eHealth NSW has announced that by the second half of next year, all New South Wales public hospitals will have access to electronic medical records (EMR), as part of the agency's wider effort to make the state's health system more citizen-centric.
During his keynote address at an Australian Information Industry Association event on Thursday, eHealth NSW CIO and CEO Zoran Bolevich outlined the EMR system is already live at 177 public hospitals across the state.
"It is important for us to start looking at how we can link disparate electronic medical records databases so we can have a more continuous flow of patient information, and that's what we're trying to do with this piece of work," Bolevich said.
"We're trying to create a more consistent patient and clinician experience, especially for junior doctors and nurses who travel around the state and work in different types of hospitals … so there is a consistent look and feel everywhere."
With an EMR system in place, Bolevich said there was now a foundation for eHealth NSW to accelerate its data analytics journey where data models can be standardised and local innovations can be seamlessly rolled out across the state.
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The EMR system will be used to support the eHealth's strategy to develop a Single Digital Patient Record (SDPR) that will be designed to give a holistic, state-wide view of a patient's healthcare information.
Earlier this month, eHealth issued a Request for Information to seek input from industry, solutions providers, and healthcare professionals to support the development of the SDPR initiative. An industry briefing on this is scheduled to take place next week.
A similar system known as My Health Record was designed by the federal government, although it was not particularly well-received by some patients. Over 2.5 million Australians opted out of the government's online medical file, after their records were automatically created for them.
Getting to know the patients
In addition, Bolevich announced phase one of the agency's patient reported measure project will go live in a few weeks' time, which will enable clinicians to invite patients to provide feedback through a survey portal, which will then be available to clinicians to inform patients' preferred process of care.
"Like most other systems in the western world, NSW Health is reframing and rethinking our value proposition," Bolevich said.
"Health systems have been very good traditionally at counting inputs and outputs of volume, but we haven't been particularly successful and or systematic in the way we collect outcome information so that we can truly understand the value the health system provides to community, and the impact we're making on people's health and wellbeing.
"We've focused a lot of the clinical outcome defined by the health system, but the idea here is the staff will systematically collect feedback on patient experience and outcomes of care in terms defined by patients."
Bolevich said eventually the patient experience outcome surveys will progressively be integrated with the EMR and GP systems to deliver a holistic process of care.
Changing for a larger purpose
These two projects are just one several that eHealth NSW has been working as part of its 10-year long digital transformation journey. The agency, which was established five years ago, is now about three and a half years into the project.
"We are working through the strategy still. It is an ambitious 10-year plans…but we still find it quite relevant," Bolevich said.
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The initial efforts of the transformation journey have been focused on building systems foundation including infrastructures, introducing core systems, platforms and applications right across eHealth NSW.
Bolevich said these efforts will enable the agency to enter the second phase, which will involve integrating its systems to support patients beyond hospital walls, and ultimately transform the patient experience to be more citizen centric.
Other milestones that eHealth NSW has achieved as part of project so far include completing the development of its long-running health roster program that uses data to manage the roster of 141,000 staff 24/7 and implementing a new enterprise service management platform delivered by ServiceNow.
Bolevich added eHealth NSW is also changing the way it procures IT so that services and platforms are delivered on an as-a-service basis, while ensuring interpretability is standard.
This is already being tested with early IoT trials currently underway with NSW Health Pathology to understand how information can be gathered from pathology devices, before artificial intelligence can be applied.
"We're starting to develop these ICT service commission approach. We're challenging ourselves to move away from technical inputs or widget-based procurement of ICT and move to more of an outcomes-based integration with industry," he said.
Work in the pipeline
To complement the work so far, Bolevich said eHealth NSW is now looking to extend clinician care to people no matter where they are in NSW through shared medical systems and virtual care.
Recently, eHealth implemented its first clinical health information exchange within disparate medical systems at two hospitals – one in the northern beaches and the other in North Sydney – to bridge the two systems together, Bolevich said.
He added remote patient monitoring is currently being trialled in different parts of the state, specifically testing out how patient support for diabetics can be improved through virtual contact with nurses and giving patients the chance to upload their glucose reading levels daily.
In addition, Bolevich said eHealth is also about to expand its telestroke pilot that received AU$1.2 million in additional funding during the recent NSW Budget that provides patients living in rural and remote areas access to specialist care.