technology enabling 'whole of person' not just 'whole of system' care
TRANSCRIPT
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HINZ 2015 Technology enabling ‘Whole of
Person’not just ‘Whole of System’ care
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Deanne Rowland, Clinical Lead, Laura Fergusson Trust
Anita Cox, Project Manager, HealthOne
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What is HealthOne?
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TheatreHealth Connect South(HCS)
General Practice
Community Pharmacy
Care Coordination
HealthOne
Primary, Community, and Private Health Care
Secondary Health Care
Other Health
provider
Other Health
provider
HealthOne View
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Why HealthOne?
The Canterbury Earthquakes
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Purpose of HealthOne• Timely access to patient information across
primary, community, private and secondary care
• Better, safer clinical decisions• Reduced inefficiencies and duplication• Patient centric
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Primary Care and Community Pharmacy Dispensing is under
HealthOne
Lab Results
Discharge Summary under Discharge Documents
Health Connect South
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Primary Care Data Contribution• General Practice patient data including
prescribed medications, diagnoses and allergies
• Community Pharmacy dispensing• Community Care Co-ordination
Canterbury, West Coast, South Canterbury (11 Nov), followed by rest of SI
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HealthOne – Summary Screen
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Most recent diagnoses – long term conditions
Enrolled GP
Alerts/ Warnings
Most recent services
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HealthOne Medications Screen
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On-Boarding Partners
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Best for Patient, Best for System• Access & Integration
Questionnaire• Technical, Business,
Security Requirements Checklist
• Community led prioritisation
• Impact on patient care, benefits for whole of system
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Pilot – Laura Fergusson Trust• Laura Fergusson Trust
Canterbury (LFT) is our pilot organisation for local On-Boarding. Its size, readiness to integrate and the value it will bring to its clients made it an ideal candidate.
• Pilot went live on 23rd March 2015.
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LFT Rehabilitation Unit• 7 bed unit providing rehabilitation to Clients
who have sustained recent traumatic Brain Injury
• ACC contract holder for this service• New client management system, completely
cloud based
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The Client is at the CentreDHB
GP
Other providers- ACC, Community Nursing
Client and family/whanau
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Rehab at LFT • Complex presentations• Patient centric care• Support from HealthOne team and LFT CEO
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Before HealthOneReferral received
Physical Preadmission assessment
Collection of data (including extensive
printing & photocopying)
Information requested- waiting…
Phone calls made…waiting
Logon required- not mine (privacy
issues)
Collation of data
Entering of data Delay in REHAB while information
obtained
Admitted
Time taken 1-4 days actual time spent gathering data 5-6 hours
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Issues Collecting Information
• Episode based information• Focus on the “problem of the day” • No helicopter view
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Good Rehabilitation Outcomes
• Body and Mind• Baseline• Medical/clinical issues• Social issues
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Case Study• “Sam” is a 23 year old man who suffered a TBI
as well as extensive facial fractures and orthopaedic injuries in April this year
• Admitted to ICU,7 surgeries,27 Radiological procedures, input from 6 teams, 320 Lab results
• Teams involved, Neurosurgery, orthopaedics, maxillo-facial, opthalmology, ENT, Infectious Diseases
• Referred to RALF on 10 May- assessed 11 May admitted 12 May to RALF with ongoing follow up from the secondary sector
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Summary of Injuries• Diffuse axonal Injury ( Severe Traumatic Brain
Injury) Neurological storming Diabetes Insipidus
• Removal of frontal skull to allow for swelling• Le Forte III fractures• Extensive eye surgeries involving muscles and
nerves• Fractured pelvis• Fractured spine• Prolonged stay in ICU due to neurological
deficit• Vocal cord injuries secondary to breathing tubeH I N Z 2 0 1 5 – H E A LT H O N E & L F T 19
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Issues for this Admission
Client
Complex presentation
Multiple teams
involved
Notes held in different
systems
Access to information
can be limited by
system knowledge
Non coordinated
follow up
Don’t know what you
don’t know
Relying on someone
else’s knowledge /
opinion
Know what someone
else knows but is it enough
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Admission with HealthOneReferral received
Pre admission assessment via
HealthOne
Data entered onto client file at RALF
Information extensive: copied
and pasted directly
Physical visit
Further written information
obtained
Time spent with family and staff
obtaining extensive history
rather than paperwork
Admitted sooner
Rehab begins immediately as
staff are fully informed
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Down to 24 hours or less. Actual time spent gathering physical data 2 hours
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Accessing InformationHealthOne
Freedom of access to
information that is
objective, current
Freedom to choose what
information I want to look at
Freedom to review and
act in a timely
manner e.g. on
results and appointme
nts
Freedom to access
information 24/7
Able to copy and
pasteCustomisab
le to meAbility to review trends
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Sam’s Outcomes
Sam
Never missed an
appointment Had medications changed as a response
to bloods on the day
Robust relationship
with Secondary
care
Seamless transition
from hospital to rehab to
community
All Staff were fully informed
Family was fully
informed
Attended appointment
s when it was suitable
for him
Information was current, didn’t need
to be repeated
Big impact on Sam’s ongoing
care
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HealthOne....• ... improves communication• ... facilitates rapid transfer of information • ... makes time for care• ... puts health providers on a level playing field• ... has improved the security of our client
information
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Moving Forward• Better understanding of the context of long
term effects• Presenting the whole of person
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