NSW Health considering FirstNet 'Lite' for small EDs

The NSW Ministry of Health is currently reviewing a simplified version of the Cerner FirstNet emergency department system to see whether it would be suitable to install in smaller EDs throughout the state.

Julie Roberts, director of the electronic medical records (EMR) program at HealthShare NSW, which manages ICT shared services for the state, told the Health Informatics Conference (HIC) in Adelaide last week that as part of the ongoing adoption of the EMR statewide, the needs of EDs in smaller hospitals were being examined.

“We have built a FirstNet 'Lite', which is the Cerner ED solution, and we've made it simpler to use,” Ms Roberts said. “It is currently being reviewed by the Ministry to see if it could meet the needs [of smaller EDs].”

FirstNet has been plagued by reports of poor performance for a number of years, leading the NSW government to commission Deloitte to do an independent review of the system in 2011.

Deloitte recommended (PDF) the establishment of a remediation program to fix some of the problems, which is now underway. The remediation program aims to improve usability, performance and work processes and some functionality in FirstNet.

Ms Roberts told the conference that HealthShare NSW has been working with Cerner on a number of enhancements, saying “there are 30-plus enhancements that are on their way”.

NSW Health is also beginning to roll out the Dragon speech recognition software in EDs across the state following a number of pilots. Pioneered by ED staff at Manly Hospital in Sydney, the Dragon system can be used to assist in completing clinical documentation within FirstNet.

NSW Health is also further rolling out its electronic Between the Flags (BTF) program for ED nurses. BTF is aimed at helping ED staff to identify when a patient is deteriorating and involves nurses recording five vital signs within the EMR, which graphs the information in three bands of white, yellow and red.

Red signifies an emergency response is required. According to a NSW Health video shown at the conference, the department plans to roll BTF out across the state and beyond the ED to the wards, where it is planned to become core clinical practice.

Part of Ms Roberts' team's work involves standardising commonly used clinical documentation such as progress notes, treatment plans, patient histories, clinical assessments, risk assessments, checklists and discharge summaries.

Electronic discharge summaries are being designed to be CDA-compliant, and the plan is to roll them out to all local health districts (LHDs), she said.

Ms Roberts also discussed moves to create a centralised patient summary page that can draw information from within the EMR but also link to external clinical repositories and the PCEHR.

This patient summary portal was demonstrated by acute care physician Will Reedy, who said NSW Health plans to allow clinicians to use it to view clinical documents held externally and in the PCEHR by the end of August.

Ms Roberts said the department was looking at a few concepts to try to bring “the maze of data” together.

She is also working on the Community Health and Outpatient Care (CHOC) program, which aims to provide IT solutions for mental health, allied health, child and family, chronic care, aged care, sexual health, Aboriginal health and community health.

These solutions will include a mixture of CHIME – a bespoke system for the NSW community health sector designed many years ago that has since been re-platformed by Fujitsu – and the Cerner EMR, depending on what each LHD requires, Ms Roberts said.

NSW Health went out to tender earlier this month for a mobile forms solution that will enable community health workers to complete forms electronically when they are with the patient and upload the data directly to the EMR.

Posted in Australian eHealth

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