The birth of ELIoT
This article first appeared in the October 2012 edition of Pulse+IT Magazine.
Eastern Health, with over 29 service locations, is the largest geographical metropolitan health service in Victoria, covering a geographical area of 2816 square kilometres.
Eastern Health recently implemented a scanned medical record system called Infomedix Clinical Patient Folder across all sites and programs. The project team continually looks for potential system integrations and during the project, integration with Symphony (ED) and and Birthing Outcomes Suite (BOS – Maternity) was put into place.
One area identified for potential efficiency improvement was typed letters and reports that are created electronically, printed and sent for scanning. The main objective was to have these documents electronically fed directly into the Clinical Patient Folder.
The project manager and health information manager developed the specifications for a new application that would allow staff to load documents directly into the Clinical Patient Folder system, thus reducing the number of paper documents to scan.
Eastern Health ICT (Applications) was approached to develop an in-house solution that would:
- Be web-based
- Be easy to use for administrative staff
- PDF all files (.doc, .docx, .rtf, .dat)
- Have the capability to load pictures (.jpg, .gif)
- Include adequate audit trails
- Help to eliminate any delays with the scanning of outpatient letters
- Reduce the amount of paper to scan (and thus reduce stationery costs)
- Reduce the amount of resources required for associated scanning processes (scanning, quality assurance, archiving and storage)
After a number of meetings and development time, the Eastern Load Interface Tool (commonly referred to as ELIoT) was developed. ELIoT’s web interface was developed using Microsoft’s ASP.NET and C#. ELIoT is tightly linked to Eastern Health’s Active Directory to ensure that the users are valid Eastern Health staff and a full audit trail exists. The audit trail is important as we rename the files during the conversion to a PDF file format. The PDF format was chosen as it meets the legal requirements for a health record.
The second application, which is not visible to the users, is a Windows service which picks up the uploaded files and converts them into PDF (.doc, .docx and .rtf). Images and PDFs remain in their original file format and will automatically move to the Infomedix Document Load Interface (DLI) module pick-up folder. This application was designed to be extremely flexible and easily modify the location of any working folder without having to alter the code.
Currently, there are a few constraints put in place by Eastern Health. They include:
- Documents to be uploaded are filed in non-episodic sections of the scanned medical record (e.g. correspondence and diagnostics)
- Documents being uploaded must be smaller than 7MB in size
- Documents being uploaded must be of the file types specified
- Medical record forms being uploaded must meet AS 2828 Standards
Eastern Health Health Information Services and ICT Applications have produced a user-friendly interface that allows administrative staff to load any documents (with the file types specified above) in five easy steps.
A number of areas have changed their processes and started using ELIoT, thus enhancing the communication process around a patient’s care. These include:
- HIS Typing Service: uploading all typed letters, which greatly reduces the amount of time compared to their previous practice (i.e. the documents are loaded at the end of each working day instead of after the doctor signs off the letter – a process that could sometimes take weeks).
- Neurosciences Department: uploading the NCS/EEG reports for all new patients. Any historical reports which are kept on a shared drive are uploaded immediately on request (eliminating the need to fax copies to the clinic).
- Fibroscan Clinic: uploading the Fibroscan reports, thus increasing the availability of all reports.
- Multidisciplinary Cancer Care Meeting document(s): timely access to the MDM documentation has improved communication between health professionals involved in patient care.
Eastern Health staff using ELIoT have been very receptive and have provided very positive feedback:
“ELIoT is very user friendly. Good to get reports to CPF immediately. Will save time running urgent reports to outpatient clinics.” Sleep Disorders Unit - Box Hill Hospital
“Since ELIoT was introduced, it has certainly decreased the time to upload our reports. Very quick and efficient.” Neuro Diagnostic Unit – Box Hill Hospital.
Manager, Clinical Patient Folder
Lisa White is a health information manager at Eastern Health in Melbourne. She has been involved in health IT for over 25 years in Canada and Australia and has interests in health informatics, eHealth and project management.
Posted in Australian eHealth