South West Alliance ramps up eHealth rollout

Victoria's South West Alliance of Rural Health (SWARH) has installed a new patient administration system in 10 of its hospitals, based on InterSystems' TrakCare web-based technology.

TrakCare is also used as the clinical information system in most of the member hospitals in the alliance, and plans are afoot to also install InterSystems' TrakCare Analytics and Community Health functionality.

SWARH CIO Garry Druitt said that by implementing the patient administration module of TrakCare, SWARH will have the power to do more with its electronic health record.

“We are working with InterSystems to implement new clinical functionality over the next six months, with electronic medication management and support for new national quality standards for clinical care at the top of the list,” Mr Druitt said.

“When we implement TrakCare Analytics, we will be able to access administrative as well as clinical information to analyse things like public health outcomes, operating theatre usage, or accuracy of diagnoses based on a set of clinical observations.”

SWARH members include Barwon Health, which operates Geelong Hospital and a large aged care service, along with regional health services that operate base hospitals at Warrnambool, Hamilton, Colac and Portland and smaller acute care facilities including those at Port Fairy, Heywood, Casterton, Terang, Apollo Bay and Timboon.

It also includes several bush nursing centres and sub-acute, primary, community and aged care services through several rural health organisations.

Most of the hospitals have used TrakCare as the clinical information system for a number of years, while Barwon Health uses CSC's i.PM and Core Medical Solutions' BOSSnet.

Last decade, SWARH designed a secure broadband connection to provide unified communications across its hospitals and clinics using microwave broadband technology initially created by Ericsson and run by AAPT. The network was then taken over by microwave broadband specialist Vertel, which has switched it over to an Ethernet-based microwave broadband network.

The technology is now capable of delivering speeds of up to 100 Mbps into every SWARH facility, with 500 Mpbs capacity across the network.

The alliance runs its own wide area network (WAN), developed by SWARH with the assistance of Dimension Data and Cisco, which allowed it to move to an IP-based telephone system way back in 2000.

SWARH began a virtualisation exercise in 2011, using Cisco's VXI virtualisation experience infrastructure, and it is using the WAN to continue to develop more services for clinicians, including the rollout of thin client technology to replace traditional hospital workstations.

Mr Druitt said it is also encouraging a BYOD philosophy, using Citrix's Receiver technology so clinicians can use their own devices running on any operating system to connect to the SWARH network and access its applications.

“With a resilient network our philosophy is to invest in our network and centralise and that will pay for itself,” he said.

“We are replacing traditional workstations with thin client technology. We have virtualised the storage, we have virtualised the processing and we've virtualised the network effectively, so now we are virtualising the end point so that we can deliver across the network a virtual workstation to any device, from a smartphone to a traditional workstation, and that is all centrally done using our WAN.

“We are rolling that out now and we have a target of about 4000 devices. We are up to about 1000 and the performance is much better. It doesn't matter what operating system you use, and there's no security issues.”

Mr Druitt said external clinicians are able to bring in their smartphone and download the Citrix Receiver, and then connect to the SWARH network.

“It creates a window within your operating system through which you can use our applications, and when you disconnect from us it all goes.

“My vision is that you can bring in any smart device that you want to, and it's your own device. You just plug it into a screen and a bluetooth keyboard and you are off, and when you go home you have remote access in the same way. Then it becomes completely agnostic to where you are working.

“We have both TrakCare and BOSSnet working, and for most of the region there is a standard look and feel that is delivered virtually on a thin client and they can access it where they want.”

It is also opening telehealth and telemedicine capability to offsite clinicians, including some GP clinics that SWARH services, he said.

“We do have GP clinics as customers of SWARH, and those that are connected to our network don't have a problem, but for those that are not connected we do have telemedicine available.

“You can register with us and download one of our clients from the internet, and that means that you can use your workstation as a video unit for telemedicine to connect internally to any of our devices. That is currently available.

“We also have doctors connected at their home via 3G to the emergency department at Geelong. We are doing quite a lot of things with external people using 3G technology and our own network.”

Barwon Health is leading the way in the implementation of the PCEHR, having instituted the Health Identifier Service as part of its work on the Wave 2 MedView project. Barwon Health began using Individual Healthcare Identifiers (IHIs) as part of that project, and Geelong Hospital was the first to have access to the National Prescription and Dispense Repository.

Mr Druitt said Barwon Health was currently looking at how best to create a model for discharge summaries to send to GPs in the region and the PCEHR.

He said the use of IHIs was key to it all. “You've got to be able to identify that this is the patient you are talking about before you start making these things available either publicly or with national summaries,” he said.

“Once we have that unique identifier we can start making that happen through the PCEHR.”

Posted in Australian eHealth

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