1. Title of the Change Project
Student ID.
MSc in Healthcare Management,
Institute of Leadership, Royal College of Surgeons in Ireland
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I.R.I.S.H Record (Irish Renal Instance Single Health Record )
Public Private all aboard
The introduction of eMEDRenal IT Patient Management System in the first Satellite Haemodialysis Units Arwa Shuhaiber
Abstract
Aim: The dissertation describes a project that aim to introduce the structures needed to implant eMEDRenal (Renal specific electronic medical records), to the three new contracted private satellite units. Complemented by full laboratory reporting integration.
Rationale: The National Renal Office (NRO) over the last four years has introduced the eMED Renal ITPMS in line with the Kidney Disease Clinical Patient Management System (KDCPMS). Seventy-five percent of the national deployment plan of the KDCPMS completed; ultimately it will be deployed in all 9 Parent Renal units and associated Health Service Executive (HSE) contracted SHU. The purpose of this organisation development project is to extend this implementation to the private Satellite Haemodialysis Units (HSU) in Ireland. This change project is first of its kind; where the Public electronic patient medical records, shared with privately contracted units, with the full complementary access and use.
Change Process: The HSE organisational development model was used to guide changes and achieve the goal. This change allows the optimisation of patients’ clinical safety, quality, equality and standardise care across the private and public sector, in real time. It illustrates the ability to deliver unprecedented cooperation, between the public and the private partnership in Heamodialysis patient care. It gives the relevant private health care provider, access to the public e-MEDRenal patient folder under their dual clinical care. This close the loops in the ability to document and exchange electronically correct clinical information about the public patient receiving dialysis in the private satellite units and dissemination plan with cost-benefit analysis. Sharing the full functionality of electronic medical records between the private and public sector can potentially used in the future with the patient universal health identifier number to access patient single electronic medical records across Europe.
Evaluation: All objective were evaluated using the relevant evaluation models such as the Context Input Process Product model and the pre and post evaluation audit, etc.
Results and conclusion: The successful introduction of the eMEDRenal to all three haemodialysis satellite units, within the first week of clinical operation, and the interface of the private laboratory patients results reporting system into eMEDRenal. The objectives of the change project not only achieved, but also demonstrated the ability to care for patients across the private and the public health services for the benefit of the patients under their dual care. Replicate the process three times give the assurance that all private satellite units can use this model as a pathway to the implementation of the eMEDRenal in the future that will truly make the eMEDRenal the national KDCPMS System.

2. 1. Introduction & Background 6. Organisational Impact
I.R.I.S.H Record (Irish Renal Instance Single Health Record )
Public Private all aboard
The introduction of eMEDRenal IT Patient Management System in the first Satellite Haemodialysis Units (SHU) Arwa Shuhaiber
1. Introduction & Background
4. Methodology
5. Evaluation
The Health Service Executive (HSE) has contracted private haemodialysis (HD)units to deliver HD in SHUs since These units traditionally had HD provider specific IT systems to manage HD treatments, with written medical notes.
The National Renal Office(RNO) identified the development of a renal heath intelligence system for the Republic of Ireland (ROI) as a key requirement.
The eMEDRenal was successful in the tendering process. This system comprise primarily of a National Clinical Patient Management System deployed where renal services are currently delivered by the HSE.
The eMEDRenal is the tool used to implement a Kidney Disease Clinical Patient Management System (KDCPMS) that will facilitate the clinical management of all patients with kidney disease from first presentation to a renal centre; right through to renal replacement therapy and transplant.1
The HSE model was used by the author
Initiation: Literature Review, service analysis. Stakeholder approval, approval of the NRO, HSE, Private providers, Clinical director.
Planning: Getting all stakeholders, and IT from the five organisations, HSE, eMEDRenal, Laboratory, HD private providers and medical clinician( the writer), to agree the plan for introduction, infrastructure, implementation, time frame and training pre and post implantation to the end user where indicated.
Figure 1: HSE Change Model 2
Implementation: The introduction of eMEDRenal in the three HSU on the week of operations. Training, Interface of all private Laboratory results and validation
Mainstreaming: The change success and reproducibility across the three units even when the parent units were not supporting eMEDRenal. It will become part of the requirement in all satellite units in constant with the National Renal polices in future. HSE is the HD service purchaser . The support of the HSE staff and the free accessibility of this model on HSELand, are key for the wider implementation. The safety of care by reduce opening in the Swiss chesses model.
Figure 2: Swiss Chesses Model
100% Electronic medical records are shared in real time with relevant parent hospital with e-MEDRenal .
100% laboratory data are accessible in patient electronic records eMEDRenal.
Figure 3: Chart of instance access to patients information in SHU/Parent hospital with eMEDRenal
6. Organisational Impact
1)Patient attending HSU care is uniformly with HSE care with access to results ,medical notes and laboratory results in real time's now closely knitted not only with the parent unit but with the national renal IT network.
2)Change project first of its kind allowing private and public healthcare providers to share electronic medical records prevent the Sews chess model,fig2 in real time for the benefit of the patients with instant access to the correct information 24/7.
3)Saving 100,00 euro per year per HSU.
2. Aims & Objectives
Aim: Managing the development of the eMEDRenal system introduction for use in the first three private haemodialysis satellite units (HSU) in the ROI.
Objectives:
1)All Patients records in the satellite units will be live and active on the eMEDRenal by the 1st of March 2015.
2)Full access to both Private Health Care Providers (HCPs) and Public HCPs to the shared electronic folder as per their a assigned role on eMEDRenal in real time.
3)Laboratory to be interfaced with the eMEDRenal, live before 30th of April of 2015.
4)The integration of the dialysis machine with the eMEDRenal in real time by 30th of April 2015.
Conclusion
Positive: All three HSU units where able to use and share patients records in eMEDRenal within the first week of operations. Closing the Lope in clinical and Laboratory data.
Negative : Due to complicated HD machines and soft wear programmes, dialysis data both way interface from machine to eMEDRenal and visa versa were not implemented in the live of the Project.
3. Change Tools
References
PESTLE
SWOT
FORCE Field analysis
Stakeholder analysis