COVID second wave threatens to swamp Melbourne Health's big bang
There's probably any number of excuses that people make to get out of training for new workplace IT systems, but “EMR training gave me the plague” is certainly a novel one. Something similar to that claim was made in a story in the Sydney Morning Herald and The Age newspapers this week, in which an unnamed doctor said Royal Melbourne Hospital was “putting staff in danger in order to satisfy their own timeline” for the roll-out of the new Epic EMR, which is due to go live next month.
Royal Melbourne, the Royal Women's and the Peter MacCallum Cancer Centre are all rolling out Epic in a big bang implementation as part of the $124 million Parkville Precinct project, which is using Royal Children's Hospital's 2016 implementation as a template. The Epic emergency department module is live at RMH and planning and training for a May go-live for the full system in the other facilities was well underway when the pandemic struck.
Melbourne Health prudently announced in March that it was postponing the go-live and then set a new date of August 8. While CEO Chris Kilpatrick, who oversaw the RCH project, seems confident that the bigger bang will still go ahead, the second wave of coronavirus now pummelling Melbourne may cause another rethink. There were 288 new cases confirmed on Friday, July 10, with 47 people now in hospital and 12 in intensive care. If those cases continue to rise, it might be prudent for Professor Kilpatrick to think again.
That being said, the pandemic has seen other health services scale up existing digital health initiatives as well as ploughing ahead with long-planned new implementations. As we've reported recently, Sydney Local Health District has massively increased its rpavirtual hospital initiative, including providing training for doctors and nurses on telehealth and the LHD's Cerner EMR.
Southern DHB in New Zealand has rolled out a new dictation and transcription system to two hospitals that involved training and implementation support delivered remotely from Australia. And to return the favour, DXC's New Zealand-based team of expert MedChart implementers was unable to be onsite for the go-live of the medication management system at Sydney's Northern Beaches Hospital due to the lockdown being called in March.
Other big hospital services such as Alfred Health, which uses a Cerner EMR, have fast-tracked the provision of Cerner's PowerChart Touch mobile suite to medical students, and Royal Hobart Hospital has brought forward its roll-out of the Medtasker clinical communication and task management platform.
Besides the NBH project, though, few are being confronted with such an Epic change, so to speak, in such uncertain times. We'll see if Melbourne Health continues on its course.
In other news this week, Fred IT was unsurprisingly announced as the winner of a contract to build South Australia's new ScriptCheckSA real-time prescription monitoring system. Like Queensland and its QScript system, SA plans to adapt the SafeScript platform that Fred built for Victoria, which makes a lot of sense. WA Health has indicated it plans to do the same.
We also reported on the fifth report in Outcome Health's POLAR GP data insights series, which is providing near real-time information on a range of general practice activities during the pandemic. The information gathered and analysed – on telehealth use, medication prescribing and mental health diagnoses, among others – is proving to be incredibly valuable. It is being sourced from 1000 general practices in five primary health networks – South Eastern Melbourne, Eastern Melbourne, Gippsland, South Western Sydney and Central and Eastern Sydney – which offers a pretty comprehensive snapshot of a good proportion of the Australian population.
One of the interesting findings from the most recent two reports is a steep increase in the diagnosis of anxiety since the pandemic struck, allied to an increase in anxiolytics, particularly diazepam. There has also been a smaller increase in diagnoses of depression. Having such recent data means the Outcome Health analytical team can make some suggestions that could be adopted quickly, such as a recommendation to the Department of Health that it consider an MBS item number for practice nurses to do check-in calls on isolated patients via telehealth. It need only be temporary, and could make a lot of difference as we face a second wave.
Telehealth and MBS funding for it was the subject of our poll from last week, which sparked off a heated debate on our blog, as did the previous poll on My Health Record. Last week we asked: should MBS rebates for telehealth only be available from the patient's usual GP? You don't get much closer than this: 49.25 per cent said yes, and 50.75 per cent said no.
This week we ask: Should Melbourne Health postpone its Epic big bang until later in the year?
Click here to vote or leave your thoughts below.