UK
• South of England Cochlear Implant Programme, Southampton, UK
• Yorkshire Cochlear Implant Service, Bradford, UK