Sysmex prepares to link Clinical Data Repositories in New Zealand
Sysmex, developer of the Eclair Clinical Data Repository (CDR) solution, has announced plans to enable geographically dispersed installations of Eclair to be connected.
Rolled out as the centralised electronic health record infrastructure for the TestSafe project in Auckland and the TestSafe South project in Canterbury, the Eclair CDR is being used to collect and store pathology and radiology results sent from various healthcare organisations operating across multiple District Health Board (DHB) regions.
“Through TestSafe, hospital and community doctors can look up a patient’s record”, says Dr Ross Boswell, Clinical Director at Counties Manukau DHB.
“Our doctors can immediately see all investigations relating to that patient: community and hospital laboratory tests, radiology reports and more, no matter where in the Auckland region those procedures were carried out. TestSafe means patients don’t have to be tested twice for a diagnosis, and it also means they’re treated more quickly, on the basis of reliable, full information,” said Dr Boswell.
The implementation of TestSafe has not displaced traditional electronic methods of pathology and radiology reporting for GPs, who still receive HL7 reports for investigations they have referred themselves. It does, however, give GPs and other referrers more ready access to reports ordered by GPs in other practices, as well as access to reports generated as a result of pathology and radiology investigations originating from within hospital settings.
In addition to the storage of pathology and radiology results, the Eclair system can be configured to provide other functionality, including the ability to check if a pathology report has not been reviewed by the appropriate clinician in an appropriate time frame. In the event of such an oversight occurring, an alert will be raised by the system, prompting someone else to attend to the result. While not deployed across all regions yet, this functionality is currently being used by Auckland City Hospital, which also leverages Eclair’s ability to store pharmacy dispensing information.
"Clinical teams at Auckland hospitals kept asking for this piece of added information," says Dr Boswell. "The system has also been made available to pharmacists and authorised healthcare professionals in the community. It allows them to cross reference medications and treatment, check related lab results and if needed, phone the prescriber."
Sysmex has six instances of its Eclair solution running in New Zealand. These installations service Auckland, Canterbury, Whanganui, Taranaki, Bay of Plenty, with two CDRs deployed in the Manawatu region.
According to Sysmex, the TestSafe South deployment in Canterbury has been particularly well utilised, the company stating: "It provided a lifeline during the February earthquake in Canterbury, which placed enormous pressure on health and emergency services in Christchurch. Many patients needing essential elective surgery and care were urgently transferred out of the devastated city to different hospital sites across the main centres of New Zealand. Urgent relocation of patients meant there was little time to arrange the transfer of medical records from Canterbury. As well as this, many GP clinics were closed due to earthquake damage meaning patient records were unavailable."
To enable authorised clinicians to access information about patients from other regions, Sysmex is developing a ‘federation’ capability into the Eclair CDR which will allow secure access between Eclair CDRs. According to the company, the federated CDR system will allow one Eclair CDR to query another CDR for patient records. For example, when a clinician accesses a patient record in the Eclair CDR system in Canterbury, they would be notified if there were records for that patient in the Eclair CDR in Auckland. The clinician can then view the results and reports held in the Auckland Eclair CDR, from within the local patient record hosted in Canterbury.
While modern IT infrastructure could facilitate a completely centralised service, the historical establishment of separate CDRs and the existing jurisdictional health boundaries make the federated approach a more viable proposition at this time.
Despite the increasing geographic reach of the system, Eclair’s security model is designed to ensure patient privacy is highly regarded at all times. Healthcare professionals that have been authenticated to their local Eclair CDR can view information about their patient, regardless of which regional Eclair CDR is hosting the data. All access to both local and remote CDRs is logged for audit purposes, with patients having the choice to opt out of TestSafe if they do not wish their health records to be shared.
"It is possible to monitor what records have been viewed and who viewed them," says Mr James Webster, CEO at Sysmex. "This adds confidence in the integrity of system use."
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