Bendigo Health to roll out Vitro for digital medical record

Victoria's Bendigo Health has chosen Slainte Healthcare's Vitro software as the digital medical record (DMR) component of its overall electronic medical record (EMR) project.

Bendigo Health will begin implementing Vitro immediately to begin the process of digitising Bendigo Hospital's paper-based processes and forms, with the roll-out expected to be complete in less than 12 months.

Bendigo Hospital is currently undergoing a $630 million redevelopment, which will see a new 372-bed hospital built adjacent to the existing hospital along with an 80-bed psychiatric unit, 72 same day beds and an integrated cancer centre. A conference centre, helipad and 128-room hotel will then be constructed on the existing site when the new hospital is complete.

Vitro has the capability to work as an electronic patient chart, replicating paper forms digitally and linking with other electronic systems such as the patient administration system. Bendigo Health's executive director of information services, Bruce Winzar, said this will reduce duplication of information and is the beginning of the health service's journey to eliminate paper medical records.

“The new hospital has been designed to be paper light upon opening and in order to achieve this we must implement an EMR, of which the digital medical record is a key part,” Mr Winzar said.

“This means clinicians will be able to view any paper forms or patient medical records via an electronic device anywhere in the new hospital via a single clinical portal.”

Slainte Healthcare's commercial director, Jeff Smoot, said the software had the capability to be implemented rapidly with quick user adoption.

“With Vitro, we are looking forward to delivering a range of benefits for both patients and clinicians at Bendigo including improving clinical access to patient information, increasing the security of information, financial efficiencies and data protection,” Mr Smoot said.

Vitro has been implemented as the electronic patient chart at Calvary's Bethlehem Hospital in Melbourne and is also being rolled out to 11 other hospitals in the group. It is also used as a paperless chart at the Chris O'Brien Lifehouse cancer centre in Sydney.

Posted in Australian eHealth


0 # A/Prof Terry Hannan 2015-04-14 14:16
On reading this article I may be missing the point (maybe my age) but this system appears to be a "document storage system (sophisticated) " and thus may be another reproduction of the paper record in an e-format. Even after reviewing the promo video it is very hard to obtain a grasp of the how "granular" the data entry (CPOE)/standard isation is within the project. I have no doubts that the system provides facilitated access to the documents however documents in current "formats" do not readily facilitate or improve clinical decision making through information management. It will be interesting to see the implementation progress and evaluations of this project.
0 # BDiggin Slainte 2015-04-14 17:44
Vitro replicates the existing (paper) Medical Record and renders it electronic. Forms in the paper record become Apps in the Vitro electronic record. You can of course have custom Apps for CPOE, e-Referrals, Medical Imaging, etc. This can also include digitised records. The paper form to electronic app migration approach removes the organisational change burden when adopting an EMR. An App is composed of the UI (often the replicated paper form, e.g. observation chart) and has associated business logic to implement the desired business logic, e.g. alerting for Sepsis based on the observations. Paper processes do not inherently have this business logic (relying on humans to carry it out). Vitro Apps provide a rapid and flexible way to encode (and optionally enforce) a particular process, or protocol, etc. The "small data" in each of the forms and pages and Apps combines to represent a patient clinical record in a familiar and highly functional (often bespoke) manner. It is rendered as a electronic patient chart. Hope this clarifies al little.... although seeing is believing.
0 # Phil 2015-04-14 18:18
Can someone decipher what the person from Slainte just said?My read is code for a scanned medical record but it was so confused I am not sure. But my local intelligence says that a scanned record is what it is?
0 # BDiggin Slainte 2015-04-14 18:32
Yes, in addition to the electronic record, scanned or digital records can be included in the Vitro patient chart. Normally, for high volume, the scanning component is provided by a 3rd party application and integrated to Vitro. In addition to these internal sources of data/content for the medical record, the chart can also include external content, e.g. referrals and results, etc.
0 # A/Prof Terry Hannan 2015-04-14 20:10
several aspects of this posting worry me. Should I be concerned?
"Yes, in addition to the electronic record, scanned or digital records can be included in the Vitro patient chart. Normally, for high volume, the scanning component is provided by a 3rd party application and integrated to Vitro. In addition to these internal sources of data/content for the medical record, the chart can also include external content, e.g. referrals and results, etc."
1. "IN ADDITION TO"-is the implication here that the scanned or digital records are a separate element of the clinical documentation and even if they are scanned INTO the EHR what is there functionality? Just a document record?
2. Involvement of a 3rd party application - what safety and security issues does this raise? Also how is any interoperabilit y being implemented?
I am NOT knocking this system I am just responding to what I think I can read in the postings.
0 # BDiggin Slainte 2015-04-14 20:32
"In addition to" means that scanning is an additional input source to the record. This source can have meta data. The scan and its meta data is integral to the record. The clinical viewer would be largely unaware of the difference.

