SLIDE 1
SLIDE 2 Musculoskeletal disorders’, conditions that affect muscles and bones: sport injuries, osteoarthritis, osteoporosis, back pain etc.
- Osteoarthritis Chronic Care Program (OACCP)
- Osteoporosis Re-Fracture Prevention Program (ORPP)
- Back Pain Program
- State wide Model of care, commenced in 2015
- Funded 2 years initially through NSW Planning and
Integrated Care
- Currently under Leading Better Value Care Program
Background
SLIDE 3 Early 2015, Osteoarthritis Chronic Care Prog Team at RNSH, requested an Integrated OACC Program solution within eMR:
- To capture OACCP program specific clinical data about
their patients
- To be able access to their program data as well as the
- ther available eMR data domains, such as:
- Patient Demographics
- History of all visits
- Pathology & Radiology Results
- Diagnosis and comorbidities
- Surgeries and procedures
- Discharge details
NSLHD OACC Program
SLIDE 4 NSLHD - OACC Program
- OACCP Coordinator - Physiotherapist
- Medical staff
- Allied Health team
- Rheumatology Researcher
- Royal North Shore
Hospital
- Ryde Hospital
- Hornsby Hospital
- Manly
- Mona Vale
SLIDE 5 OACC Program Goal
- To improve quality of patients life by
- Reducing pain
- Improving mobility
- Encouraging losing weight
- To receive feedback from patient via Patient Reported Outcomes
Measures
- To assess necessity of surgery either remove from waitlist or
escalate surgery earlier
- To decrease unnecessary hospital visits:
- establishing shared care plan with their GP’s
- encouraging patient’s to receive care from community
services
SLIDE 6
NSLHD MSIC Informatics and Analytics Program Stakeholders
SLIDE 7 NSCCLHD OACC Program Clinical Workflow using eMR Phase 1:
Patient
OACCP Clinic Presentation With Osteoarthritis
OACCP Coordinator complete
OACCP Assessment
Visit details captured
HOSPITAL DETAILS Hospital name Medical Speciality Admission date/time PATIENT DETAILS Unique ID Demographic information Personal details PRESENTATION DETAILS Reason for Admission Source of Referral
OACCP Initial Assessment
OACCP Assessment Document Client profile Physical Assessment MSIC Assessment DASS21 – Patient Reported Outcome Measure KOOS and/or HOOS Setting up Personal Care /Goal
OACCP Coordinator complete
Interventions Referral
OACCP Coordinator complete OACCP Initial Assessment
Referral to: such as Rheumatologist Multidisciplinary team based on clinical needs, such as. Discharge Process
OACCP Initial Assessment
Automated GP Discharge Letter
certain test finding
- Medication
- interventions
- Care
Management Plan
Visit End Exit
GP Surgeon Rheumatologist/ Orthopaedist Allied Health Emergency
Referred to
This workflow repeats for WK12, WK26, Final Visits
SLIDE 8 To achieve these goals…
- To access their patients historical and near
real time clinical data
- To visualise individual or specific population
treatment trend on a daily basis
- To ask questions of their own data,
benchmark and use data
- To assess effects of changes in their
practice
- To assist with continuing evaluation
- f the program
Next requirement is a robust integrated solution that allows :
SLIDE 9
Existing NSLHD EMR system doesn’t have a capacity to meet these requirements An Operational system Integrate multiple data sources, view only Reporting capacity is limited to predefined, not adhoc Database architecture is not designed to allow online analysis Any plan to extract certain datasets may have significant impacts on system performance NSLCCHD - Enterprise EMR System
SLIDE 10
Phase 2: MSIC Informatics and Analytics Application using QlikSense MKM Health
SLIDE 11
Filter : Year Jan 2016 – 20 July 2018 MSIC Prog : OACCP
Example Dashboard 1: OACCP Program Profile
SLIDE 12
Filter : Year Jan 2016 – 20 July 2018 MSIC Prog : OACCP
Example Dashboard 2: OACCP Clinical Progress
SLIDE 13 Conclusion
- It has been proven that the program provides data driven decision making
capacity to clinicians to support clinical program quality and safe patient care.
- It can be introduced into the eMR, that requires cross disciplinary collaboration
with strong leadership.
- It allows accessing and analysing near real time Patient Reported Outcome
Measures periodically to provide more personalised care to patients
- To response to clinician’s ongoing questions about their data, and to explore the
data with full potentials, following skills are vital
- SQL Programmer with Data Visualisation and BI expertise
- Data Scientists/Engineers for advance analytics
SLIDE 14
Ms Jillian Eyles, Physiotherapist , Researcher at RNSH Rheumatology Mr Matthew Williams, Lead OACCP Coordinator, Physiotherapist at RNSH Ms Anna Butcher, Service Development Manager, NSLHD Musculoskeletal and Neuroscience Ms Robyn Speerin, ACI Musculoskeletal Network Manager Prof Jonathan Morris, Obstetrics and Gynaecology Director, Biostatistics and Health Informatics, The Sydney University Ms Ann Mirapuri, Manager eMR and Clinical Programs, NSLHD ICT Mr Simon Hill, Director NSLHD ICT
Special Thank you
SLIDE 15
Osteoarthritis Chronic Care Program Prof David Hunter, Program Director Matthew Williams, Senior Physiotherapist, RNSH Carin Pratt, Physiotherapist, RNSH Jillian Eyles, Researcher , RNSH Rheumatology Osteoporosis Refracture Prevention Program Prof Lyn March, Program Director A/Prof Roderick Clifton-Bligh, RNSH Endocrinology Lillias Nairn, Physiotherapist, RNSH Christian Girgis, Registrar, RNSH Endocrinology Back Pain Program Prof Rodger Laurent, Program Director Patricia Schlotfeldt, Physiotherapist Agency for Clinical Innovation Robyn Speerin, Musculoskeletal Network Manager NSCCLHD ICT eMR Support Unit Chris Oxby, eMR Architect Jenny Gilbert, eMR App Specialist Samrit Pamnani, eMR App Specialist
MKM Health- Best Patient Outcomes
Kaye Hocking, Business Development Manager Vivek Krishnan , Technical Lead
Acknowledgements
NSLHD Musculoskeletal and Neurosurgery Network Anna Butcher, Service Development Manager
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