MyEHR to National eHealth Record Transition Impact Evaluation Presentation of findings from phase 1 Prepared for public release June 2015 1 Prepared for public release National E-Health Transition Authority www.nehta.gov.au
Acknowledgement The evaluation team recognises this work would not have been possible without the contribution and collaboration of a wide range of people and organisations. Particular thanks to the following: Northern Territory Department of Health • Aboriginal Medical Services Alliance Northern Territory • Northern Territory Medicare Local • Aboriginal Health Council South Australia • Ms Sally Mainsbridge, formerly of NEHTA • Lastly, and importantly, thank you to the many healthcare providers who sacrificed their time to provide input and insight into their use of the My eHealth Record service. 2 Prepared for public release National E-Health Transition Authority www.nehta.gov.au
Overview of the MyEHR service My eHealth Record (MyEHR), formerly known as the Shared Electronic Health Record, is a way of securely storing and sharing an individual’s health information. The service was designed principally to overcome fragmentation of clinical information by ensuring it could be quickly and easily accessed by participating healthcare providers. The My eHealth Record service is operated by eHealthNT, NT Department of Health. It was developed with financial assistance from the then Department of Health and Ageing as part of HealthConnect, and has been operating since 2004. More information can be found at www.myehealthrecord.com.au 3 Prepared for public release National E-Health Transition Authority www.nehta.gov.au
Screenshots of the MyEHR service (training record) Kanga icon indicating presence of a record 4 Prepared for public release National E-Health Transition Authority www.nehta.gov.au
M2N Transition Impact Evaluation project • The MyEHR-to-National (‘M2N’) Transition Project is transitioning the existing MyEHR Service over to the National eHealth Record System (PCEHR) • At the request of the M2N Project Steering Committee, NEHTA is conducting an evaluation of the impact of the transition • A pre- and post-implementation evaluation approach is being used • Phase 1 has been completed prior to transition; it comprised qualitative analysis of n=94 in-depth interviews, and quantitative analysis of close to 15 million system transactions covering 10 years • This presentation is an overview of phase 1 results 5 Prepared for public release National E-Health Transition Authority www.nehta.gov.au
View over Ltyenty Apurte (Santa Teresa) 6
Overview of key findings • Benefits attributable to the MyEHR service provide strong evidence validating the value proposition of the PCEHR system • The MyEHR service was able to realise this value via a gradual evolution towards critical mass, which allowed it to become embedded into workflow • Lessons learned from this evaluation suggest specific ways to accelerate achievement of critical mass in the PCEHR system, and emphasise the importance of sustaining effort aligned to a clearly defined long term strategy 7 Prepared for public release National E-Health Transition Authority www.nehta.gov.au
Value the MyEHR service provides A description of the benefits attributable to the MyEHR service 8 Prepared for public release National E-Health Transition Authority www.nehta.gov.au
The evaluation provides strong evidence of benefits attributable to the MyEHR service Increases Increases access to provider & consumer health confidence information Increases Supports capacity to clinical deliver decision population- based primary making health care Reduces Improves time spent continuity sourcing of care information "Without the MeHR you "I've been obsessive with couldn't have made the MeHR since it first came in because of everything I can same decision" see. It saves you so much Registered Nurse & Midwife trouble, so much time." GP 9 Prepared for public release National E-Health Transition Authority www.nehta.gov.au
The MyEHR service bridges gaps between unconnected clinical information systems 10 Prepared for public release National E-Health Transition Authority www.nehta.gov.au
MyEHR enables vast flows of information between and within sectors – close to a million document views so far Total document views by sending and viewing facility type Sending facility type Viewing facility type Direction of information flow 11
In recent years, the volume of information exchange between and within sectors has increased exponentially 2012 viewing facility type, and 2013 sending facility type 2012 sending Document views by sending and facility type viewing facility type, per year The MyEHR service reached approximately 50% of NT Indigenous population registered during 2010 2008 2009 2010 2011 2012 2013 2014 12
MyEHR service reduces the amount of time and effort required to source health information “It's a lot less time consuming because you're not ringing up another clinic down the road.” Registered Nurse "It saves you so much trouble, so much time." GP “You can get a history immediately rather than starting again.” Registered Nurse “Rather than ring the clinic and humbug them, if you look on the shared records it should be all there.” Clinic Manager 13 Prepared for public release National E-Health Transition Authority www.nehta.gov.au
MyEHR service supports providers’ clinical decision making and clinical safety Improved decision making: “ I look up the date and when they were last there or whatever and then I would judge whether that's the latest or whatever they've come in for or when was your last fracture, look at that, see what the doctor said from the hospital.” Aboriginal and Torres Strait Islander Health Practitioner “ I think we can approach the whole complex problem a bit better because we're better informed basically… I find I've got the big picture; I've got a better picture.” GP Evidence of improved clinical safety: “We actually looked up on the MeHR and that's where we've seen it, this patient is actually allergic to penicillin. So the patient didn't get the needle and went onto a different medication.” Registered Nurse & Midwife 14 Prepared for public release National E-Health Transition Authority www.nehta.gov.au
Almost a third of all MyEHR records have been accessed by 2+ providers in the last 12 months Different providers Different facilities 100% 100% Over 20% of records have been accessed at 2+ facilities 80% 80% in the last 12 months Percentage of all records Percentage of all records 57.4% 60% 60% 51.3% 40% 40% 20.6% 20.3% 17.4% 20% 20% 11.7% 5.7% 6.0% 4.1% 2.8% 1.9% 0.8% 0% 0% 0 1 2 – 5 6 – 9 10 – 19 20 + 0 1 2 3 4 5 + No. different providers who have accessed a record in No. different facilities where a record has been accessed the last 12 months (Nov 2013 to Nov 2014) in the last 12 months (Nov 2013 to Nov 2014) 15 Prepared for public release National E-Health Transition Authority www.nehta.gov.au
87% of all documents viewed are viewed at facilities that are not the person’s HHC Percentage of documents viewed at a facility that is/isn't the consumer’s home health centre (HHC), by viewing facility region Outback SA Region where the viewing facility is located Anangu Pitjantjatjara Yankunytjatjara Queensland Western Australia East Arnhem Katherine Darwin Alice Springs Barkly 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Percentage of documents viewed Viewed at a facilty that is NOT the record holder's HHC Viewed at a record holder's HHC Home Health Centre (HHC): location identified by the consumer as a preferred / main healthcare facility, i.e. their place of usual care. 16 Prepared for public release National E-Health Transition Authority www.nehta.gov.au
The MyEHR service enables clinical information to be accessed at a consumer’s non -usual place of care; overcoming limitations of point-to-point transfer Total documents sent by NT acute facilities and subsequently viewed at an NGO health centre that isn't the consumer’s HHC , by doc type 45 Thousands “They might present to ED 40 overnight and come here with nothing, we can have a look in 35 MeHR, if they're registered and 30 see what's happened in that presentation.” Aboriginal and ED Discharge Summary 25 Torres Strait Islander Health Inpatient Hospital Document Practitioner 20 Other Hospital Document Outpatient Hospital Document 15 10 5 0 2008 2009 2010 2011 2012 2013 2014 17 Prepared for public release National E-Health Transition Authority www.nehta.gov.au
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