1 Journey to a Scanned World Northern Health & North Western Mental Health

2 Before the Scanned World

3 Setting the scene

4 Why a Scanned World? Support the continuity of patient careSupport the continuity of patient care Reduce clinical riskReduce clinical risk Cost reductionsCost reductions Storage restraintsStorage restraints Manual handlingManual handling 1 st big step towards a full electronic medical record1 st big step towards a full electronic medical record

5 The Journey Begins…… Feb 2006 Tender advertised 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-live Sept 2008

6 The Scanned Record

7 Initiation to Implementation Establish governance structures and project teamEstablish governance structures and project team Engagement and liaison with stakeholdersEngagement and liaison with stakeholders Review and Re-designReview and Re-design Identification, acquisition and implementation of IT infrastructureIdentification, acquisition and implementation of IT infrastructure Communication and TrainingCommunication and Training Monitoring and EvaluationMonitoring and Evaluation

8 Governance Two governing bodiesTwo governing bodies –Northern Health –NorthWestern Mental Health (Melbourne Health) Project Control GroupProject Control Group Reference GroupsReference Groups Risk ManagementRisk Management

9 Stakeholder Engagement InternalInternal –Clinical Staff –Administration –Health Information Managers ExternalExternal –Mental Health Review Board –Consumers and Carers

10 Review and Redesign Paper flow v’s Future flowPaper flow v’s Future flow Redesign of HIS departmentsRedesign of HIS departments Redesign of administration rolesRedesign of administration roles Clear Business rules:Clear Business rules: –Prepping –Scanning –Use of CPF Quality Assurance checksQuality Assurance checks

11 Mental Health Review Board Statutory TribunalStatutory Tribunal Conduct reviews and hear appealsConduct reviews and hear appeals Access clinical information via LaptopsAccess clinical information via Laptops First site in Victoria to have lawyers and patients access information directly from scanned medical record.First site in Victoria to have lawyers and patients access information directly from scanned medical record.

12 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

13 IT Infrastructure Scope IT infrastructure and resourcesScope IT infrastructure and resources Rollout:Rollout: –Scanners – 13 –New/replacement PCs and Laptops – 259 –Mobile Computing –Double screens –Data Projectors and LCD Screens Remote accessRemote access Access for Shared ServicesAccess for Shared Services

14 Communication Plan

15 Training! Training! And More Training! Clinical trainingClinical training –Group –One on one –Online Administration/ClericalAdministration/Clerical –Scanning Training –Scanning Practice sessions –Prepping sessions

16 After the Scanned World

17 Monitoring System & processSystem & process Scanning KPI’sScanning KPI’s –12 hr turnaround ED presentations –24 hr turnaround outpatients/admissions –48 hr turnaround community episodes –24 hr turnaround Mental Health –98% accuracy of scanning staff –98% accuracy of document preparation staff

18 We are listening! SurveysSurveys –Clinical, Administration and External Stakeholders User GroupsUser Groups User FeedbackUser Feedback Consumer & Carer feedbackConsumer & Carer feedback EvaluationEvaluation

19 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

20 Lessons Learnt Prepping focusPrepping focus EngagementEngagement Scope IT earlyScope IT early Identify best communication methodsIdentify best communication methods Quality Assurance processesQuality Assurance processes More clinical super usersMore clinical super users Identify changing processes earlyIdentify changing processes early

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

22 Questions!