WentWest links LinkedEHR to HealthPathways

Western Sydney Medicare Local (WentWest) has begun integrating its HealthPathways web-based clinical decision support portal into its recently launched LinkedEHR shared care planning system, which has been designed to facilitate better team care arrangements between GPs, specialists and allied health practitioners.

Piloted in July last year, LinkedEHR allows local clinicians to create GP management plans and team care arrangements and provide access to other clinicians working with the patient. It is suitable for any chronic illness as it is based on the ICPC 2 coding system, and is currently being rolled out as a pilot initially to GPs and allied health professionals such as podiatrists and dietitians who are sharing the care of patients with diabetes.

Local hospitals have also shown interest in using the system with their diabetic patients, and patients have a view-only access to their shared care plan.

LinkedEHR has been designed by Ocean Informatics based on its open source openEHR technology and using the Multiprac CP application as its basis. It is being offered to GPs and allied health practitioners in the Western Sydney area free of charge. Authorised users are also able to view a patient's PCEHR from within the system.

It is now being linked to WentWest's HealthPathways portal, which allows clinicians to access standardised care pathways that are tailored to local resources and services.

Paul Campbell, PCEHR program lead with WentWest, said one of the ideas behind rolling out LinkedEHR was the realisation that GP management plans and team care arrangements were not being reviewed that often. While they can be created from within the GP's desktop software, most actual information sharing with allied health practitioners and medical specialists was still being done on paper.

“In Western Sydney in the first quarter of 2013, there were about 33,000 of a combination of GP management plans and team care arrangements billed through Medicare, but in that period there were only 21,000 reviews of these plans,” Mr Campbell said. “One would have expected two to three times the number of reviews as basic plans.”

WentWest business development and program director Ian Corless said team care arrangements often tended to drop off the radar screen of busy GPs unless their practices had a functional recall and reminder system, so the idea was to develop a flexible solution that allows all clinicians in the team care arrangement to view and update patient information at the point of care.

WentWest convened a GP clinical advisory panel to guide the function, look, feel and usability of the system, and also worked with HealthShare NSW to ensure it was compatible with its eHealth developments.

There are a number of products on the market that allow GPs to create shared care plans and share them with other practitioners electronically, including Melbourne-based Precedence Health Care's cdmNet system and New Zealand company HSAGlobal's CCMS.

However, Ocean Informatics won WentWest's tender as it is an open source product that allows the organisation to easily add new functionality, such as linking up with HealthPathways and accessing the PCEHR. WentWest has registered with the national eHealth system as a contracted service provider (CSP) so it is able to interact with the PCEHR and the Healthcare Identifiers Service on behalf of clinicians.

To allow GPs to easily use the system, WentWest has worked with Pen Computer Systems to install a button on its Sidebar tool to allow data to be extracted from the GP's clinical software and sent to the LinkedEHR server, which is hosted by WentWest, not on the GP or allied health practitioner desktop. This server has all the privacy and security compliance features of the PCEHR.

“We manage it directly,” Mr Campbell said. “[The GPMP] is held on that server so that anyone who is registered on the system can have access to it and update it. The GP can also see any of the other participants in the team who have updated that record.”

WentWest is also working with the Western Sydney Local Health District (LHD) to provide access to hospital clinicians. Mr Corless said the roll-out to GPs is being based around a joint diabetes strategy with the LHD.

“Rather than just going out with an offering that is looking for a use, we are beginning with diabetes so there is a concrete, tangible benefit to the GP and broader care team in terms of patient groups, particularly as diabetes is identified as a health priority in the region,” he said.

“In terms of the roll-out, we have also already identified some allied health providers in the diabetes field like dietitians and podiatrists. That is how we are starting to roll out – it is around the disease focus so that there is a very clear functional application from day one.”

Mr Campbell said hospital clinicians would have to come out of their hospital system to log in to LinkedEHR, but that they were amenable to doing that. “They are really interested in being able to get into the care plan as the GPs and allied health and everyone that is treating the patient will all be looking at the same document.”

With the HealthPathways portal, WentWest is installing a button within LinkedEHR so that when a care plan is brought up, clinicians can also choose to go directly into HealthPathways. Mr Corless said Went West will build in the option to allow GPs to create a care plan from the relevant section of HealthPathways.

While the PCEHR does allow clinicians to share information, it is a static document that can't be updated immediately and functions more as a snapshot in time than a dynamic care plan for individual patients. Clinicians can view documents within the PCEHR such as discharge summaries while they are using LinkedEHR, and while it may be possible to one day upload a shared care plan as an event summary, this is not yet on the development agenda.

WentWest believes there are a number of benefits to all parties in using the new system. For GPs, it will assist in improving communication with allied health practitioners about care plans, as well as with patients. Evidence shows that involving patients in their own care improves outcomes, the organisation says. “To this end, consumers have been engaged in contributing their views to optimise the access by consumers of their care plans,” Mr Campbell said.

For allied health practitioners, it will provide improved information about patients and improved communication with GPs, allowing them to become an integral part of the care team.

WentWest hopes that improvements in shared care will improve outcomes and reduce rates of admissions to hospitals. And for the organisation itself, the benefits include the ability to add other applications on top of the initial care planning application. This will also allow de-identified data to be used to better support GPs, the rest of the chronic disease care team and their patients.

Posted in Australian eHealth

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