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eHealth in 2015 – what’s in store?

08 Dec
eHealth in 2015 – what’s in store?

2015 is set to be a progressive year for eHealth.  Following the momentum built up in 2014, I take a look at the top 4 predictions and eHealth “hot-spots” that deserve the attention of Healthcare strategists in 2015.

 

Personally Controlled Electronic Healthcare Record (PCEHR)

In 2015 expect to see substantial progress in the PCEHR and integration of clinical information. Some of the progress made in 2014 will flow on to impact providers and consumers of Healthcare in 2015. Healthcare providers in particular should already have plans in place to align with the work NEHTA is doing, and if not, get prepared now for change.

The National E-Health Transition Authority (NEHTA) will offer funding to private hospital groups to begin integrating their systems with the PCEHR. They have released the details of their Private Hospital PCEHR Rapid Implementation Program (RIP), which will contribute towards the technical requirements for uploading and viewing of clinical documents. Release five of the PCEHR will pave the way for NEHTA to work with pathology and diagnostic imaging services to enable provider information systems to send PDF pathology and diagnostic imaging report to the PCEHR.

In Aged Care, 2015 will (hopefully) see the formation of a single client record that aligns the Aged Care Gateway system and the central client record, to the PCEHR.

In Melbourne, Western Health is gearing up to enter phase two of a project to securely deliver notifications from its hospital systems directly into GP desktop practice management software through an SMD-compliant eMessaging Gateway.  This initiative, and others like it, will become more common-place in 2015.

 

Expanding Consumer Choice

Consumer Directed Care (CDC) is set to be more widely integrated in 2015, with a broadening of services offered under this model.  Whilst CDC within the home and community care setting will continue to develop strengthen, residential aged care looks to embrace the same model of handing control to consumers over their choice of providers.

The My Aged Care gateway website for example, could be the “virtual marketplace where consumers and providers – or demand and supply – meet”.   The quote from a speech delivered by Senator Mitch Fifield goes on to say “Trip Advisor style capacities on the My Aged Care website will develop ratings for the quality of providers and their services, according to what matters to consumers, rather than what Departments and providers think they should be”.

CDC for Residential Aged Care is good for consumers, and is currently in the mindset of policy makers.  Residential Aged Care providers would be wise to consider the impacts of this, and think about strategies to best position themselves for the years ahead.

A current challenge is how Healthcare Providers will manage the new CDC reporting requirements. From July 2015 all Home Care Packages will be delivered on a CDC basis, so there is some concern in the industry around the lack of IT capability to deliver on these reporting requirements as July 2015 approaches.

 

Digital Healthcare

In 2015 many facets of healthcare will increasingly be digitised. Healthcare digitisation offers many benefits around clinical workflow automation, storage savings, longevity of records, and transmission and communication of clinical information.

Fully digital hospitals promise connection, integration and digitisation of medical records, x-rays, pathology results, radiology imaging, medications, CT/MRI scans, vital signs and other health information. Digitisation also provides opportunities around big data analytics and business intelligence to gain a broader picture of patients to improve health outcomes.

Other examples of digital healthcare include: doctors using speech recognition software to translate voice instructions directly onto patient records; linking patient meal planning with allergies and conditions (eg diabetes); medication verification and stock supply; and fingerprint biometrics for clinical staff access to rooms and systems.

It is not just hospitals that will benefit from digital healthcare in 2015. In the home care space a clinically validated monitor has recently been released that allows home users to measure blood pressure and heart rate, and connect it wirelessly to a mobile app. QardioArm works with Apple’s HealthKit, which lets users access all their health and wellness information in one place. It also records irregular heart beat history to provide a reference for doctors. This is just one of many examples.

With digitisation of healthcare inevitably on the rise, appropriate management and governance within this new paradigm will be required.  One example that helps pave the way is the release of the “Clinical Images and the Use of Personal Mobile Devices” guide, which was created to assist doctors and medical students in the proper use of personal devices such as smartphones, when taking and transmitting clinical images.

 

Interoperability

Interoperability is essentially an expansion of the PCEHR.

In the medication management space, 2015 may be the year to directly import medication information out of the PCEHR or GP systems straight into Healthcare Providers medication management (or clinical) system.   From a hospital perspective, work needs to be done to address the challenges faced by interoperability between different clinical systems, as well as the challenges in mapping the Australian Medicines Terminology (AMT) to SNOMED CT-AU.

