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The gold in the thread

The gold in the thread. Michelle Martella HIS Operations Manager – Barwon Health Anna Coote (HIM) Managing Director PH Primecare P/L Heather Grain (HIM) E-Health Education P/L. Introduction. Why are we talking about…?

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The gold in the thread

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  1. The gold in the thread Michelle Martella HIS Operations Manager – Barwon Health Anna Coote (HIM) Managing Director PH Primecare P/L Heather Grain (HIM) E-Health Education P/L

  2. Introduction Why are we talking about…? The process of replacing paper with a Digital Medical Record (DMR), the progression to an Electronic Health Record (EHR) and the gold found when doing so.

  3. Barwon Health Overview A truly great place to work • 390 acute beds • 511 sub acute and aged beds • 40 mental health beds • Unique patient identifier across all 23 sites • Largest employer in the region • Regional receiving hospital servicing 400,000 people across Barwon South West Region • 40,000 presentations to ED annually

  4. What is the DMR? An umbrella term covering electronic capture and delivery of information that has traditionally been stored on paper - a health record in computer readable format. • It is a combination of the:  • Electronic Health Record (EHR) –information is entered electronically or imported via external electronic systems • Scanned Medical Record (DMR)- information is created using paper, then archived in an electronically viewable format.

  5. The project • Our chosen system BOSSnet by Core Medical Solutions • Embedded on site since 2001 • DMR Go live 2007 • Multiple user access, all locations • Access to all patient related health information via one access point with one password • Configurable to specific filtered views • Audit trail – read/write

  6. How are we looking now? • COST NEUTRAL in 18mths (projected 5 years) • Record requests have significantly reduced, all pre existing records now offsite • HIS clerical staff up skilling • DMR spawned to finance and HR

  7. The DMR - a snap shot of how do we do it • No back scanning • Bar-coded MR forms • Current folders on wards • Scanning controlled in HIS, 24/7 • Post discharge 24 hours, 30 mins for patient transfers • Archived and sent offsite for storage • No intention to destroy, at this stage! • 10,000 sheets scanned per day

  8. The benefits of a DMR ? Gold– interoperability of the electronic record through • Consistent structure for information • Application of computer logic and algorithms to the content of the medical record • Medications profile from one system available in another • Information sharing The thread, the processes linking the gold

  9. The threads and their attributes Electronic Health Record (EHR) • Sharing of complete/summarised information across multiple health organisations/health care professionals • Automation, streaming workflow, improved decision support, ……improved patient outcomes

  10. Digital Medical Record (DMR) The progressive removal of non-computable, paper-originated, records towards computable information

  11. Health Information Health related information that is accessible and usable from the point of capture … through to national health statistics

  12. What did we dig up? • Paper • Electronic • Digital • Health Information • Clinical Coding

  13. The mining operation Gold Workload figures A smarter way to work

  14. The production of priceless nuggets Diamonds Daily reporting

  15. Digging further we uncovered more priceless gems Sapphires Administrative monitoring Remote coding and auditing

  16. Now in regular production Rubies The audit trail – is it really just a way to police patient confidentiality? Silo sites – to share or not to share?

  17. In hindsight…. • Training • Communication • Dr/patient relationship • HIS support at “Go-Live” • Silo sites • Audit trail – new uses

  18. What would have helped? • Standards • Greater working parties with other health organisations

  19. Where to from here….? Clinical teams are now driving the move to electronic entry 2010/2011 • Medication management and administration • Electronic alerts • Continue with our professional partnership with CMS to find smarter and safer ways to work • Continue progression from DMR > EHR • EHR > PHR ???

  20. Fruits of our labour • 2009 Outstanding Achievement’ for Information Management from the Australian Council on Healthcare Standards Surveyors • 2010 Gold award at recent Victorian Health Care Award for ‘Delivering sustainable & efficient healthcare services’ by ‘Increasing information availability in health care’

  21. Conclusion Was it worth it? Would be do it again? In a heartbeat

  22. For further project information Michelle Martella Barwon Health  michellem@barwonhealth.org.au  0403 605 306

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