Mental health and addiction service goes paperless

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Picture: A Waikato DHB staff member edits a form from the generic XML toolkit.

eHealthNews.nz reporter Sam Sachdeva

The Waikato DHB's mental health and addictions service 10-year transition to an electronic record system shows a “big bang” approach is not always the best solution, one of the people behind the transition says.

The DHB’s mental health and addictions service team has been paperless since the end of 2015. It has now created 2.6 million electronic forms and 6.5 million unstructured documents from scanning.

Waikato DHB system implementation analyst Paul Docherty says the transition to an electronic record had “almost an accidental start” after the introduction of the Clinical Workstation access point for clinicians.

When the Ministry of Health introduced new outcome reporting requirements in 2005, the DHB chose to use a generic XML form toolkit to collect the information instead of a one-off application.

As more reporting requirements were introduced, Docherty says the DHB implemented greater electronic collection of information, allowing clinicians to bypass the use of paper forms.

Geographical requirements meant some organisations such as Auckland DHB chose a “big bang” implementation with back scanning of paper records, while Waikato DHB was able to more gradually transition due to a lack of similarly strong drivers, he explains.

Docherty says the gradual process meant clinicians were never confronted with dramatic changes, allowing an upskilling for some nurses who claimed to have never previously turned on a computer.

“Saying ‘Move the mouse across the screen’ resulted in the mouse being physically picked up and physically moved across the screen,” Docherty tells eHealthNews.nz.

The use of XML forms ensured the data was collected in a structured format, allowing more valuable information to be provided to clinicians and making it easier to produce audits for information not systematically collected.

The DHB went fully paperless in December 2015, with some documents unable to be turned into electronic forms, such as those that require the signature of a patient, scanned instead.

Docherty says it has received approval from Archives NZ to dispose of the paper copies after holding them for an archive period, shortened from three months to one month.

Docherty says the electronic record is useful for the “highly mobile patient group” who use the DHB’s mental health and addiction services, ensuring clinicians who see them at any site can view their details.

It has also made it easier for the DHB to carry out clinical audits and performance reporting for the Ministry.

Docherty says the DHB has been asked to find mobile solutions, and there are “a few challenges on the horizon”, including the possible development of a universal recovery plan which can be accessed and updated by the patient, DHB staff, GPs and NGOs.

He is reluctant to offer advice to other DHBs planning to go paperless, but believes events like the HiNZ Conference 2018 provide an opportunity to tell his team’s story in a “non-threatening” way.

Paul Docherty will be presenting on Waikato DHB’s transition to paperless at the HiNZ conference 2018 to be held at Wellington TSB Arena from November 21–23.

To read more about the HiNZ Conference 2018 click here >>

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