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Digital PEWS

The Digital PEWS observation chart for a child aged 5 to 12. A red banner at the top reads Emergency, PEWS 19, call 2222 immediately. Below it, respiratory rate, oxygen saturation, oxygen delivery, heart rate and blood pressure are plotted over 24 hours against colour-coded scoring bands, showing the child's observations deteriorating into the high-concern bands.

The Digital PEWS chart, showing demonstration data for a deteriorating child.

Digital PEWS is an open-source charting and scoring component for the NHS National Paediatric Early Warning System (NPEWS) observation chart. It calculates NPEWS scores from observations recorded in your electronic patient record (EPR) and draws the chart clinicians recognise, inside the system they already use. Patient data stays in your EPR.

It is an OHTF Foundation Project. The work began at the Royal College of Paediatrics and Child Health (RCPCH); OHTF continues it independently following RCPCH's indefinite pause of its PEWS work, with existing attribution retained.

Contact the Digital PEWS team View the demo Source code

Why it matters

The National Paediatric Early Warning System (NPEWS) gives NHS hospitals one shared way of recording a child's observations and recognising when they are becoming seriously unwell. A common chart only helps if it looks and scores the same wherever a child is cared for, yet each EPR supplier builds its own version, or a trust falls back on paper.

Digital PEWS is one open, inspectable implementation of the chart that any EPR can host. Every trust using it sees the same chart and the same scores, and every improvement made for one trust is available to all of them.

How it works

  • A component, not a new system. Digital PEWS is a bounded scoring and charting component. Your EPR keeps ownership of observation entry, patient identity, records, audit, alerts and escalation workflow.
  • EPR-agnostic. It runs as a SMART on FHIR app, using the FHIR R4 standard to read observations from the host EPR, and can also be embedded directly in a web page or application.
  • Plain web technology. Plain HTML, CSS and JavaScript, with no framework and no build step, so it is simple to host, review and maintain.
  • Open and auditable. The source code is published under LGPL-3.0-or-later and the documentation and clinical content under CC BY-SA 4.0. Its scoring rules are defined in a machine-readable specification, traced to the NHS NPEWS source material and checked by automated tests.

Key facts
Lifecycle status Foundation Project, Incubating
Current version 0.1.0, a development snapshot with an experimental interface
Clinical release No clinically approved release has been designated. Not approved for direct patient care until supplier and deployer clinical safety assessment is complete.
Intended use Calculate NPEWS scores from supplied observations and draw the chart, embedded in a governed clinical system
Licence Code: LGPL-3.0-or-later. Documentation and clinical content: CC BY-SA 4.0. The NHS NPEWS specification and reference chart remain the property of NHS England.
Maintainer OHTF Digital PEWS project maintainers
Clinical Safety Officer Not yet appointed for the component; required before clinical deployment
Medical device Intended-purpose and classification assessment not yet completed
Clinical safety documentation SAFETY.md: initial hazard identification, transferred controls and known gaps
Standards NHS NPEWS observation chart, FHIR R4, SMART on FHIR
Contact pews@openhealthtechnology.org

Why is all this public? See why we publish so much.

Support for NHS organisations

OHTF works with NHS trusts and other providers to take Digital PEWS from open-source component to a governed deployment in their own clinical system.

Integration

Hands-on help connecting Digital PEWS to your EPR, including Oracle Health (Cerner Millennium) and other SMART on FHIR capable systems: app registration, launch configuration, FHIR mapping of your observation data, and testing against your environment, working alongside your EPR team and supplier.

Clinical safety

Digital PEWS publishes its clinical safety documentation openly in the project's SAFETY.md. OHTF provides the component's safety case material and works with your Clinical Safety Officer on your DCB0160 assessment of the integrated system. The component has no clinically approved release yet; completing that work for a deployment is part of what this service delivers.

Training

Training for clinical, digital and EPR teams: how the chart and scores work, what the component does and does not do, configuration, and the safety controls your organisation owns.

Ongoing support

An annual support agreement at a fixed price agreed in advance, so there are no surprise costs. It covers a named support contact, agreed response times, help with updates and new releases, and advice as the NPEWS specification and your EPR change.

Open by default

Paid support never makes Digital PEWS less open. Improvements made during support work go back into the open project unless they are specific to your deployment, so every organisation using it benefits. See OHTF's open-source commitment.

Talk to us

To discuss integration, training or a support agreement for your organisation, email the Digital PEWS team at pews@openhealthtechnology.org.

Contact the Digital PEWS team

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