eHealth NSW Cerner roll-out running ahead of time

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eHealthNews.nz editor Rebecca McBeth

eHealth New South Wales has rolled out an electronic medical record to more than 170 hospitals state-wide as part of a 10-year programme of work in digital health transformation.

Part of this roll-out is eMeds, which adds electronic medication management functionality to the EMR.

The eMeds programme was forecast to finish in 2022, but by feeding back and learning from prior implementations, it is being rolled out much more quickly and will now be completed by July 2020.

NSW Health is the largest public health system in Australia, with a population of around 8 million and $25 billion in spending every year.

The state’s eHealth strategy is a 10-year programme of work designed as a set of guidelines and roadmaps that drive investment in this area.

eHealth NSW chief executive and chief information officer for NSW Health Zoran Bolevich says even in the fast-changing world of digital health it is possible to have a 10-year plan, as “it’s about the what not the how”.

The three key goals of the strategy are that patients are supported, well informed and actively engaged in their health; staff have the tools to make effective decisions with access to the very best training; and organisations have the capacity for smart, transparent and efficient management, business and service planning.

The programme has three horizons, which are all being worked on concurrently. Around 70 per cent of horizon one was funded via a business case three years ago and further business cases are going to the State for approval.

A key building block has been the roll-out of the Cerner electronic medical record to more than 170 hospitals across the state. Every day 45,000 clinicians log into the EMR and a large proportion of education is now done online.

By the end of this year, nearly 95 per cent of those facilities will also have electronic medication management.

eHealth NSW acts as a co-ordinating agency, but implementation is done locally and co-funded with providers.

Bolevich says this ensures everyone has “skin in the game” and allows for good governance and consistency in project management, as well as driving standards.

Key to the success of the programme has been clinician engagement and strong executive leadership, says Bolevich.

The agency has also focused on building infrastructure as “you can’t build a sophisticated environment with a high-performance system if you don’t invest in the hardware and infrastructure that will deliver that,” he says.

NSW has invested particularly in rural areas via the Rural eHealth Programme, lifting their infrastructure, bandwidth and wi-fi capabilities to allow them to implement the EMR and invest in telehealth.

Next steps are around improving the use of and usability of the systems, such as introducing single sign-on, and this is being driven by clinical ownership and accountability.

EMR is currently separated into several different databases, so the team is working to combine these into a single digital record for NSW, as well as moving a lot of infrastructure to the cloud.

“Over time, we want to get out of the concept of always having to purchase, own and run our technology, so we’re moving towards ‘as a service’,” Bolevich says.

Horizon two of the strategy is focusing on integration of care and linking hospitals and community-based providers, while horizon three is about engaging the consumer and creating a “fully patient-centric experience”.

A project involving Patient Reported Outcome Measures and Patient Reported Experience Measures being fed back into the EMR system is underway, with phase one implementations occurring in the next couple of months.

The agency is working to build relationships with some key industry partners as well as with academics and researchers.

One area being considered is the use of real time data analytics to improve safety and quality of care, as well as enhanced management of new clinical risks when moving to digital.

Bolevich says this poses some workforce development challenges and opportunities, as there are new cohorts of clinicians who have never worked on paper entering the workforce, while many others are having to adopt new skills to make the best use of digital tools.

eHealthNews.nz editor Rebecca McBeth travelled to Sydney NSW with the support of HiNZ.

If you would like to provide feedback on this news story please contact the editor Rebecca McBeth.

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