Remote access to GP clinical systems for district nurses

District nurses in Hawke's Bay are being given remote access to patient notes held in general practice systems in a pilot project that looks likely to be opened up to more clinicians next year.

Under the pilot, Hawke’s Bay DHB district nurses are being aligned to three general practices – The Hastings Health Centre, Totara Health and Te Mata Peak Practice – and are able to remotely access Medtech32 while in their patients' homes.

They are also able to file any actions they have taken, note anything they have observed when visiting the patient in their home, and express any concerns. They can also schedule doctor’s appointments.

The nurses are employed and resourced by Hawke's Bay DHB within its Oral, Rural and Community Service, but they are also closely aligned to the practice, at times physically basing themselves there when not visiting patients in their home.

Hastings Health Centre GP Alan Wright said the development of closer ties with district nursing staff was long overdue and the project was well integrated.

“GPs will learn quickly, as I have, that these district nurses are at the coalface of health care, working with patients in their own homes,” Dr Wright said.

“Giving them unrestricted access to our files can only benefit general practice. The inputting of their case notes can only advance our knowledge of our patients. Previously we might not have even known that a patient had been seen by a district nurse, and more importantly, what for.”

Hawke's Bay DHB said there were several teething problems initially, mainly around poor knowledge of roles and incompatibility with each other's methodology and way of practising. However, with the pilot now running for 15 months, a model is scheduled to be finalised by April next year and other general practices will be invited to participate.

The pilot, which was initiated by the general practices, also involves nurses working in the areas of assessment and advice regarding wounds, catheter and bowel management, administration of prescribed medications and support for patients with the management of other health issues.

Hawke's Bay DHB clinical nurse manager for community nursing, Maree Gladstone, said opportunities to develop the concept of integration were becoming clearer. These include the possibility of holding district nurse clinics within the practice setting, streamlining the referral process and investigating alternative nursing models.

Posted in New Zealand eHealth

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