Electronic Health Records

1. Electronic Health Records Cash Cow or Money Maker Kate HorkingsHealth Information Services Operations Director

2. Our Locations

3. Southern Health Vital Signs • Acute, Sub-acute, Mental Health, Aged & Community • Service area of 2,800 square kms and 750,000 people • 12,000 staff • Annual turnover of $700 million

4. Southern Health Vital Signs • 134,000 inpatient attendances • 700,000 outpatient attendances • 1.8 million Patient Master Index entries • 2.6 million MR location moves annually

5. Why are we doing this?

6. Our Vision Advanced health record management Enhanced Information access and distribution Better decision support Clinical focus on the patient not the process Better patient outcomes Improve clinical productivity Improve error rates Full history always at hand Results acknowledgement Improved care Multi-site access for clinical discussions Improve accessibility HealthSMART clinical integration Better service co-ordination Remove Paper handling First place to find results and reports Increased privacy of Health information Vastly Improve efficiency No clinician need to manage record • A paperless Medical Record always at hand

7. Preparing for an EHR System How does a Health Service start? An EHR is a journey, not a destination

8. Think BIG, Start Small

9. Target Objectives • Reduce clinical access times for current medical records by 100% • Reduce clerical costs by 50% (per record movement) • Reduce medical record movement to other sites by 100% • Improve time to provide test results viewing in medical records by 95% • Return floor space • Reduce incidence of lost records to 0%

10. Scanned MR – The Bridge to an EHR Paper Based Record Includes: Requesting the MR Awaiting MR arrival Receiving MR Updating tracking screen Sending MR to requestor Systems / Databases Used: Homer – PMI & Tracking PRT – Mental Health Tracking Lab Vision – Pathology Merlin – Pharmacy Electronic Health Record Includes: Logging into EHR system Typing in appropriate UR Number Systems / Databases Used: Homer – PMI EHR System – including Interfaces with Pathology, Pharmacy etc.

11. The Southern Health Project DELIVERABLES • Expand Casey model across SH to replace paper records • Execute two year project (Infrastructure and business change) • Change Medical records processes and lower costs by 52% • Achieve 3 year return on investment • Implement new functionality to gain additional benefits • Results acknowledgement • Electronic discharge summaries • Electronic alerts

12. The Southern Health Project BENEFITS • Gain patient, staff and financial benefits proven at Casey • Greater efficiency at clinics @ Casey • Enable clinicians to make informed decisions based on timely access to accurate record and results information • Use clinical buy in to support HealthSMART clinical system project and ultimately EHR • Safer working environment – less physical handling of records

13. Outpatients Clinic Retrieval Process 2 hours 15 minutes Get Outpatient List for Clinics Request additional Records from storage Search Local Records Collate in booking order Appointments Deliver to Clinic Record Treatment observations Open Record Treat Patients Paper Record Search SMR for Patient Record treatment observations Open Record Treat Patients Appointments Eliminated Processes Scanned Record • A significant number of processes are eliminated through the use of a scanned medial record.

14. Lessons Learnt • Know your current processes • Monitoring systems of a paper based department are still paramount • Turn around time is critical • Clinical buy-in is essential • Forms management is critical • Implementation plan – big bang or site based

15. Testimonials “I think the CPF system is desirable in that it allows me quick and easy access to obtaining patient information at times when the patient record is off site or needed by others (eg the ward, coding) etc. It allows for rapid review of the patient’s presentation, management and staff involved which is often necessary in a short space of time.” Medico Legal Officer Southern Health

16. Testimonials “I loved the scanned record as it was; • User friendly – very easy to use and teach somebody else to use. • Convenient to be able to look up patient information quickly. • Really great if a patient arrives for an appointment on the wrong date as history is available electronically and patient can thus be easily seen. All in all, makes for greater efficiency in clinic.” Manager, Outpatient Services South East Sector

17. Financial - Operating Cost Control Operational cost $5m Increased record numbers and record management cost drives up total costs As is $4m SMR roll out $3m Costs are much less sensitive to increased records numbers and IT automation contains record management cost $2m 2004 2005 2006 2008 2009 2010 2007 Note: $ values approximated Year

18. Financial Return on Investment FINANCIALS – 3 year payback

19. Adding Value to Southern Health Reduces the unit cost from $11.97 to $5.92 Contributes to a financially sustainable organisation with marginal growth costs Added Value Has a 3 year payback period Financial Accountability

20. Project Savings • Major operating cost savings will come from: • Labour • Storage • Consumables • Transportation

21. Paper Vs Scanning - some costs Paper Department $23.04 per separation Scanned Department $11.40 per separation 51% reduction Tracking in a paper dept $1.17 per move Tracking in a scanned dept $0.58 per move 51% reduction Paper Record Construction $1.62 per record Scanned Record Construction $0.00 per record 100% reduction

22. Remember…. Be brave, be determined, be resolute! What may seem impossible today, may be the norm tomorrow!

23. It’s not going away! Moving to an EHR is not an alternative. It is not an IF, it is a WHEN! Don’t get left behind, the planning starts NOW!