Practice Managers Heather McDonald, Manager Clinical Adoption and - - PowerPoint PPT Presentation

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Practice Managers Heather McDonald, Manager Clinical Adoption and - - PowerPoint PPT Presentation

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Digital health for Practice Managers Heather McDonald, Manager Clinical Adoption and Usability Katrina Otto, eHealth Adoption Education Support Officer AAPM Sydney 9 March 2016 1 National E-Health Transition Authority www.nehta.gov.au The My

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AAPM Sydney 9 March 2016 Heather McDonald, Manager Clinical Adoption and Usability Katrina Otto, eHealth Adoption Education Support Officer

Digital health for Practice Managers

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The digital health record is a secure electronic summary of a patient’s health records. It provides an active online record from different sources that over time will follow patients as they move through Australia’s health system.

The My Health Record system

Previously called PCEHR, now called My Health Record system.

My Health Record

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Information in a digital health record comes from three main sources

Patient Health Professional Medicare

  • Personal medications and

allergies summary (can be viewed by healthcare professionals)

  • Personal health notes

(cannot be view by providers)

  • Child development

information

  • Advance care directive

custodian contact details

  • Shared Health Summary
  • Event Summary
  • eDischarge Summary
  • eReferrals and Specialist

letters

  • Prescription and dispense

records

  • eDiagnostic Imaging and

Pathology reports

  • Medicare claims data
  • Pharmaceutical Benefits

Scheme

  • Australian Childhood

Immunisation Register

  • Australian Organ Donor

Register

  • DVA claiming events
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eHealth progress over past three years

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  • Over 2.5 Million people have a record
  • An extra 1 Million to get a My Health

Record during participation trials

  • Over 2.9 Million Prescription and

Dispense records

  • 8,010 Healthcare providers registered to

use the system

  • Over 337,000 Clinical Document

Uploads

  • Including 260,000 hospital discharge

summaries

  • 470 public hospitals and health centres
  • 24 private hospitals

My Health Record is growing!

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Total uploads as at 4 February 2016

Health Summaries

Discharge Summaries

Specialist Letters

10,330

73,119

298,651

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Discharge Summaries uploaded in one week

5,236

As at 4 February 2016

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Clinical documents uploaded in one week

9,290

As at 4 February 2016

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Benefits of digital health

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How does the My Health Record system benefit clinicians?

Better access to health information Health Information around patient’s current conditions and past records like diabetes, heart disease, medications

  • r past surgeries.

Improved Continuity of Care Continuity of care through accurate and timely communication and clinical hand-over across health professionals using eHealth products. Informed decisions on patient’s medical needs Informed decisions

  • n patient’s medical

needs through access to a health history that is shared rather than recalled by the patient. Benefits

  • It will reduce the time taken in chasing up on documents such as

Discharge Summaries

  • It will reduce the volume of paper documents
  • It will reduce time in scanning
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  • Health information will travel with the individual
  • Healthcare is not affected by the individual’s ability to remember

their medical history

  • Individuals have the ability to update personal data and view their

health information online

  • Better quality, safer and more efficient care for individuals

(information availability and less time wastage)

  • Reduction in duplication (tests, information, etc.)

How does the My Health Record system benefit individuals (patients)?

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  • 1. Gradual evolution towards

critical mass

  • 2. Becoming embedded into

routine clinical and administrative workflow

How has the MyEHR service been able to realise value?

Benefits & Learning from NT Experience

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Evaluation of NT eHealth showed strong evidence of benefits attributable

Increases access to health information Reduces time spent sourcing information Supports clinical decision making Increases provider & consumer confidence Improves continuity

  • f care

Increases capacity to deliver population- based primary health care

"I've been obsessive with MeHR since it first came in because of everything I can

  • see. It saves you so much

trouble, so much time." GP "Without the MeHR you couldn't have made the same decision" Registered Nurse & Midwife

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“It's a lot less time consuming because you're not ringing up another clinic down the road.” Registered Nurse "It saves you so much trouble, so much time." GP “You can get a history immediately rather than starting again.” Registered Nurse “Rather than ring the clinic and humbug them, if you look on the shared records it should be all there.” Clinic Manager

Digital Health reduces the amount of time and effort required to source health information

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Digital health foundations

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The foundations combine the basic technologies of unique identification to provide a safe and secure method of exchanging healthcare information – identification, authentication and encryption

Digital health foundations

HPI-I

Healthcare Provider Identifier-Individual

IHI

Individual Healthcare Identifier

HPI-O

Healthcare Provider Identifier-Organisation

Who provided the service Who received the service Where the service was provided Heathcare Event

The right health information associated with the right individual at the point of care

Healthcare Identifiers (HI) Service

Operated by the Department of Human Services (Human Services) which allocates a unique 16-digit number (a Healthcare Identifier) to individuals using healthcare services, their practitioners and healthcare organisations. For more information on the HI Service visit: www.humanservices.gov.au/hiservice

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What may be on a patient’s digital health record?

