Cabrini and Argus achieve automatic uploads for specialists

Melbourne-based not-for-profit private health service Cabrini Health has partnered with secure messaging provider Argus to develop the ability to extract clinical documents and correspondence from visiting medical officers' (VMOs) practice software and automatically upload them to its hospitals' webPAS patient administration system.

Cabrini Health's surgical and hepato-biliary groups visiting its Malvern and Brighton hospitals are both using the capability, in which documents such as operation reports, procedure notes and discharge letters can be extracted by Argus from the specialists' Genie practice management systems and attached to the patient's record in webPAS.

They are then accessible to clinicians through Clinical Viewer, the name used at Cabrini for CSC's Mobility Suite, which allows them to connect via webPAS to laboratory, radiology, PACS imaging and medications management systems remotely and on their mobile devices.

Medical staff at Cabrini's palliative care service at Prahran are also using the system, using Ozescribe to transcribe clinical correspondence which is then sent in the same manner via Argus.

The partners are now also hoping to bring other specialities and specialists on board, currently testing the system with surgeons from Eye Surgery Associates, who use the VIP system from Houston Medical that is widely used by ophthalmologists.

Cabrini's director of Health Information Services (HIS), Cameron Barnes, said he understood that this was the first example of this type of innovation in any private hospital in Australia.

Mr Barnes said that while webPAS acts in effect as a partial electronic record, hard copy records were also used by the hospital as part of its hybrid system. So in addition to electronic correspondence being attached to webPAS, messages can also be sent to a hospital printer to be printed out and filed in the traditional manner.

“Because we have a hybrid hardcopy and electronic record, anything received via Argus is printed in my office at 5 o'clock that day, so it is available immediately electronically and also the hard copy is then still filed in the record until we go completely electronic,” Mr Barnes said.

“That sort of functionality is what makes this very good, in that currently we are serving both masters in hard copy and electronic, so then that functionality would be switched off once we go fully electronic.”

“There have been some difficulties associated with clinical software systems and naming of document templates which has created a situation where we have to roll out this project very slowly and case by case.

“If the Clinical Document Architecture was consistent through all clinical software then sending and receiving documents with appropriate naming conventions would be a far easier process.

Mr Barnes' clinical coding team are also able to use the system, accessing it through webPAS while VMOs would generally use Clinical Viewer. Surgeons and physicians can also share clinical information with anaesthetic teams and nursing staff.

For individual doctors, the benefits in using the system are instant access to documents that would normally take days if not weeks to have available.

Mr Barnes gave as an example colorectal surgeon Paul McMurrick, who has been using it to upload clinical correspondence since the system became available.

“For example, he did an operation and dictated the operation report. It was then typed and sent via Argus and by the time the patient was in recovery, it was available on the Clinical Viewer,” Mr Barnes said.

“Sharing of information is also an advantage, and it means that for documents that historically have not been available to him in a timely manner, let alone documents that are created in his suite in software that is separate to the Cabrini software, there is now the capacity to share the information across different software.”

And it doesn't really matter what software the clinician uses in their private practice, he said. “Because it is using HL7 messages it really doesn't matter what is sent from. What it does is make the messages in effect agnostic, in that no matter what software they have got in their suites, the message is readable in our PAS and can be placed in there.

“Although almost all of our go-lives have been Genie so far, we are looking at other software vendors that will enable that to happen regardless of the suite software that is used.”

Cabrini and the specialists are sharing the costs of installing and subscribing to Argus between them, but Mr Barnes said these costs were minimal. The use of the system would also be beneficial in reducing admin time printing letters and addressing envelopes, and will hopefully prove revenue positive.

“From the coding staff and Cabrini's perspective, advantages for us include revenue optimisation because we are receiving important coding information in a timely manner, or a more timely manner,” he said.

“And sometimes we don't know what we are not receiving from the suites. By doing this, we can make it advantageous for them to send this information that they historically may not have been sending to HIS because it will appear on their Clinical Viewer.”

Cabrini also hopes to explore other advantages of using secure messaging, including sending outbound messages such as discharge summaries to GPs, which are currently faxed.

“It is possible that you would have Argus as the first port of call but if the GPs had no Argus capability, that would revert to faxing,” he said. “There are a lot of other potential applications, like referrals coming in.

“From our perspective, it's a win for both in that we are able to receive crucial information in a timely manner that benefits both Cabrini and the VMOs. It is using existing technology in the Clinical Viewer and PAS, and the nursing staff on the wards have access to these reports that they routinely wouldn't.

“The emergency department can use it as well, so when the patient presents at midnight, that operation report that Paul McMurrick did two weeks ago is there ready and waiting. They can start making judgements based on existing information that is readable, accessible, relevant. It's a great boon for them as well.”

Posted in Australian eHealth

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