HINZ 2015 Technology enabling ‘Whole of

Person’not just ‘Whole of System’ care

H I N Z 2 0 1 5 – H E A LT H O N E & L F T 1

Deanne Rowland, Clinical Lead, Laura Fergusson Trust

Anita Cox, Project Manager, HealthOne

What is HealthOne?

H I N Z 2 0 1 5 – H E A LT H O N E & L F T 2

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

Why HealthOne?

The Canterbury Earthquakes

H I N Z 2 0 1 5 – H E A LT H O N E & L F T 3

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

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

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

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

H I N Z 2 0 1 5 – H E A LT H O N E & L F T 22

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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