Australia's first paperless hospital is set to open this weekend, using e-health records to manage patient care.
Macquarie University Hospital, located on the Macquarie University campus, is designed to be a "digital hospital", according to chief information officer, Geoff Harders. Existing paper records will be migrated into a digital format for use on workstations, and patient care is tracked by Siemens "cockpit" systems, eliminating clipboard charts in a patient's room.
"There's a lot of things being done that haven't been done in the past ... we're about trying to become an exemplar," Harders said. The paperless system sees patient records, tests, dietary requirements and other relevant information entered into the hospital's system and added to the patient's digital record.
The primary method of recording patient interactions in the paperless environment is through 150 bedside "cockpit" systems installed by Siemens Enterprise Communications. The cockpit allows patients to order meals, make phone calls using voice over internet protocol (VoIP), browse the internet and watch television using a touchscreen interface. It also acts as a workstation for medical personnel, from which a clinician can prescribe medication, record notes on patient care and have the ability to access a patient's test results digitally. Day patients also get access to a computer on wheels — a streamlined version of the cockpit system that tracks patient care.
Harders said that the cockpits instead of clipboard approach would reduce human error in note taking and prescriptions, while maximising the availability of electronic patient records throughout the hospital. He outlined a scenario whereby a clinician who prescribes conflicting medications through the cockpit system would encounter a background process alerting them to the conflict.
The cockpit systems are also hooked up to back-up power systems, which in the event of a power outage would see clinicians still able to access patient's information to provide essential care. In the case of a catastrophic data failure, a series of back-up servers exist on site to restore patient data. The primary data servers are situated off-site in a "more secure environment than we could give it here", Harders said, providing a two-fold level of data security.
Macquarie University Hospital has built its systems with the Health Identifiers legislation — which enables the introduction of individual health numbers for Australians — in mind. "In our environment, our systems are being built in such a way that we will be able to access records ... available online [when the Bill is passed] to provide health care to our patients," said Harders.
"I feel that the [healthcare identifiers Bill] is a fabulous Bill for the provision of healthcare to Australians," he said. "Instead of a patient bringing us their medical records in a physical form, we would be able to get those records electronically after they authorise us to get access to them. I see the benefits for everyone."
Macquarie University Hospital's main IT vendors include Hewlett Packard for server, storage and workstation equipment and Microsoft for the supply of workstation and server operating systems. The cockpit technology runs in a Citrix environment, eliminating the risk of patients' information being copied to flash memory from a cockpit workstation, according to Harders.
"A lot of effort has been put in to integrate a variety of systems. There's more work that needs to be done and it will be a constant evolution in order to get it to an area where [the day-to-day interactions of a hospital] become seamless."