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Care coordination app saves bed days at Christchurch Hospital

Wednesday, 14 March 2018   (0 Comments)
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eHealthNews editor Rebecca McBeth


PICTURE: Screenshot of Cortex app


The introduction of a care coordination app at Christchurch Hospital has reduced the average length of stay in the general surgical department by nearly 20 per cent – without any increase in readmissions.


Cortex is a mobile app that allows doctors, nurses and Allied Health staff to work together from remote locations.


The application provides documentation and visibility of clinical notes, team and individual task management, partial electronic ordering of diagnostic tests, notification of results’ availability and direct access to the results and patient observations on mobile devices.


Cortex was introduced to the general surgical department at Christchurch Hospital in June 2017. Since then, the almost 20 per cent reduction in the average length of stay has resulted in savings of around two beds a day.


More than 30,000 clinical notes have been created over the past eight months and patient information has been viewed more than 500,000 times via the app.


Surgeon Saxon Connor is the e-clinical health lead at Canterbury District Health Board and a clinical champion for the Cortex app.


He says the reduction in the average length of stay has been marked, particularly for acute admissions, because the mobile app shortens the gap between decisions being made.  


“We’ve created a platform where everyone looking after a patient has visibility of what’s going on in a mobile way,” Connor says.


“We’ve created a closed loop communication with regards to task management and we can create clinical notes in an electronic environment and push them to the electronic medical record.


“Previously, the management of inpatient care was very heavily paper based. No one could see what was happening with a patient unless they had the paper notes to read and task lists were hidden in people’s pockets,” he explains.


“Communication between multi-disciplinary teams – Allied Health, nursing and surgical staff – was really around phone calls and pagers, which are really inefficient ways of communicating, and there was no closed loop.”


Staff were given the app and told usage was voluntary. Within the first week, 95 per cent of patients in the general surgical admission unit had their admission note performed via Cortex, indicating that it met the end users’ needs in a busy environment, says Connor.


The error rate is very low and data completion rates are very high, particularly for demographic details, which have risen from as low as 30 per cent being recorded on paper to 100 per cent on the app.


The app has also made booking patients for follow-up appointments after admission to the ward safer and more reliable.


The CDHB has used surveys to determine the amount of time Cortex saves clinical staff, and it estimates an average of 5–10 minutes per hour, per person across the board.


Connor says that figure seemed very high, but when he adds up all the micro-time savings, for example, by being able to order blood tests for 20 patients all at once, they quickly add up.


“All these micro-wins about making a process safer and with less errors are really important in healthcare because often the things that cause errors are communication failures,” Connor says.


Cortex pushes information back into the CDHB’s electronic medical record system, provided by Orion Health, and has read-only views into the observations and results systems.


New Zealand software company Sense Medical developed the Cortex app with the CDHB through their Via Innovations initiative, which was set up to support emerging health technology solutions.


PROJECT CONTACT: To find out more about this project please contact Saxon Connor.



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