Indexed scanning is possible directly into Vitro. However this is not designed for high-volume. This is where other solutions can be integrated (securely) with Vitro to perform this high-volume scanning, document recognition, data extraction, indexing, etc.

Our commercial staff can provide a detailed Q&A, discussion and demonstrations if appropriate; please make contact with the Sydney office. Thank you.
0 # Phil 2015-04-14 22:38
So Mr/Ms Slainte, is this a true EMR with true electronic interaction with the clinicians or a slight of hand to masquerade as an EMR because the Victorian Department of Health wouldn't approve anything other than Cerner or didn't provide sufficient funds under the New Bendigo Hospital to include an EMR or.....
Could someone from Bendigo Health set the record straight? What is being bought here???
0 # Bruce Winzar 2015-04-15 11:06
Interesting discussion.
As reported above, Bendigo Health has purchased a DMR as a stepping stone to an EMR. We are currently evaluating EMR products.
The product set purchased includes workflows, integration, electronic forms, scanning and single user interface.
The Department of Health and Human Services Cerner mandate expired some 18 months.
0 # Philip Robinson 2015-04-15 12:27
Interesting discussion but too many assumptions
about the process undertaken by Bendigo Health.
Bruce is correct and in the right position to know.
For the record, the Phil above is not me.
0 # Heather Grain 2015-04-16 14:33
I am concerned at the apparent lack of understanding of the criteria for an EHR as opposed to a DMR which have been clearly outlined in national standard AS4846 - after considerable input from ACHI, HIMAA and other significant contributors, including state health departments. Though a transitional or digital record system can be of great value the benefits which can be achieved by these systems are very limited in comparison to a truely computable record with a standardized information architecture. Internationally the definition of an EHR today requires computability not just computer based storage and retrieval. It would be helpful to clarify whether the project will user or establish a solid and standardised structure to the content of the record components as the digitized approach moves towards transition to computable including terminological representations . If not done well initially this can lead to considerable re-work and potential safety issues when data is used in future EHR applications.
0 # Bernie Crowe 2015-04-21 20:47
Extract from Slainte website may assist:
Vitro captures complex clinical data for analysis, allowing you to reduce costs, improve clinical decision support, and ultimately improve patient care & outcomes, creating an electronic medical record – It documents the clinician-patie nt activity in an efficient & paperless environment, that is familiar and intuitive, it retains the look and feel of your current paper documents, creates an electronic version and adds intelligence.

Move to a stage of the HIMSS EMR Adoption Model that meets your business needs and requirements. Vitro’s inbuilt functionality means that no matter what stage you reach it is already paving the way for you to become fully paperless at stage seven.

Vitro works by taking an image of your existing paper document and using it as an electronic background on which to overlay user controls, Vitro retains your existing intellectual property, increases user adoption and reduces change management. Scripting adds intelligence and the result is an electronic version of your document which now captures your data digitally and in a familiar manner.

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