15/08/2010 Clinical Decision Support System (Acute) interRAI Acute - - PDF document

15 08 2010
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15/08/2010 Clinical Decision Support System (Acute) interRAI Acute - - PDF document

15/08/2010 Our strategies to improve access to Centre for Centre for Research in Geriatric Medicine Online Health geriatric specialists... Structured pre-assessment performed by trained nurses T ELEGERIATRICS Clinical decision support


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SLIDE 1

15/08/2010 1

Centre for Online Health Centre for Research in Geriatric Medicine

Centre for

Research in Geriatric Medicine

Centre for

Online Health

TELEGERIATRICS

Professor Len Gray Hanoi Teleconference 2010

Centre for Online Health Centre for Research in Geriatric Medicine

Our strategies to improve access to geriatric specialists...

  • Structured pre-assessment performed by trained nurses
  • Clinical decision support systems
  • Case review online
  • Bedside consultation by video-conference

Centre for Online Health Centre for Research in Geriatric Medicine Centre for Research in Geriatric Medicine

STRUCTURED ASSESSMENT SYSTEMS: THE INTERRAI ACUTE CARE

Centre for Online Health Centre for Research in Geriatric Medicine

The interRAI Acute Care instrument is designed to support assessment and management of frail older patients in the acute care setting

Centre for Online Health Centre for Research in Geriatric Medicine

Second generation assessment systems

Clinical

  • bservations

Cognition Mood Communication Mobility Self care IADL Continence Falls Pain Physical environment Social support Formal services

Scales for screening & severity

Cognitive scale Delirium scale Depression scale Communication scale ADL scale IADL scale Pain scale

Automated recommendations

Cognition , delirium, depression, falls, pain, ADL, nutrition, readmission, institutional risk Centre for Online Health Centre for Research in Geriatric Medicine

What does it deliver?

  • Improved quality of documentation
  • An ability to create electronic information
  • Consistency & reliability of decision-making
  • Reduced cost of assessment
  • Potential to:

– Monitor quality – Enhance casemix systems

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Centre for Online Health Centre for Research in Geriatric Medicine

Clinical Decision Support System (Acute)

interRAI Acute Care Recommendations for intervention Risk assessment Diagnostic screeners Clinical

  • bservations

Casemix tools Quality indicators Problem lists Care plan Utilisation monitoring e-Referral ACAT reporting Geriatrician reporting Severity measures Centre for Online Health Centre for Research in Geriatric Medicine Centre for Research in Geriatric Medicine

ONLINE ASSESSMENT...

Centre for Online Health Centre for Research in Geriatric Medicine Online consultation Structured assessment Nurse interviews patient, family, staff Records observations

  • nline (www)

Software interprets & reorganises information Geriatrician reads & reports online Referrals dispatched for

  • ngoing care

The Online Process

Centre for Online Health Centre for Research in Geriatric Medicine Centre for Online Health Centre for Research in Geriatric Medicine Centre for Research in Geriatric Medicine

VIDEO-CONSULTATION

Centre for Online Health Centre for Research in Geriatric Medicine

Desktop consultation

Radiology Pathology Library Google Street-view Progress notes Geriatric profile Ward staff & patient

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SLIDE 3

15/08/2010 3

Consultation by video-conference…

A geriatric e-geriatrician...

Centre for Online Health Centre for Research in Geriatric Medicine

Case conferencing with a multi-disciplinary team

Gray, Wright et al, MJA 2009; 191: 605–608 Centre for Online Health Centre for Research in Geriatric Medicine

Websites...

CRGM

www.som.uq.edu.au/research/crgm

Centre for Online Health www.uq.edu.au/coh interRAI www.interrai.org CeGA Online www.cegaonline.com