Shared Health Summary

Prepared by a Nominated Healthcare Provider (an RN, Doctor or Aboriginal Healthcare Worker providing ongoing care) in consultation with the individual, it is a summary of the individual's health at a point in

  • time. It could include medical history, allergies and adverse reactions,

medications the individual may be taking and any immunisations they have had. The Nominated Healthcare Provider (NHP) is the only person that can upload a Shared Health Summary.

Event Summary

A clinical document used to capture health information about significant healthcare events from a healthcare professional. Information may include clinical synopsis and medications. You are not required to be a Nominated Healthcare Provider. It is likely that other parties will upload an Event Summary eg a nurse documenting wound management care or a flu vaccination, or a patient on holiday and visits a non-regular GP.

Discharge Summary

Created for an individual when associated with an event/hospital

  • admission. May include diagnosis, key dates, clinical synopsis, diagnostic

investigations and medications upon discharge, improving the continuity

  • f care between healthcare professionals.
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How is the My Health Record system accessed?

Individuals can access their digital health record via the consumer portal. Consumers are able to contribute to their health record by inputting personal health notes, medications and allergies.

Consumer Portal

The Provider Portal is view only. Healthcare providers can view and download a patient’s health information but cannot contribute to it.

Provider Portal

Healthcare providers with access to My Health Record system conformant software are able to contribute to the patient’s digital health record by uploading clinical documents via their software.

Conformant Clinical Software

The ’my child’s eHealth record’ app is for consumers with children under the age of 14 years. It allows parents and authorised representatives to access the child’s eHealth record and and view information about the child’s development.

Mobile Application

Consumers Providers

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Training & Tools to assist with My Health Record System

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Access Software Summary Sheets & videos

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  • Can be used in existing clinical information system
  • Accessible whenever you need
  • Self-contained and no registration process

On Demand Training

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On Demand Training Environment: Log on anytime and practise with a ‘test’ patient.

Available at http://www.nehta.gov.au/using-the-ehealth-record-system

Training Environment

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How do you use the eHealth record system in your practice?

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  • 1. Register your practice online
  • Online eHealth Registration forms for healthcare providers

www.nehta.gov.au

  • Interactive forms for a better user experience
  • Information verified before submitting to improve application

success

  • You will then receive ‘certificates’ to load into your software to

enable access to the My Health Record System

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  • 2. Enter HPI-Is into your software

Link Clinicians:

  • Ensure doctors & nurses obtain their HPI-I from AHPRA
  • View the Software Demonstrations on the NEHTA website

http://www.nehta.gov.au/for-providers/ehealth-support- tools/software-demonstrations Register for your own eHealth record and familiarise yourself with the record

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  • 3. Start Uploading Summaries

Shared Health Summary

Prepared by a Nominated Healthcare Provider (an RN, Doctor or Aboriginal Healthcare Worker providing ongoing care) in consultation with the individual, it is a summary of the individual's health at a point in

  • time. It could include medical history, allergies and adverse reactions,

medications the individual may be taking and any immunisations they have had. The Nominated Healthcare Provider (NHP) is the only person that can upload a Shared Health Summary.

Event Summary

A clinical document used to capture health information about significant healthcare events from a healthcare professional. Information may include clinical synopsis and medications. You are not required to be a Nominated Healthcare Provider. It is likely that other parties will upload an Event Summary eg a nurse documenting wound management care or a flu vaccination, or a patient on holiday and visits a non-regular GP.

Discharge Summary

Created for an individual when associated with an event/hospital

  • admission. May include diagnosis, key dates, clinical synopsis, diagnostic

investigations and medications upon discharge, improving the continuity

  • f care between healthcare professionals.
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What does a Shared Health Summary look like?

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What does an Event Summary look like?

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What does a Discharge Summary look like?

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What does a Discharge Summary look like?

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1.Gradual evolution towards critical mass 2.Becoming embedded into routine clinical and administrative workflow

How has the MyEHR service been able to realise value?

Learning from NT Experience

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Receptionist Role in My Health Record System

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Receptionists can register patients

Ensure you have set up user permissions in your software for Assisted Registration

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Example scenario - sample dialogue

“Do you know if you have a ‘My Health Record’? If

you don’t have one we can create one for you now, it only takes a minute. A My Health Record means your other doctors or the hospital will be able to see your medication list and any allergies and significant history. You can also access this record yourself at home if you wanted to. You can choose also if you would like to see your own Medicare or prescribing history. If you think you might like to access from home I can get that first access code sent to you by SMS or email or I could write it down now and give it to

  • you. It’s up to you”
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Receptionist registers patient for eHealth record

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Registering patients

Download and read: The Assisted Registration: A guide for Healthcare Provider Organisations

