Royal Children's a model of EMR adoption
By far our most popular story for the week was the announcement that Melbourne's Royal Children's Hospital had attained Stage 6 in the electronic medical record adoption model (EMRAM) framework developed by the US-based HIMSS, not just for its inpatient systems but for outpatients too.
While a framed certificate is all well and good if you get to hang it on your wall and it's even better if you've got two of them, the obvious question is whether an EMR is worth all of the time, effort and money put in. The total for RCH for that time and effort came to $48 million, which does make your eyes water a bit but which is pretty much par for the course these days when you take a mainly paper-based hospital to a fully digital one virtually overnight.
It's early days yet but according to RCH's chief medical information officer Mike South, there are measurable improvements from his hospital's Epic implementation, not just in financial efficiencies but in workflow efficiencies too. More importantly, however, there are demonstrable improvements in patient safety and quality of care.
We'll have more on this next week but the early stats are pretty good for RCH. Professor South tells us that the hospital did a survey of senior doctors and nurses eight months after go-live and found that the majority were reasonably or very satisfied with the EMR, very few thought it had made them less efficient, and almost 60 per cent said it had helped to improve the quality of care.
That latter stat is of course the big one. While the beancounters and box-tickers eye up the financial benefits and efficiencies, the clinicians and care-givers are a bit more keen on the safety and quality aspects and how the system can help avoid mistakes. In a hospital, fewer lapses mean fewer corpses. Now that's something to stick on your wall.
Australia now has two hospitals with a HIMSS Stage 6 rating – St Stephen's at Hervey Bay was the first – and they should be joined in time by Brisbane's Princess Alexandra when it rolls out its medications management module. New Zealand recently went through a process to estimate where each of its tertiary hospitals would sit on the model, and found three out of 20 district health boards would probably reach Stage 5. Like Australia, most Kiwi hospitals would rank around Stage 2.
The ultimate is Stage 7 but you need to function at Stage 6 for a certain period before going for the top prize. That's the target now for RCH, and Professor South is confident that the process of attaining EMRAM validation is a worthwhile one. Take our poll and let us know if you agree.
Last week, we asked if you'd like your GP to turn on MediTracker, a new app from Precedence Health Care that will put your medical record from your primary GP on your phone. Sixty-six per cent said yes but a substantial 34 per cent said no. Comments on why people aren't keen are most welcome.