Orthopaedic Hospital Case Study
The Challenge
Robert Jones & Agnes Hunt Orthopaedic Hospital– Patient Medical Database and Analysis
The Robert Jones & Agnes Hunt Orthopaedic Hospital (RJAH) has the highest patient numbers of all the metabolic bone units in the UK. The Hospital sees over 10,000 patients a year. Patient questionnaires, clinical notes and consent were mostly captured on paper or spreadsheets, which made analysis slow, audits difficult and longitudinal research hard to run. Clinicians needed reliable data at the point of care and researchers needed flexible queries across years of records.
RJAH asked us to build a secure, cloud system that digitises patient questionnaires, captures consent, supports clinician-entered clinical forms and produces analysis-ready datasets. Crucially, hospital teams needed to add and change questions themselves without breaking historical data. Integration to hospital systems and standardised messaging was also required. The data was then passed to 3rd party systems within the hospital and wider NHS via HL7 which is a set of international standards for exchanging and integrating electronic health information between different healthcare systems.
The Development Process
We began by understanding the process that was currently in place. We worked with clinicians to produce a detailed specification covering screens, form structures, versioning rules, roles and permissions, consent handling, audit trails and reporting. Screens for patient and clinician views were reviewed and signed off before build.
Dynamic questionnaires were built with strict version control. Any change creates a new version, so past answers remain intact and comparable. Core questions stay stable, while optional sections can evolve as research priorities change. Clinicians configure questions from an admin area using field types such as radio, checkbox, dropdown and free text.
To improve access, the public questionnaire supports magic link login for patients, while staff use role-based access on tablets or PCs. All submissions are encrypted, every change is recorded to an audit log and reporting pivots by date range, cohort and questionnaire version. HL7/EPR, DEXA and imaging links are planned in later phases once the core dataset is established. Caldicott guidelines were adhered to at all stages of development.
Testing and delivery were phased with each increment being documented. Strict validation was enforced during data migration with any erroneous data being flagged. Test scripts were written from the specification so acceptance was objective.
We ran performance checks for peak clinic usage, including security reviews on roles and encryption. We put in place post-go-live monitoring with a rollback plan.
- Patient and clinician questionnaires with point-of-entry validation
- Versioned forms so edits never overwrite historic answers
- Consent capture and searchable audit trails across all records
- Role-based access for admins, database managers, researchers and clinicians
- Reporting that filters by demographics, conditions, dates and versions
- Secure public access via time-limited magic links for patients
- Foundations for HL7/EPR and DEXA integrations in later phases
Data captured from the DEXA scanner is passed to the database and linked with patient records. Information show below is test data only but the Apps and forms are real.
Outcome
The system has recently gone live and early feedback from clinicians and the research team is positive. Data capture is fast and consistent, searches and reports that once took days now run in minutes and audit readiness is greatly improved. The platform gives RJAH a single source of truth for questionnaires, consent and clinical forms, while preserving the flexibility researchers need as studies evolve. As integrations roll out, the dataset will enrich care pathways and accelerate ethically approved research.
“In addition to the technical build, RD Research are a fantastic team to work with, friendly, professional and highly skilled. We would not hesitate to recommend them.”
Dr Claire Mennan
Consultant & Clinical Lead Metabolic Bone Disease.