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Journey to a Scanned Journey to a Scanned WorldWorld

Northern Health & North Western Mental Northern Health & North Western Mental HealthHealth

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Before the Scanned World

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Setting the sceneCPF

Northern Health

NorthWestern Mental Health

The Northern Hospital

Broadmeadows Health Service

Bundoora Extended

Care Centre

Craigieburn Health Service

PANCH Health Service

Northern Area Mental Health Service

Aged Persons’ Mental Health

Program

North West Area Mental Health Service

Inpatient Unit (Northern Hospital)

Crisis and Emergency and Triage

Commuity Programs

Residential

Community and Triage

Acute Inpatients

Residential (Nursing Homes/ Hostels)

Inpatient Unit (BHS)

Crisis and

Triage

Community Programs

Residential

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Why a Scanned World?• Support the continuity of patient careSupport the continuity of patient care• Reduce clinical riskReduce clinical risk• Cost reductions Cost reductions • Storage restraintsStorage restraints• Manual handlingManual handling• 11stst big step towards a full electronic big step towards a full electronic

medical recordmedical record

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The Journey Begins……

2006 20082007 2009

Feb 2006

Tender advertise

d

Infomedix chosen

April 2006

Pilot site go-live

April 2007

Project phase begins

Jan 2008

Community Mental

Health go-live

Feb 2009

Northern Health & Mental Health

Bed Based

Services go-liveSept

2008

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The Scanned Record

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Initiation to Implementation• Establish governance structures and project Establish governance structures and project

teamteam • Engagement and liaison with stakeholdersEngagement and liaison with stakeholders • Review and Re-designReview and Re-design• Identification, acquisition and Identification, acquisition and

implementation of IT infrastructureimplementation of IT infrastructure• Communication and TrainingCommunication and Training • Monitoring and EvaluationMonitoring and Evaluation

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Governance• Two governing bodiesTwo governing bodies

– Northern HealthNorthern Health– NorthWestern Mental Health NorthWestern Mental Health

(Melbourne Health)(Melbourne Health)

• Project Control GroupProject Control Group• Reference GroupsReference Groups• Risk ManagementRisk Management

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Stakeholder Engagement• InternalInternal

– Clinical StaffClinical Staff– AdministrationAdministration– Health Information ManagersHealth Information Managers

• ExternalExternal– Mental Health Review BoardMental Health Review Board– Consumers and CarersConsumers and Carers

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Review and Redesign• Paper flow v’s Future flowPaper flow v’s Future flow• Redesign of HIS departments Redesign of HIS departments • Redesign of administration rolesRedesign of administration roles• Clear Business rules: Clear Business rules:

– PreppingPrepping– Scanning Scanning – Use of CPFUse of CPF

• Quality Assurance checksQuality Assurance checks

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Mental Health Review Board

• Statutory TribunalStatutory Tribunal• Conduct reviews and hear appealsConduct reviews and hear appeals• Access clinical information via Access clinical information via

LaptopsLaptops• First site in Victoria to have lawyers First site in Victoria to have lawyers

and patients access information and patients access information directly from scanned medical record.directly from scanned medical record.

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The Forms Journey• Started EarlyStarted Early• Review and ConsolidationReview and Consolidation• 1500 to 1400 forms1500 to 1400 forms• Electronic formsElectronic forms• Process and PolicyProcess and Policy

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IT Infrastructure• Scope IT infrastructure and resourcesScope IT infrastructure and resources• Rollout:Rollout:

– Scanners – 13 Scanners – 13 – New/replacement PCs and Laptops – 259 New/replacement PCs and Laptops – 259 – Mobile Computing Mobile Computing – Double screens Double screens – Data Projectors and LCD ScreensData Projectors and LCD Screens

• Remote access Remote access • Access for Shared ServicesAccess for Shared Services

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Communication Plan

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Training! Training! And More Training!

• Clinical trainingClinical training– GroupGroup– One on oneOne on one– OnlineOnline

• Administration/ClericalAdministration/Clerical– Scanning TrainingScanning Training– Scanning Practice sessionsScanning Practice sessions– Prepping sessionsPrepping sessions

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After the Scanned World

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Monitoring• System & processSystem & process• Scanning KPI’sScanning KPI’s

– 12 hr turnaround ED presentations12 hr turnaround ED presentations– 24 hr turnaround outpatients/admissions24 hr turnaround outpatients/admissions– 48 hr turnaround community episodes48 hr turnaround community episodes– 24 hr turnaround Mental Health 24 hr turnaround Mental Health – 98% accuracy of scanning staff98% accuracy of scanning staff– 98% accuracy of document preparation 98% accuracy of document preparation

staffstaff

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We are listening!• SurveysSurveys

– Clinical, Administration and External Clinical, Administration and External StakeholdersStakeholders

• User GroupsUser Groups• User Feedback User Feedback • Consumer & Carer feedbackConsumer & Carer feedback• EvaluationEvaluation

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Clinician Perspective

“Improved access to the record means multiple

clinicians at different locations can discuss a client with the information in front of them, this has reduced the need for

hospitalisation in some cases”

“Electronic note writing in CPF has reduced clinical risk because notes and medication information are clearly legible”

“CPF has improved clinical

care by providing

clinicians with permanent

access to the medical

record, regardless of the

site you are on. You no

longer have to wait for

files to be couriered across

sites”

“CPF saves

time!”

NorthWestern Mental Health Clinician’s, September 2009

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Lessons Learnt• Prepping focusPrepping focus• EngagementEngagement• Scope IT earlyScope IT early• Identify best communication Identify best communication

methodsmethods• Quality Assurance processesQuality Assurance processes• More clinical super usersMore clinical super users• Identify changing processes earlyIdentify changing processes early

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Where are we heading?• Destroying scanned documentsDestroying scanned documents• BackscanningBackscanning• System & process improvementsSystem & process improvements• Culture ShiftCulture Shift• Paperless office ???Paperless office ???

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Questions!