EpiSoft signs with CSC to market eAdmissions

Cloud-based software platform developer EpiSoft has signed an agreement with technology leader CSC to commercialise EpiSoft's eAdmissions system, and has also signed a recent contract to pilot-test the system at Calvary John James Hospital in Canberra with a view to a wider roll-out to the private Calvary hospitals network.

eAdmissions is a secure consumer portal that allows patients to register their full clinical and administrative details in advance of their admission to hospital. Developed in association with the Sydney Adventist Hospital (the San), the system allows patients to upload data such as their current medications and allergies and helps to reduce time spent on entering data into the hospital's patient administration system.

eAdmissions was first piloted at the San in late 2011 and is now available for use throughout the 352-bed hospital. Following a contract signed recently with the Little Company of Mary (LCM) Health Care group, it is now being pilot-tested in the maternity unit at Calvary John James before a wider roll-out to other hospitals in LCM Health Care's Calvary network, subject to the trial's success.

CSC Healthcare has also signed up the Mercy Health & Aged Care group to the eAdmissions portal, with plans for an implementation in its hospitals later in 2012.

EpiSoft's director of business development, Jenny O'Neill, said more than 1400 patients had used the system at the San with the eldest patient registered so far being 95. “We promoted it through selected private doctors' rooms to a finite set of patients and there was excellent take up across all types of patients,” Ms O'Neill said.

“We recently did a survey of the first 1000 users and 97 per cent reported that they would use the system again for their next admission. We also received a very good overall satisfaction rating with about 92 per cent of users saying they were satisfied with the whole module.”

EpiSoft's partnership with CSC is a commercialisation and distribution agreement that will see CSC market the eAdmissions portal to both its own PAS customers and those using other systems.

eAdmissions is designed around a user self-registration module that patients can continue to access after they have left hospital and for any return visits. “It saves all of your data online and it is all structured information and fully validated against the patient administration systems in hospitals,” Ms O'Neill said.

“There is also a set of structured clinical datasets that the patient steps through. There are different forms and content for different patient groups – if you are a maternity patient you have a different clinical data capture relative to a paediatric or a general medical or surgical patient.”

There are some common modules such as a medication look-up powered by MIMS, which allows the patient to record their current medications against MIMS' drug list and view the drug images online to help patients verify their choice. For allergies and co-morbidities, the system links to the SNOMED CT dataset.

“The hospital is getting really good quality information in advance of admission,” Ms O'Neill said. “eAdmissions has eliminated data entry to the patient administration system and we are gradually eliminating data entry to the electronic health record in the hospital.

“There are significant safety benefits with a more complete and comprehensive medication list and allergy list and patients are selecting and coding their clinical data from lists well, in fact very well.”

While no hospital users have taken up the capability as yet, the system does allow for clinical staff to edit the submitted record online and the patient has immediate access to the edited changes. “We developed this capability for staff to make corrections where required to self-reported medications and other information and resubmit an amended version of the patient history to the hospital’s EHR.

“At the moment only very limited data goes back to the portal from the hospital systems via the HL7 standard preadmission messages but there is the capacity to expand this to establish a more interactive communication between hospitals and patients around their record.”

EpiSoft's patient survey also showed a substantial time saving over paper-based forms, which showed the system could save patients over 30 minutes compared to manual form submissions.

“For future admissions, it has a copy forward function, so patients can hit the copy button and simply amend their data for their next visit,” Ms O'Neill said. “They still have to step through the screens and validate that data is still current, but the website is very wizard-driven and easy to use. For subsequent admissions it will save patients a lot more time as all the data is pre-populated from their previous use.

“It is very legible of course, so the handwriting issue has gone away, and we are populating the hospital's own medical record forms. We have a familiar, print-friendly view both for the patients and the hospital staff that is consistent with the forms still being received manually, the difference being the medical record forms from the eAdmissions system have been electronically populated.”

From the hospital's end, the eAdmissions record lands in the hospital's worklist to verify the person and to match to the patient master index and to a doctor booking if one has been received. As soon as data matching has occurred, admissions staff click a button and the data populates straight into the PAS.

The system also has functionality to allow the patient to upload a set of associated documents, such as the doctor's referral, any consents associated with the admission, advance care directives, or a birth plan if they are a maternity patient. The patient can also upload any other documents relevant to their admission in addition to the data capture.

Ms O'Neill said about 20 per cent of patients were taking advantage of this document upload function, even though it requires them to have a flat-bed scanner or pre-scanned documents. “We expected the use of this to be a pretty low percentage of admissions but it is actually quite a bit higher than expected.”

eAdmissions has a series of web services that other EMR vendors can call up. It is not using a NEHTA-approved standard as when EpiSoft was developing the system, sample specifications for such comprehensive structured datasets were not available, but Ms O'Neill said the company was open to suggestions on how to map the eAdmissions data to a standard.

“We did attempt in the early days to get it into the recommended clinical document architecture (CDA) format but we and the hospital jointly decided on a custom XML interface. Formatting the data in a standard way was much less critical than ensuring we had all the data provenance rules established and our integration design was sufficiently robust to cater for all possible administrative and clinical preadmission workflows.

“We have web services for the administrative and the clinical history data as well as separate web services for different clinical components and to retrieve uploaded documents. The San is automatically populating allergies into the EHR and they are currently working on integrating special diets that will link directly to the dietetics system."

The next step is to integrate all of the patient's co-morbidities, which are also coded to SNOMED-CT. Ms O'Neill said EpiSoft is now working with CSC on an integration method from the eAdmissions portal to their market-leading PAS. It is likely the partners will adopt the secure messaging delivery (SMD) specification developed jointly by NeHTA and industry for this purpose, she said.

Posted in Australian eHealth

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