DAWN RH User Group Summary 2015

Thank you to those customers who joined us for our recent DAWN RH User Group webinar and especially to Laura Bromilow from Bolton and Dr Michael Power from Newcastle who presented to attendees. This informative workshop provided a great opportunity to share ideas, learn alternative methods of best practice and help customers get the most out of their DAWN software.

The presentations were both interesting and informative with great feedback received from attendees. The write-up for the session can be downloaded here as a pdf or read below.

DAWN RH User Group Webinar Summary 2015


  1. Welcome and Introduction
  2. Bolton Rheumatology: DAWN Processes
  3. Using DAWN to improve the evidence for safe, efficient and effective monitoring of patients on DMARDs
  4. New patient communication methods within DAWN RH

Alistair from 4S DAWN welcomed everyone to the meeting and gave a brief overview of DAWN as a company including its background and mission:

“Our goal is to make life easier and safer for people tasked with managing the care of patients prescribed dangerous medications”

Bolton Rheumatology: DAWN processes
Laura Bromilow, Pharmacist, Bolton

Laura’s presentation outlined the rheumatology service for blood monitoring at Bolton and focussed on the DAWN processes that have been put into place to manage their   patient population.

Within Bolton’s rheumatology service, a variety of staff contribute to the DAWN processes from Consultants, specialist nurses and pharmacists to healthcare assistants and admin staff. Each staff group has a designated role within DAWN and the service currently manages 258 active initiation patients.

All new DMARD patients are registered on DAWN. As part of a shared care agreement, the rheumatology service is required by the CCG to monitor patients for the first three months or until their bloods are stable, at which point they are passed to their GPs for monitoring.

In addition to new patients, patients requiring dose increases and unstable patients that require enhanced monitoring are also registered on DAWN.

For all new patients and those requiring dose increases, a paper ‘DAWN registration form’ is completed that contains all the patient’s key information such as, consultant; contact  details; diagnosis; drug history; drug and dose prescribed; date of first blood test and first prescription required by their GP.

DAWN ‘packs’ are produced for each patient containing the registration form, completed blood forms with required bloods and a calendar of agreed blood dates. Advice line information is also included in the packs along with a prescription covering the first half of the monitoring period. The registration form and a copy of the calendar is also kept by the rheumatology service.

The healthcare assistant registers new patients on DAWN twice weekly using the registration form.

Other formal DAWN processes are in place for:

    • Abnormal bloods
    • Non-attenders
    • Phase changes
    • Repeat prescriptions
    • Dealing with ‘rescue’ patients (those who require more intense monitoring)

Bolton rheumatology service are now also starting to put all of their monotherapy biologic patients onto the DAWN RH system so that these patients are also monitored using the DAWN processes.

Using DAWN to improve the evidence for safe, efficient, and effective monitoring of patients taking DMARDs
Dr Michael Power, Rheumatologist, Newcastle

Dr Power’s presentation looked at the sparsity of evidence available to guide the monitoring of patients on immunosuppressants both in terms of testing intervals and monitoring phase duration for individual drugs and combined therapy.

The large variation in monitoring practices across and within hospitals was highlighted as possibly related to the lack of such evidence.

The opportunity to improve safety, efficiency and effectiveness by filling this evidence gap was the focus of the presentation.

Dr Power drew attention to a number of guidelines from local Trusts and other healthcare associations such as the BSR that, whilst robustly developed, still lacked evidence. Furthermore, a literature review suggests little scientific evidence for monitoring patients on DMARDs.

First pass analysis presented by Dr Power from two sites showed wide variation in monitoring. Potentially, such scientific evidence could facilitate:

    • Quality Assurance: doing the “thing right”
    • Quality Improvement: doing the “right thing”

Dr Power suggested that the large amount of data held within DAWN RH systems across the UK, could be the first step in gathering the evidence required to reduce this variation in monitoring practices by analysing the pooled (anonymous) DAWN RH data.

A possible project plan was outlined:

    • Develop a keen research group and a formal project
      • Identify sites and people as collaborators
      • Draft project proposal
      • Apply for research funding

Two DAWN RH sites have already shown an interest in joining this project.

If you would like to find out more or join the project, please contact Dr Michael Power at Michael.power@nuth.nhs.uk.

New patient communication methods in DAWN – Email, PDF, SMS/Text Messaging  
Alistair Stewart, 4S DAWN Clinical Software

Alistair discussed the new communication tools within DAWN RH that are available in Version 7.9.42 and above. In addition to the existing functionality that enables users to send emails, letters and faxes from the system, the latest version now provides users with the tools to send SMS/Text messages (in conjunction with a third party) and emails with a pdf attachment to patients and other healthcare professionals.

These new communication methods can be set up as timed messages, set to go out at a certain time on a certain day i.e. automatic appointment reminders set to go out three days before a patient’s appointment; or prompts set to go out to healthcare professionals regarding outstanding results that need reviewing.

Patients can choose their preferred communication method and this preference can be recorded within their DAWN patient record to ensure they are always communicated with via this medium. Likewise, they are able to ‘opt out’ of receiving communication via certain methods.

If you would like to find out more about these tools or about upgrading your DAWN RH system to enable their use, contact support@4s-dawn.com If you are already on the web-based DAWN RH Version 7, then your upgrade to the latest version would be included in your current support and maintenance contract.