2015 will also see the continued proliferation of wearable devices. A recent survey from Kronos indicates that 30 per cent of Australians use wearable devices in their personal lives. This adoption rate could result in a smooth transition to wearables for health and fitness use. Health and fitness data can be useful in doctor consultations to aid diagnostics, and in the future could be designed as medical devices and for monitoring general health and well-being.   There will be a time where the patient will upload the data and it will end up on the health professional’s screen.  It may not happen in 2015, but it will happen.

Some wearable devices that already exist include glucose meters that allow clinic alerts and remote monitoring; devices that monitor vital signs; devices and apps that allow patients to monitor their diets; and apps to help with medication compliance. Check out my blog “The Mobile eHealth Revolution” for more information.

 
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Posted by on December 8, 2014 in e-health, strategy

 

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Electronic Medication Management (eMM) in Residential Aged Care – Getting Started

03 Mar

There is something reassuring and comforting about using paper charts in medication rounds. The paper charts are usually up-to-date, the Doctors updates to the medication regime are fairly legible most of the time, paper records never need rebooting, and it has been done this way for years.

Whilst this opening statement is somewhat tongue and cheek, it is reasonably safe to assume that the majority of Residential Aged Care Facilities in Australia still use paper based medication charts.  This is hard to digest considering that electronic solutions are able to deliver quantifiable benefits to client safety and clinical workforce efficiency.  Most clinicians are aware that medication errors are one of the biggest sources of preventable errors for most healthcare organisations. In a report by the Australian Institute of Health & Welfare, 30% of patients admitted from residential aged care facilities to hospitals were as admitted as a result of adverse medication events. Around 75% of these were preventable.

With so much promise of reducing medication incidents, why are more Residential Aged Care Facilities not making the shift to electronic medication management?  Is it the cost, resistance to change, the complexity between the different parties (doctors, pharmacists, nurses), or is this 21st century initiative put into one of those baskets labelled “too hard”, or “next year”?

From my own experience as a Carer and RN in Residential Aged Care, I found it challenging to grasp how all the pieces fit together. The Aged Care Facility holds valuable information relating to patients and their care, whilst the pharmacy has valuable information about patients medication and dosing regimen. Throw the Doctor into the mix with medication changes and we have a melting pot of rich data from different sources, but a seemingly complex web of interrelated yet disparate information.

All is not lost. There are reputable companies out there that do this for a living. You don’t need to go down this journey alone.  Remember, moving to electronic Medication Management (eMM) is essential to reducing medication errors, better compliance, time savings, cost savings and better drug safety. eMM IS a worthwhile initiative.

So, how do we push through the barriers and challenges to facilitate safer medication management practices for our patients/clients?  How do we start the transition to eMM?

  • Be open and prepared for change – Understanding the clear benefits of eMM and discussing it with others is the first step. Set realistic expectations. Keep reminding yourself of the end goal (improve medication outcomes for clients). System changes are only one aspect of the transition to eMM. Processes will also be impacted, and it will take a little time to adjust and work through the teething problems.
  • Plan and communicate – Set clear objectives and plan for the change. Understand the impacts, and communicate your planned changes to clients, colleagues and any person/entity that is potentially affected by the change. Reiterate the benefits.
  • Close the loop – eMM systems that are not connected (ie, pharmacy and aged care systems) hold much less promise of reducing medication errors. If an Aged Care eMM system is not sourcing the drug/dosing data direct from the pharmacy system, then there is significant risks of data entry duplication, transcription errors, contraindication errors, etc. Having connected systems saves time, eliminates duplication, minimises dosing errors, and increases efficiencies and communication between Pharmacy and Aged Care.
  • Plan for implementation – Discuss implementation and planning with your software provider(s). They should have the expertise to properly plan for your transition to eMM.

It may only be a matter of time before the accreditation standards and compliance requirements force Aged Care Providers down the road of eMM. And it makes sense too, as hand-written medication charts need to be a thing of the past (illegible hand writing dramatically increases the chance of medications being wrongly prescribed, dispensed and administered). With the ability to streamline medication administration, improve communication with pharmacies, and integrate the clinical and medication information, now is a good a time as any to make the shift to eMM.

Good luck.

Medications

 
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Posted by on March 3, 2014 in e-health, medication management

 

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