Aged care at the epicentre of epidemic
We had our fingers crossed this week that things would go well at the Parkville precinct in Melbourne, where three hospitals went live with a new electronic medical record on Saturday morning, and it appears that things have gone smoothly. We have not heard a peep or a grumble about the implementation so far, apart from questioning the wisdom of going live during a global pandemic in a city experiencing a second wave of infections in the first place.
The Royal Children's Hospital implementation, which has been adopted by its neighbours, seems to have been the right one and if there were major problems this week, everyone would have heard. Parkville's big bang during COVID-19 will make a fascinating case study one day.
The Epic event was our top story for the week, followed by the announcement by the WA government that it would begin planning for its statewide EMR. If Clive Palmer doesn't bankrupt the state first, this EMR could be an important legacy for WA, which has not really managed health IT projects overly well in the past. WA is also replacing its Agfa medical imaging systems with a new Canon set-up that is due to roll out in 2022, and is in the final stages of rolling out the new laboratory information system for PathWest from SCC Computer, which is a bit overdue and a bit over budget.
We also had some interesting stories this week about health IT on the frontline. Melbourne's Austin Health is doing between 70 and 80 per cent of its specialist clinics by telehealth and is reporting good results. And RPA Hospital in Sydney along with the local district nursing service are trialling a new remote wound analysis and monitoring system that interfaces with RPA's Cerner eMR. If successful, this trial may lead to statewide adoption of the technology, which can also be used by patients at home and in residential aged care. It sounds very promising.
Speaking of aged care, we heard from two aged care providers in Victoria and NSW that are looking into how best to protect vulnerable residents using new contact tracing technology. With aged care now at the pandemic epicentre in Australia and the subject of a scathing dressing down by counsel assisting the Royal Commission into aged care safety and quality, Peter Rozen, we wonder if technology could have been put to better use. Aged care software vendors certainly worked overtime to ensure their systems all included COVID-19 screening and documentation tools and many offered the use of their messaging and communication tools for free, but the problem in aged care has never been lack of technology options. It has been lack of technology uptake.
Also this week, the Australian Digital Health Agency has called for a go slow – or go slower – on the roll-out of electronic prescriptions to try to avoid situations where a patient is unable to have an eScript dispensed. Most of the leading dispense systems are conformant, according to the agency, including Fred NXT and Fred Dispense, Chemist Warehouse's in-house myScript system, Minfos, Aquarius, Z Dispense, Dispense Works and Corum's LOTS. Conformant GP software includes Best Practice and Zedmed, with MedicalDirector registering a couple of weeks ago.
The agency says 10,000 eScripts have been successfully transmitted; we understand most of this is by SMS, with the email option not yet used. With the federal government subsidising the cost of the SMSs only until September 30, we wonder what will happen when GPs have to pay to send a script. Even at 4c, this might prove a barrier.
ADHA also this week released an independent report summarising the response to its request for information about re-platforming the My Health Record as part of the national infrastructure modernisation program, which we fondly know of as the NIMP. We took a look and quite frankly, it was all a bit “well derr”. Apparently, the national infrastructure should be flexible, highly interconnected, with appropriate security and good governance, stakeholders should be engaged and there should be a focus on consumers to drive better health outcomes.
All of the usual suspects for technology solutions were mentioned: open APIs, standards such as FHIR, containerisation, web-based mobile and desktop apps, elastic cloud (after all, elastic is nothing if not flexible), biometrics, cyber security, secure messaging, distributed ledger (ding ding!), AI, data visualisation, IoT and 5G. There wasn't anything in there that wasn't a bit obvious so we wonder what the use of this document is.
Speaking of being of use, our poll question last week asked: Has ADHA assisted in Australia's pandemic response? Not many were overly positive, we're afraid: 19 per cent said yes, 81 per cent said no.
This week we ask:
Can technology be put to better use in aged care for COVID-19 management?
Vote yes or no here and feel free to comment below.