realisation in Opt-Out trial site Nepean Blue Mountains Jo-Anna - PowerPoint PPT Presentation

HealtheNet & My Health Record benefits realisation in Opt-Out trial site Nepean Blue Mountains Jo-Anna Wood Change & Adoption Manager eHealth NSW

Introduction ________________________________________________________________________ In October 2015, the Nepean Blue Mountains Local Health District • (NBMLHD) was selected as one of two sites to trial the automatic creation of My Health Records for all residents. The trial commenced in March 2016 and finished on 31 October 2016 The trial set NBMLHD on the path to embedding the process of viewing the • NSW HealtheNet Clinical Portal and My Health Record into clinical workflows More work to be done to drive uptake and adoption across all clinical • groups and sustain the use of these systems as part of clinical practice This presentation will cover lessons learned and present clinical case • studies that outline how HealtheNet and My Health Record information is being used successfully in practice, such as by hospital pharmacists and clinicians on the wards for medication reconciliation

Introduction ________________________________________________________________________ In the Nepean Blue Mountains region 98% of patients have an eHealth  record due to less than 2% ‘opting -out ’ Clinicians view a patient’s My Health Record information through the  HealtheNet Clinical Portal, via their EMR HealtheNet shares a patient’s hospital discharge summary with their My  Health Record, unless the patient requests that their discharge summary is not shared with their My Health Record on admission (or throughout their stay) Adoption increasing as the number of documents in the system grows,  which recently expand to include pathology results We are now seeing patients with over 100 ‘documents’ in their combined  My Health Record and HealtheNet record

HealtheNet ________________________________________________________________________ Better information results in better patient care HealtheNet helps to improve communication between hospitals, community and private healthcare settings by sharing patient information electronically and securely with: Doctors, nurses and allied health providers across all NSW Health  Local Health Districts and Specialty Health Networks through the HealtheNet Clinical Portal General Practitioners (GPs) by sending discharge summaries directly  to a patient's nominated GP using secure electronic messaging Patients and their care team by sharing clinical documents with a  patient's My Health Record For further information (including Quick Reference Guides and videos): http://www.ehealth.nsw.gov.au/programs/clinical/healthenet

HealtheNet ________________________________________________________________________

Local statistics – info in the record ________________________________________________________________________ Approximately 1,500 per month Shared Health Summaries have been  uploaded in NBMLHD since July 2016, There are 88 general practices in our region uploading to the record (out  of 108 practices with computers) There are 22 pharmacies in the region uploading to the system, this  number is increasing as more software becomes compliant From July 2016 to Feb 2017 171,000 dispense records have been uploaded  31,852 dispense records from community (retail) pharmacies in the region  were uploaded in January

HealtheNet ________________________________________________________________________

Clinical Portal – available documents

Discharge Summaries These are the discharge summaries able to be sent electronically in NBMLHD: PowerForm: • ― Baseline (Standard) ― Gastroenterology ― Geriatric ― Neurology ― Toxicology ― Renal PowerNote: • ― Emergency

Pharmaceutical Benefits Report Two year date range

Pharmaceutical Benefits Report – used by Pharmacist ________________________________________________________________________ How is HealtheNet and My Health Record used in practice (as pharmacists)? As an additional resource for medication history/reconciliation  Useful screening tool for unusual/omitted medications to prompt further  investigation Useful for identifying regular pharmacy/GP/Medical Specialist  Can indicate level of compliance through dispensing history  Wade McKeown Pharmacist Nepean Hospital Pharmacy Department

Medicare Benefits Schedule Information Medicare Information View contains a selected date range of Medicare data: • Pharmaceutical Benefits Report Information (PBS) • Medicare Benefits Schedule Information (MBS) • Australian Immunisation Register • Australian Organ Donor Register

Shared Health Summary A Shared Health Summary is uploaded to the patient’s My Health Record directly from their GP’s practice software. It may contain: Adverse Reactions • Medications • Medical History • Immunisations •

Prescription records

Dispense records

Imaging If images/reports available this icon appears Repository Indicates no images/reports available

Imaging Viewer

Benefits Realisation Pilot The benefits realisation pilot partnered with clinicians and together we have • identified key benefits of the (combined) systems We are now starting to track and measure these benefits • The benefits are measured through either quantifiable data • E.g. how many discharged patients had a discharge summary sent to o HealtheNet, their GP and My Health Record? Via case studies and stories such as asking clinicians "how much time was • saved by having access to other LHDs discharge summaries?" or "how do you use HealtheNet to support your medication reconciliation processes?

Benefits Realisation Pilot Approach Workshop 1: 5 key stakeholders • Workshop 2: 30 key stakeholders including executive, health information • managers and medical records, administration managers, clinicians (Head of Renal Medicine and Head of ENT Surgery, ED Nurse Unit Manager etc) Presentations and in-services conducted to over 500 clinicians between • December 2016 and April 2017 Developed relationships with key clinical groups such as pharmacists, • NUMs and junior doctors who were keen to embrace the technology

Benefits HealtheNet Benefits – validated and prioritised by NBMLHD stakeholders on 30/3/17 1. Enhance integrated care by improved information sharing with primary care All GPs to receive an electronic discharge summary directly as well as it being sent • to My Health Record 2. Access to patient information contained in record on presentation to ED Increased viewing of HealtheNet and My Health Record for medical history, allergies • and current medications on presentation to ED 3a. Provide an aggregated source of relevant patient information Increase the number of times HealtheNet is viewed for every patient, on first • contact/encounter, across all specialties b. Viewing of diagnostic images Increased use of the imaging portal, particularly in Outpatient Services • c. Viewing of pathology information Increased viewing of pathology results in HealtheNet •

Benefits HealtheNet Benefits – validated and prioritised by NBMLHD stakeholders on 30/3/17 4. Access to and visibility of patient medication information Increased viewing of record for medication reconciliation purposes on admission • and throughout patient stay. 5. 24/7 real-time access to past results (medications, radiology, pathology, discharge summaries from other LHDs) Reduced time spent searching for information from other LHDs/labs, and reducing • time spent waiting for information to arrive (a fax, paper record, GP clinic to open) 6. Improved patient engagement and involvement in their healthcare Improve patient awareness and use of their My Health Record through viewing • information and entering OTC medicines, allergies and ACD. 7. Improved handover and continuity of care between acute and primary care settings Increased GP contribution to and viewing of the record – SHS & Prescribe uploads, • viewing DS & pathology info. Increased viewing by community pharmacy and other providers (dentistry, • specialists etc)

Confirm benefit sources, measures and baseline targets Baseline Target Target Outcome Outcome Measure Measure Data Data Perio Perio Period Final Current Descriptio Owner Name Owner source source d 1 d 2 3 n and ID and ID [The name [The name [Metric #1 [The best [Where will [The [Where [Goal of the of the The name authority this data starting did this amount relevant person of the on this come figure at data for the outcome] nominated measure] measure] from? E.g. comme come current with making Name of ncemen from? E.g. period] sure this system] t of the Name of outcome project] system] happens] Wherever possible Wherever use possible measures use that measures already that exist in the already business! exist in the business!