NSW south ready for e-health identifiers

South-east area health deploys bottom-up medical records

Walk into any hospital, Emergency Department or outpatient clinic in South-Eastern Sydney & Illawarra, New South Wales, and the clinician will bring up your full medical history on a computer before you sit down.

It’s what more than a million residents can expect through what is likely the biggest implementation of an electronic medical records (eMR) system in the Southern Hemisphere. The massive ground-up IT system has tentacles in almost every facet of healthcare: From surgery and emergency, to pathology and nutrition, to bedside care and discharge.

Phase one of the state baseline build — the standardised foundation for NSW — was quietly completed last month. It introduced eMR into clinics under the massive South Eastern Sydney Illawarra Area Health Service (SESIAHS). The emergency departments and operating theatres at the Prince of Wales, Sydney Children’s and the Royal Women’s hospitals are the latest of 16 hospitals to tap into the eMR system, which supports 14,900 health professionals.

The SESIAHS already has its own patient identification numbers.

The Cerner eMR system is being deployed across the 88 NSW hospitals with the aim of allowing health professionals to devote more time to patient care. Cerner was commissioned to lead and manage the eMR project, with assistance from Health Support Services and from hospital staff, who are all involved in the overall design and implementation of the applications.

There are six components of the eMR system, including electronic orders, results, an operating theatre system, emergency department system, enterprise scheduling, and an electronic discharge referral system.

The SESIAHS eMR covers:

  • Emergency departments with FirstNet
  • Operating theatres with SurgiNet
  • Pathology
  • Radiology and dietary, which are connected to order management and results reporting under PowerChart
  • General practitioners access encrypted electronic discharge summaries which integrate with a variety of GP practice management systems.

The entire eMR system integrates with the health service’s iSOFT Patient Administration System.

Electronic orders and results allow clinicians to request laboratory tests, medical imaging exams, consultations, and diagnostic and service orders, and manages resources including surgical teams, rooms, and patient availability.

Surgical departments now have access to waiting lists and patient pre-admission information bookings for procedures, which can be tailored for specific preferences surgical teams.

The system will provide better transparency around the workload of individual nurses and doctors and help to prevent patient bottlenecks from full beds. Emergency departments will be able to access a patient’s status, list the number of patients waiting to be seen, and generate medical history alerts.

The Emergency Department System is part of the eMR and all locations will have access to the activity in the Emergency Department, facilitating improved communications.

At St George Hospital, clinicians tap patient treatment information into tablets, computers on wheels or wall-mounted laptops that are connected to the eMR over a wireless network.

The SESIAHS was the first area health service in NSW to implement a state baseline build.

The eMR paves the way for the introduction of electronic health identifiers which will record each treatment, condition and aliment into a medical history that will stay with every Australian for life. Each health practitioner in the country will have access to detailed medical histories, once the national eMR systems are in place and the health identifiers are deployed.

But the deployment of identifiers has become a major point of contention due to the lack of information surrounding how the government will implement the nationwide system by mid-year. A health service manager, who spoke to Computerworld under the condition of anonymity, said it is unclear how the National e-Health Transition Authority (NeHTA) will integrate the e-health identifiers with the melting pot of medical systems across the country.

“It will never get anywhere if NeHTA simply provides the national identifier and each vendor is required to link into it,” the person said.

NeHTA has yet to find a software vendor to integrate the identifiers, although Health Department officials told a Senate committee in November that work was in progress.

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