These smaller systems have been developed for Counties Manukau DHB, Auckland, New Zealand. They read patient demographics from a PiMS patient management system running off an Oracle database (PiMS is developed by iSoft). 

The link is patient NHI number. The rule is that nothing enters these feeder systems unless the patient is in PiMS.

They have mainly been developed for smaller user groups who have a specific need to keep clinical data. Their budgets often don't allow expensive modifications to the core PiMS product. It makes sense to develop smaller add-ons, using Access or SQL Server. They all read from the central repository (PiMS). Users get the flexibility to track specialized data, print reports, create mail merges, perform analysis via Excel and so on. 

PiMS is a relational database design, as are these:

Clinical systems

Name Function Platform (front-end / back-end) Comments
MedDocs Document management Access/SQL Server

Typists use MedDocs to create letters dictated by clinicians. Once approved, the letters are available to a wide audience through an intranet. 

More information...

PHN database (Public Health Nurses)

Manage information about events:

  • School Health
  • Vision Tests
  • Sore Throat Clinic
  • Hearing Defect Schedules
  • New Entrant Health Checklist
  • Ear Clinic
  • Form 1 Immunisation
  • New Entrant Immunisation Checklist
  • Enuresis Program
  • MMR Catch up
  • Pre school Ear Test
  • Pre-school vision test
  • Photo screen test
  • Eye specialist exam

Produces detailed reports for each event, together with periodic  statistic reports.

Access/ SQL Server In production since 1999. Used by 4 outlying offices of the main Middlemore campus.

The success of the system is based on early data modelling sessions Natalie and I had together with 3 other key members of the project. 

Screen shots: Child, Add event, Referral, Discharge, Follow-up, Sample event - hearing defect schedule, hearing defect referral report

More information...

Renal database

For patients on dialysis, this system records information about:

  • Pre-dialysis care plans
  • Patient modality
  • Daily/periodic activity
Access/Access Also creates invoices for billing other providers for services SAH provides to their patients.

Now in its fifth year, the system has about 6 people using it all day, every day. It has never missed a beat: a testament to the robustness of Access 97 !

Pulmonary Rehabilitation database Used for physiotherapy patients on the Pulmonary Rehab programme:
  • Waiting list details
  • Appointments
  • Test results: Walk and Spirometry
  • Contacts and action dates
  • Letters sent
Access/Access Using PiMS demographics makes it easy to send letters to patients and GP's using Word templates.

Patients enter a 6 week, 12 session programme. Workload reports help staff plan their days in advance.

A wide range of detailed and summary reports can be printed to Excel.

Screen shots: Waiting list entry, Appointments, Tests, Documents, Contacts, PiMS

Bronchoscopy database Captures detailed data about Bronchoscopy procedures. Prints a report for the bronchoscopist to sign. Summary reports available.  Access/Access Retaining detailed information allows clinicians to perform long term research.
Anaesthetics - Acute Pain audit Captures detailed information from Acute Pain audit data sheets. Access/Access Designed for rapid data entry and retrieval of existing records. Screen shot.
Anaesthetics - Obstetrics audit Captures detailed information from Acute Pain audit data sheets. Access/Access Similar to the Acute Pain system above. Screen shot.

Research data is easy to analyse.

Anaesthetics - Brachial Plexus Block audit Captures detailed information from Brachial Plexus Block audit data sheets. Access/Access As above
Anaesthetics - Chronic Pain clinic audit Captures detailed information from Chronic Pain clinics. Access/Access As above. Allows multiple records for a patient.
Diabetes foot ulcer management Used to capture data from a specialist clinic:
  • Ulcer details and grades over time
  • Co morbidity
  • Medication
  • Amputations
  • Clinical results
  • Admissions with reasons and diagnosis
Access/Access Originally designed as a study by Professor Lester Reed.
Thrombosis database Tracks detailed data about patients with deep vein thrombosis:
  • Treatment and diagnosis
  • Co morbidity
  • Complications
  • Contacts made
  • Contributing factors
  • Lab results
  • Symptoms
  • Therapy
Access/Access Prints patient notes and summary reports.


Home IV Database Tracks detailed data about patients with on the Home IV drug programme:
  • Treatment and diagnosis
  • Co morbidity
  • Medication
  • Contacts made
  • Readmissions
  • Clinic visits
  • Allergies
Access/Access Produces a wide range of statistical reports.


Bone tumour register database Tracks clinical data about bone and soft tissue tumours:
  • Tumour details
  • History and follow-ups
  • Therapy
  • Surgical details
Access/Access Developed to replace a number of disparate existing system. 

The Bone Tumour Register as SAH records information for the whole country. The database will be used primarily as a research tool.

Drug dosage system Calculates and prints drug dosage, route, warning and signoff.  

Administrators maintain all data.

Access/SQL Server Developed for Paediatric doctors - saves time by calculating dosages based on birth date, age or NHI. 
Breast Reconstruction database A huge amount of clinical data is stored about each operation, including follow-ups and a satisfaction survey. Access/Access This started in 1997 as study by Dr Janek Januszkiewicz in the Plastic Surgical Department.

It has just been upgraded to a full clinical system for capturing detailed data about breast reconstruction operations and post-surgery satisfaction-survey results.

Clinical Pathway variance db Captures pathway information including goals, variances, actions, KPI's. Access/Access Summary reports make analysis easy.
IV Infected site Used to track a wide range of infection details for patients on IV treatment
  • Actions
  • Co morbidity
  • Outcomes
  • Treatment etc

Non-Clinical systems

Meals on wheels Hospital cooked meals are delivered by volunteers to elderly people in the community. Tracks: 
  • Preferences 
  • Days off/holidays
  • Kitchen lists
  • Teams, etc
Access/Access Designed to replace an existing non-Y2K compliant system. Screen shot.  

It prints kitchen lists and team reports.

BIDI - ACC invoicing Used to create ACC invoices and manage the process of billing for:
  • Outpatient assessments
  • Inpatient surgical stays
  • Non-acute claims
  • Physiotherapy clinics
Access/Access Designed before the Labour government changed the ACC laws, BIDI somehow manages to work. It produces invoice files for upload into a PeopleSoft general ledger.

Also, a  Houston physiotherapy system sends BIDI files which are reformatted as invoices for upload into PeopleSoft. Schedules are printed to Excel which are signed by clinicians. 

Centre for Youth Health Tracks client information including:
  • Referrals
  • Pre-assessments
  • Assessments and follow-ups
  • Action plans and case notes

The system also records information about:

  • Training events
  • Networking
  • Consultations


Access/Access The Centre for Youth Health is a specialist service that covers the whole Auckland region.


HARP Used to track patients who visit ED more than normal. Used by Case Workers to track:
  • ED events via PiMS
  • Assessments
  • Questionnaires
  • Action plans
  • Case notes and follow-ups
  • Completion

The administrator can modify questions and responses to questionnaires.

Access/Access Unfortunately the HARP project at CMDHB was canned in May 2001: only a month after going live. The HARP database system had only just begun to show its paces...
Healthy housing SAH and Housing New Zealand are piloting a project to see if improving housing in poorer areas can reduce the number of hospital encounters.

The system tracks:

  • Assessments
  • Action plans
  • Questionnaires
Access/Access This project is recycled much of the functionality of the HARP database above.



Inpatient satisfaction survey
  • Imports outpatient and inpatient encounters
  • Survey random selections
  • Create mail merges
Access/Access More information...
IV audit Captures a large range of audit point information. Access/Access