Bridging the gap across regional and rural Mental Health care - - PowerPoint PPT Presentation

Community Psychiatry Digital Medical Record (CP-DMR)

Bridging the gap across regional and rural Mental Health care through digital transformation

Community Psychiatry Digital Medical Record

CP-DMR Project Bendigo Health in partnership with Data Capture Experts (DCE) CP-DMR Care Co-ordination Platform Project Team

Executive Sponsors: Phillip Tune and Bruce Winzar Project Directors: Danny Lindrea and Tim Lenten Project Manager: Trish Arnold Psychiatry Clinical Lead: Bianca Matthews Technical Leads: Graham Hynman and Luke Garton Project Officer: Enya Murray Education Leads: Michael Thompson and Billie-Jo Bolch

Overview - Bendigo Health Psychiatric Services

Loddon Campaspe Southern Mallee Region

 37,036 square km  300 km from top to bottom  200 km at its widest point  23 Small Rural Hospitals

LGA Profile

 Population - 274,129 increasing by 4,000 per year  In the state of Victoria, per 1,000 population:  2nd highest registered Mental Health patients  3rd highest intentional injuries treated in

hospital

Overview - Bendigo Health Psychiatric Services

After hours Regional Triage Service also covers the Northern Mallee region

Services are:

 provided across 3 service settings; Inpatient,

Residential and Community

 based from 11 sites; Greater Bendigo (6), Echuca,

Swan Hill, Castlemaine, Maryborough and Kyneton 2016/17 Service Data

 Triage phone screenings: 11,564 (avg. 31 per day)  Psych ED Presentations: 1413  Total admissions: 1150 (Inpatient)

602 (Residential)

 Current active cases: 1157

How could we achieve this?

Developed and deployed on Microsoft Azure Cloud

What has been delivered

• Full Triage screening and assessment

application

• Interactive Patient Banner
• Patient Profile; Demographics and Mental

Health

• 53 e-Forms including:
• Dual signature functionality
• Patient Mode
• Automated notifications to a clinicians Outlook

and their ‘My View’ dashboard

• Forms Management module
• In context link with hospital Acute DMR
• Alerts and Allergies Profile: integrated with

broader hospital Acute Digital Medical Record system (DMR)

• Interoperability via HL7 messaging with

Patient Administration System (iPM) and Acute DMR

• Patient timeline including live feed of all

iPM episodes

• Decentralised Scanning functionality: via

Kofax across the region

• Medication Profile

e-Forms and Instant PDF Generation

What has been delivered

• Letter writing module with talk to text

functionality, including talk to text across six e-forms

• Export functionality at the clinician level

inclusive of Medication Profile and Alerts and Allergies Profile

• Business Continuity across the Triage

Dashboards as well as full suite of patient documentation

• Interactive online Help module for both the

clinical and scanning applications

• System security including:
• Multifactor authentication for mobile device users
• System time-out
• Full audit log functionality
• System compliance with:
• IRAP requirements in relation to Data Centre

Security requirements

• AS2828.2 requirements for digitised medical

records

• Device Agnostic; allowing use of a range of

desktop and portable devices

Patient Timeline and Interoperability

Benefits in practice

Patient Timeline and Interoperability

Benefits in practice

Functionality

• Live feed from Patient Administration System

(PAS) iPM including all:

• Inpatient and Residential Admissions
• Emergency Department Presentations
• Outpatient Appointments
• Day Surgery Admissions
• Interactive filtering of clinical documentation;

e-forms and scanned documentation

• In context link with the Acute hospital DMR

including active Alerts and Allergies

Clinical Benefits

• High level information is ‘pushed’ to clinicians in real

time to flag the presence of potentially relevant clinical information

• In context link provides immediate access to all

relevant patient information

• Integrated and complete list of all patient Alerts and

Allergies

• User friendly filtering of the patient record

Full system audibility and user permission groups ensure clinical information is only accessed as required

Staff have real time access across the region to all relevant clinical documentation to enhance clinical decision making and enable proactive service responses

Patient Mode and Document Exporting

Benefits in practice

Patient Mode and Document Exporting

Benefits in practice

Functionality

• Patient Mode locks down and secures the

system

• Clinician Mode requires staff log in

verification to open the system back up

• Device agnostic technology
• Full export functionality at the clinician level

Clinical Benefits

• Provides secure and restricted access by the patient

and/or carer to the system in order to:

• review and complete treatment planning documents

with the level of staff support that the patient requires at the time

• provide or decline consent to treatment or the sharing
• f clinical information between third parties
• Allows the use of portable devices appropriate for

the setting, allowing user friendly interaction with the system on the patient level in all environments including their own home

Supports and protects a patients right to be involved in decision making and treatment planning according to their needs in a digital environment

Dashboards and Notifications

Benefits in practice

Dashboards and Notifications

Benefits in practice

Functionality

• Ability for a clinician to tailor a document

notification to a specific user

• Notifications received by clinicians through an

Outlook email and flagged on the clinicians ‘My View’ tasks list

• Live dashboards with multiple views;
• Administration
• Clinical; Triage and Assessment
• Mental Health Act (Vic MHA14)

Clinical Benefits

• All staff, clinical or administrative, have real time

notification of the completion of documentation relevant to their role enabling timely action to be taken concurrently

• Tailored notifications enable clear allocation of

clinical tasks and clinical authorizations to be sought and received across the region both within and out of hours

• Dashboards manage critical workflows on a regional,

team and individual level allowing work to be communicated in real time across all teams, prioritised and actioned

Streamlined workflows and real time notifications supports clear communication, allocation of tasks and real time support across teams

How it was received

“This feels like we are moving with the times” “This makes it so much easier to keep track of my notes” “It is an exciting new system (about time!).” – written feedback “Less paper forms which means everything will stay together and make everything flow together and also less paper which is amazing! So much easier” – written feedback “I think this system is brilliant and quite user friendly”

– written feedback “I’m still getting the hang of it, but I am loving the system”

“Faster, comprehensive electronic management of patient information” – written feedback

Future Opportunities

• Patient Portal

Enabling patients and carers to securely interface with the platform through an app allowing:

• Information to be pushed both to and from the

patient and/or carer and the service (i.e. Recovery Plans, Medication lists and Advanced Statements)

• Clinical appointments with the service to be set

and accepted in the patient calendar

• Digital resources to be shared and stored
• Invitations to be sent and connection to

meetings with the treating team (i.e. Family meetings) enabled across the region

• Virtual Healthcare

Increasing availability and ease of use for patients and carers, particularly those living remotely, to maximise access to service supports in a timely manner

• Scheduling Module

Allowing individual clinical appointments, clinical team meetings to be scheduled and monitored for both staff and patients, integrated with MS Outlook

• Integration with broader applications; i.e.

My Health Record

Thank you

Trish Arnold Project Manager, Community Psychiatry Digital Medical Record Bendigo Health tarnold@bendigohealth.org.au Ph: 0400 238 783