(http://www.ehealth.gov.au/internet/ehealth/publishing.nsf/content/assiste dregguide)

Containing:

  • An outline of the registration process
  • Steps for getting ready
  • More information on the registration process
  • Audit and compliance

Before you start… For more information… Assisted Registration Healthcare Providers FAQs

(http://ehealth.gov.au/internet/ehealth/publishing.nsf/Content/faqs-hcp-ar)

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Registering patients

  • 1. Essential information about

assisted registration and your privacy in the eHealth record system’ document

(http://www.ehealth.gov.au/internet/ehealth/pu blishing.nsf/content/assistedregessential)

Download and Print

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5 Tips for success

  • 1. Train staff so they are prepared for conversations about eHealth
  • 2. Design a workflow that works for your practice eg. nurses may

register, GPs may give forms to Practice Managers etc.

  • 3. Design a dialogue with your staff so they know what to say to patients
  • 4. Add information on your new patient form / TV screens / website
  • 5. Focus on assisting patients who have chronic conditions or ‘at risk’

Registering patients

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eHealth Reality – Patient Scenarios

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Identify your patients who may benefit from a shared eHealth record

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Role Play Scenarios

Regular patient comes in for visit. This patient has a cardiac problem and visits often and does not have a My Health Record. a) Talk to patient regarding a My Health Record and getting registered. b) Obtain consent c) Use clinical software to register the patient. d) Patient goes to see Doctor for consult. e) Doctor uploads health summary.

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Doctor uploads shared health & event summaries

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Example scenario – Doctor uploads shared health summary

Patient presents who is your regular patient and who has registered for a My Health Record. Patient: “I have registered for an eHealth record and believe you can put my medication list on it so other doctors can see it?” Doctor: ”Yes, let’s just take a quick look at your health summary to check the medication and history list is up to date”

  • Previews and uploads shared health summary
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You have a travelling/visiting patient not known to your doctor?

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Example scenario – Doctor accesses My Health Record

Patient presents who is not your regular patient Patient: “I’ve been in hospital not long ago and now I’m on holidays and just don’t feel quite right. They changed my medications when I was in hospital and I have no more scripts.” Doctor: ”I can see you have a My Health Record. Shall we have a look to see what your doctors have put on that?” Doctor accesses the patient’s My Health Record

  • views hospital discharge summary
  • views shared health summary from regular GP

.

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Example scenario – Doctor uploads event summary

  • 1. Doctor sees patent who is a visitor to the area.
  • 2. Accesses My Health Record and views discharge

summary & shared health summary from regular GP .

  • 3. Treats patient, changes medications.

“I have changed your medications today. I’ll just upload an event summary and that way should you need to see another doctor they will be able to see my changes on your My Health record. This is what your event summary looks like and your regular GP will be able to see that document too when you return home. So go and see her when you return and they will check on you and update your record there.”

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1.Gradual evolution towards critical mass 2.Becoming embedded into routine clinical and administrative workflow

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Example scenario – Updating shared health summary

At the end of the consultation. “We’ve changed your medications today so I will just quickly upload your health summary to your My Health Record.”

  • 1. “This is what it looks like (either display or print)”.
  • 2. “Does that look accurate?”
  • 3. “Great, that’s been uploaded now.”

(Should take less than 30 seconds)

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A team approach

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A team approach

  • 1. Practice Managers write the

policy & train staff

  • 2. Receptionists register patients
  • 3. Registrars & nurses may be

able to help clean up data

  • 4. Nurses, Registrars, GPs &

Aboriginal Health Workers can upload

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Checklist for Practice Managers

  • 1. Ensure NASH certificate is renewed and installed
  • 2. Link HPI-I of all clinical staff HPI-I to the HPI-O
  • 3. Give staff relevant access/‘permission’ in your medical software
  • 4. Write a practice Digital Health policy
  • 5. Have ‘essential information’ sheets ready to give to patients to read.
  • 6. Include Digital Health information on your “New Patient registration

form”

  • 7. Train all staff on policy, key Digital Health features and software use
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Data Quality

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Download the Data Quality checklist from NEHTA website

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Data Quality checklist

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Coding is Essential!

  • 1. Integrating Healthcare Identifiers
  • 2. Data Records and Clinical Coding
  • 3. ePrescribing
  • 4. Secure Messaging
  • 5. Upload Shared Health Summaries

to eHealth record (My Health Record)

ePIP requirements

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Where to get help?

Call the NEHTA Help Centre on 1300 901 001 or email help@nehta.gov.au Visit the eHealth registration resources available at www.nehta.gov.au/for-providers Visit www.myhealthrecord.gov.au for information on the My Health Record system and promotional resources View the Software Demonstrations on the NEHTA website http://www.nehta.gov.au/for-providers/ehealth-support- tools/software-demonstrations

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Thank You!

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Contact

help@nehta.gov.au 1300 901 001