15/08/2010 Clinical Decision Support System (Acute) interRAI Acute - PDF document

15/08/2010 Our strategies to improve access to Centre for Centre for Research in Geriatric Medicine Online Health geriatric specialists...  Structured pre-assessment performed by trained nurses T ELEGERIATRICS  Clinical decision support systems  Case review online  Bedside consultation by video-conference Professor Len Gray Hanoi Teleconference 2010 Centre for Online Health Centre for Online Health Centre for Research in Geriatric Medicine Centre for Research in Geriatric Medicine The interRAI Acute Care instrument is designed to support assessment and management of frail older S TRUCTURED A SSESSMENT patients in the acute care setting S YSTEMS : T HE INTER RAI A CUTE C ARE Centre for Online Health Centre for Online Health Centre for Research in Geriatric Medicine Centre for Research in Geriatric Medicine Centre for Research in Geriatric Medicine Second generation assessment systems What does it deliver? Scales for screening & Clinical severity observations  Improved quality of documentation Cognitive scale  An ability to create electronic information Cognition Delirium scale Mood Depression scale  Consistency & reliability of decision-making Communication Communication scale ADL scale Mobility  Reduced cost of assessment IADL scale Self care Pain scale IADL  Potential to: Continence Automated – Monitor quality Falls Pain recommendations – Enhance casemix systems Physical environment Social support Cognition , delirium, depression, falls, Formal services pain, ADL, nutrition, readmission, institutional risk Centre for Online Health Centre for Online Health Centre for Research in Geriatric Medicine Centre for Research in Geriatric Medicine 1

15/08/2010 Clinical Decision Support System (Acute) interRAI Acute Care Problem lists Diagnostic screeners Care plan Risk assessment O NLINE ASSESSMENT ... observations Severity measures Geriatrician reporting Clinical Recommendations e-Referral for intervention Quality indicators ACAT reporting Casemix tools Utilisation monitoring Centre for Online Health Centre for Online Health Centre for Research in Geriatric Medicine Centre for Research in Geriatric Medicine Centre for Research in Geriatric Medicine The Online Process Nurse interviews patient, family, staff Records observations online (www) Structured assessment Software interprets & reorganises information Geriatrician reads & reports online Online consultation Referrals dispatched for Centre for Online Health Centre for Online Health ongoing care Centre for Research in Geriatric Medicine Centre for Research in Geriatric Medicine Desktop consultation Ward staff Geriatric profile & patient Progress notes V IDEO -C ONSULTATION Radiology Library Pathology Google Street-view Centre for Online Health Centre for Online Health Centre for Research in Geriatric Medicine Centre for Research in Geriatric Medicine Centre for Research in Geriatric Medicine 2

15/08/2010 Consultation by video- conference… Case conferencing with a multi-disciplinary team A geriatric e-geriatrician... Centre for Online Health Centre for Research in Geriatric Medicine Websites... CRGM www.som.uq.edu.au/research/crgm Centre for Online Health www.uq.edu.au/coh Gray, Wright et al, MJA 2009; 191: 605 – 608 interRAI www.interrai.org CeGA Online www.cegaonline.com Centre for Online Health Centre for Research in Geriatric Medicine 3