CAReHR adapted for children in out-of-home care

The Clinical Audit Research electronic Health Record (CAReHR) developed by Melbourne firm Arcitecta for Melbourne's refugee health network has been adapted for use to securely share health information about children and adolescents in out-of-home care.

Victoria currently has more than 6400 children and young people living in out-of-home care such as foster care or kinship care. Under the Pathways to Good Health project, overseen by the Department of Health and Human Services, children entering out-of-home for the first time are given a medical assessment by a paediatrician and other members of a multi-disciplinary allied health team.

Doctors, mental health clinicians and speech pathologists can use CAReHR to create health assessments and treatment plans for children that can be accessed across a number of sites and as the child moves through different parts of the health and social care system.

Predominantly focused around north-west Melbourne, the project involves health services such as Dianella Community Health, Travancore, the Royal Children’s Hospital and Djerriwarrh Health Services, which operates the Bacchus Marsh & Melton Regional Hospital along with a number of community clinics and aged care services.

Clinicians can use CAReHR to generate health management plans and health summaries that can be sent to the child’s carer and general practitioner, and to identify health trends and health interventions needed for children sharing common conditions from de-identified clinical information.

Djerriwarrh Health Services acting CEO David Grace said the child's GP is kept in the loop but on many occasions children entering out-of-home care don't have a regular GP and there is little information on them.

“In the past we have been doing assessments without any additional information, and this is what this system helps with in particular,” Mr Grace said. “If there has been other healthcare assessments done in the past then this will allow us to have access to that information and it allows others that require access to that information in the future.”

In addition to medical assessments, it can store assessments from audiologists, speech therapists and mental health workers.

The system is based on Arcitecta's Mediaflux technology, a data management platform that is able to manage any type of structured or unstructured data through the capture and storage of metadata fragments, stored as encoded XML.

Mr Grace said one of the key benefits of using CAReHR is that it provides a consistent database of health information and management plans for children in out-of-home-care.

“These children have undergone a comprehensive multidisciplinary assessment using a consistent approach, with the resultant information entered into CAReHR,” he said.

“The areas of assessment include physical health, development, speech and language development, communication, and mental health and wellbeing. This information identifies areas that require further assessment or intervention, and/or treatment.

“Previously unrecognised areas of concern are often identified and able to be addressed at the time of assessment, expediting early referral to appropriate services.”

For the refugee health network, CAReHR is used to share and store information but also for research purposes on emerging infectious disease trends. Arcitecta chief technology officer Jason Lohrey said CAReHR can be easily configured by the clinicians and hospital administrators who use it and it can be adapted to any patient group or clinical service.

“This is a key point of innovation with CAReHR and one that arises from our collaboration with the clinicians involved in its design and those seeking a better way to manage patients with multiple health conditions,” Mr Lohrey said.

Posted in Australian eHealth

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