Ballarat prepares for better information exchange

Ballarat Health Services (BHS) in Victoria has deployed Orion Health's Rhapsody integration engine to better manage the increasing amount of electronic information exchanged and link up the health service's various clinical, patient and administrative systems.

BHS provides acute and sub-acute care to the Ballarat and Grampians region, along with residential aged and community care, and psychiatric and rehabilitation services. It is also building an integrated cancer centre and will soon install an electronic oncology system.

The organisation is anticipating the growth in message exchange will be 30 per cent every six months, and its previous message platform, which used the Java Composite Application Platform Suite (JCAPS), was not thought capable of handling the capacity.

BHS's IT manager, Cameron Allen, said that while JCAPS is fairly standard throughout Victoria, it requires a lot of detailed Java-specific programming that has proved quite burdensome.

“JCAPS is a system that you can basically do anything you want to do with it, but you really need to know Java programming to the nth degree to get it to do it,” Mr Allen said. “With our JCAPS implementation, we have one person who knows the details about it, [but] whenever that person was not available it becomes difficult. Teaching a person Java programming to the level required was a big ask, given limited resources.”

Mr Allen said it became obvious that BHS was outgrowing its existing system, so the decision came to whether to upgrade it or look at an alternative. “Capacity was key, but more key in my opinion was the usability of the system,” he said.

BHS is predominantly using Rhapsody to manage its information exchange requirements at the moment, but there is the potential to expand it further. Extracting data from messages and notifications can be easily done in Rhapsody, for example, while JCAPS would have required a huge amount of time to program the capability, he said.

“I describe HL7 messaging as similar to an email service, so if I send an email to a particular address, it goes through a server and gets to where it needs to gets to and I don't care whether you are reading it on an iPad or a computer or a phone.

“HL7 is like that with the exception of when it is passing through the server, Rhapsody gives me the option of checking out that message and doing some other processing with it. For instance, if I'm doing a study of say particular operations on people between the ages of 17 and 18 that live at this particular post code, I can grab that information and start putting it in a database for some of the research aspects.

“I could have also done that with JCAPS, but the amount of time that it would take me to get that across the line is rather large, as opposed to what we can do with the Rhapsody implementation.”

For messaging, Rhapsody has a management console that allows the IT department to monitor messages and be notified if there is a failure, but for clinicians, all of the work is carried on the background. “Rhapsody takes information from point A to point B, so the clinicians don't care how it got there, but part of the reason we are using this is that they don't have to look at numerous systems to get the information they are after,” Mr Allen said.

Mr Allen also believes the new system will help with to link up the non-clinical systems used, particularly in administration and HR. “It has the capability to connect data from point A to point B in a very powerful manner, which again is another reason why we've decided on Rhapsody.

“There's a big tick next to its clinical capabilities ... but the potential is in linking up all of our other systems that previously haven't been able to be linked. That's where we want to drive this product within BHS.”

BHS director of information management, Kate Nolan, said there was a lot of potential with new system, particularly in ensuring a single medical record is maintained. BHS introduced a scanned medical record three years ago, using Core Medical Solutions' BOSSnet system, which provides a fully indexed electronic replica of a patient's historical medical record.

“We haven't had the luxury of introducing a fully electronic medical record like a Cerner or an Epic but we do have our single medical record,” Ms Nolan said. “There is still a lot of paper around so we are not fully electronic by any means, but somewhere like the ICU department, they do generate nearly everything electronically.

“We are in a transition period from getting everything off JCAPS and brining them over to Orion, but those clinical systems will message to a single medical record, so from a clinician's point of view, there is still a single record.”

Ms Nolan said she hoped to explore how to streamline mandatory reporting to the government. “The guys tell me that through Rhapsody we could probably run an extract that is HL7-specific. I'm really interested to see where we can go with reporting of activity and things like that too, starting to interrogate some of the data or messages.”

Mr Allen said Rhapsody would also enable the health service to connect to the PCEHR in the future. “It will become the core of our information exchange,” he said.

Posted in Australian eHealth

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