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Digitising healthcare: The state of e-health in Australia

Digitising healthcare: The state of e-health in Australia

Several health organisations give examples of how digitisation is transforming healthcare

If there is one industry experiencing rapid change right now, it is healthcare. Whether it’s the shift from paper to electronic records, face-to-face consultation to telehealth diagnosis, or instructing patients to empowering them, the industry is evolving fast.

Here, we look at several examples of how digitisation is transforming the healthcare industry.

Integrated digital hospital

UnitingCare Health is rolling out Australia’s first fully integrated digital hospital, which will connect up e-medical records, X-rays, pathology results, vital sign machines and other health information.

St Stephen’s digital hospital in Hervey Bay, Queensland is set to open on 13 October and is receiving $47 million from the Federal Government's Health and Hospitals Fund, with UnitingCare contributing $49m.

The hospital has a goal to reach Healthcare Information Management System Society (HIMSS) level 6 when it opens, and then level 7 about a year after. This global benchmark for IT maturity is aimed at improving patient care.

The hospital is working with its main technology provider, Cerner, to allow healthcare workers to not only access e-medical records but also gain a broader picture of patients to improve patient outcomes.

“The meal ordering system, for example, will be integrated so if a patient has a diabetic condition we can alert staff whether the patient needs a different diet ... or it will only show certain [food] choices to diabetic patients in hospital,” says UnitingCare Health’s chief medical information officer, Monica Trujillo.

More than 1,000 clinician hours went into designing the systems, she adds. “As I say to the technical team, they are there to facilitate the design of what the clinicians want, not the other way around.”

The hospital will use a closed loop medication system, Trujillo says. When a doctor prescribes medication to a patient, the nurse can use a scanner from the automatic drug dispensing cabinet to check if it’s the right medication, the right dose, for the right patient and if the patient has any allergies before opening the cabinet. The cabinet not only connects to patients’ e-medical records but also a pharmacy stock database to alert staff when the hospital is running low on particular medications.

Trujillo says having this system in place is vital to patient care, as one of the biggest issues in many hospitals is medication errors, which can be life threatening.

Workstations on wheels will also be supplied at the hospital when it opens. The 22-inch computer screens, running on a Citrix platform, are attached to lightweight carts that allow nurses to access information on patients wherever they are in the hospital.

For doctors, speech recognition software, Dragon Dictate, will be used to translate voice instructions into text and record them on a patient’s e-medical record, so they won’t have to waste time manually typing out notes, reports and letters. Trujillo says doctors are training with the software now to become familiar with their different nuances and voice patterns. “Doctors can spend more time with patients and less time documenting,” she says.

Trujillo says the hospital will also supply iPads to doctors in 2015 so they can access patient lists, once the software’s iPad version is released in Australia.

When it comes to security and privacy, Trujillo says users tap their ID cards and enter their password code to log onto any system. Users are asked to declare the reason for logging in, and the date and time is recorded.

Fingerprint biometrics will be used when staff log into the automatic drug dispensing cabinets, too.

“We have also built this on all the national privacy law requirements,” adds Trujillo.

On the spot pathology

NSW Health Pathology is rolling out point-of-care devices in its rural and remote emergency departments where there are no 24/7 laboratories onsite. The devices allow emergency staff to do pathology tests such as blood, lactate and haemoglobin on the spot within nine seconds, or up to 10 minutes for more complex tests.

Andrew Sargeant, point-of-care manager at NSW Health Pathology, says laboratory testing offsite can take hours, so the new solution cuts waiting time down substantially.

By December, 175 NSW emergency departments will be supplied with the devices. A tender was also released in August for more devices to do further types of testing, which are expected to be implemented beyond emergency departments in 2015.

Inside the devices are cartridges that carry out different types of testing. All devices connect to Radiometer’s AQURE middleware, where results are delivered not only to the device’s display screen but also to NSW Health Pathology’s laboratory information systems and e-medical records.

“The smaller sites may have to send that patient on somewhere else, usually a larger facility, for treatment. Now they can treat the patient at the site without having to transfer them, which saves on costs to the local health district but also to the patient,” Sargeant says.

“Also, without the full clinical picture of the pathology involved, a patient might not be treated appropriately. Or, a patient might have pain around the chest and arm area, but it might not look like a cardiac event and maybe he/she will be sent home without that piece of evidence.”

The devices are set up with a lock out feature, which means only trained and competent staff can use them. “We manage that remotely, and each operator is uniquely identified, so you can’t run a sample unless it recognises you as a competent operator,” Sargeant explains.

To run a test, users put in their operator ID then a patient ID, which matches that result to that patient’s record.

Next page: Telehealth

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Tags e-healthbusiness intelligencevideoconferencingehealthtelehealthPersonally Controlled Electronic Health Record (PCEHR)Digital HospitalComcareNSW Health PathologySilver ChainHealtheNetclosed loop medication systempoint-of-care devicesworkstations on wheelsSydney Children’s Hospital Networkpathology testse-medical recordsSt Stephen’s digital hospitalclinical document architectureHunter New England HealthUnitingCare Health

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