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RCH EMR Team #RCHbigbang #HIC19 Mike.south@rch.org.au April 2016 - PowerPoint PPT Presentation

Dec 28, 2022 •432 likes •727 views

RCH EMR Team #RCHbigbang #HIC19 Mike.south@rch.org.au April 2016 EMR implemented Why might this be of interest & why now? 1 st Epic implementation in Australasia Extensive Big - Bang methodology 1 st Hospital patient / family portal

  1. RCH EMR Team #RCHbigbang #HIC19 Mike.south@rch.org.au

  3. April 2016 – EMR implemented Why might this be of interest & why now? 1 st Epic implementation in Australasia Extensive “Big - Bang” methodology 1 st Hospital patient / family portal Structured benefits monitoring program 3 years

  6. Big-Bang: Broad Inpatient wards, Oncology OP clinics Mental Health Service Emergency Dept Regional Outreach clinics Hospital in the home ICUs Theatre / Anaesthesia

  7. Big-Bang: Deep Documentation Scheduling Ordering Referrals Medications (eMM) My Health Record Blood management Patient/family portal Barcode scanning External provider portal Device integration Self-service analytics All mobile apps Research

  8. RCH Services still on paper 1 st May 2016 : None!

  9. Big-Bang: Novel

  10. Big-Bang: Why? Avoid financial / momentum issues Achieve benefits sooner Patient safety all electronic vs hybrid workflows Extensive literature review / site visits / external review

  11. Benefits – a structured program All Leadership Benefit Ongoing Departments Workshop Owner Monitoring 8 quarters before and 8 quarters after go-live Health Round Table, Uni of Melbourne Statistics

  12. Benefits An EMR has potential for real improvements in: Staff satisfaction Clinical outcomes / patient safety Patient / family engagement Operational efficiency Financial performance Research

  13. Staff satisfaction Survey – satisfied/highly satisfied

  14. Staff satisfaction Survey – satisfied/highly satisfied

  15. Outpatient November 2018 Inpatient & Outpatient 2017

  16. Operational / financial

  17. Patient / family engagement Patient portal accounts Satisfaction survey

  18. Clinical incidents EMR related 16 ISR 4. No Harm/Near miss 10 ISR 3. Minor harm Missing referral x2 Wifi drop out in Neuro theatre Research med not in system Doc could not sign med admin Missed dose hydrocortisone Med rec completed incorrectly TPN order wrong Lost letter Patient address wrong Many suggestions for new EMR functionality

  19. Investigations -6.3%

  20. Medication safety -13.4%

  21. Patient safety - Detecting the deteriorating patient

  22. Deteriorating patient +13%

  23. Mortality (p= 0.0145)

  24. Standardised mortality rate (HRT) -27%

  25. Mortality 55 - 84 fewer deaths since go-live

  26. Causality? Imaging tests per episode Medication errors Mortality MET calls

  27. Extending our system

  28. Conclusions “Big - Bang” approach validation Health informatics saves lives Thank you #RCHbigbang #HIC19 Acknowledgements Clinical Epidemiology & Biostatistics Unit, University of Melbourne Mike.south@rch.org.au Health Round Table

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