How digital systems are essential in navigating a healthcare crisis

eHealthNews.nz: Covid-19

How digital systems are essential in navigating a healthcare crisis

Monday, 28 September 2020

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Industry Article - Ergotron

Part two of a three- part series exploring why digital health systems are the secret to future-ready care, this feature looks at how nationally integrated digital health systems provide data and support for decision-making at both national and local levels during a health emergency.

In one of the most extensive COVID-19 risk analyses done in the world, the Deep Knowledge Group looked at 130 indicators to determine what level of exposure different countries faced during the pandemic.

Peppered amongst the risk-reducing indicators were multiple assessments of digital health capacity -

2.3.7 - Does the region utilise electronic health records?
3.2.3 - Does the region use online diagnostic tools?
3.6.6 - Does the Ministry of Health provide data on confirmed COVID-19 cases, critical cases and deaths on a daily basis?

New Zealand ranked 9th– we sit among the top ten safest countries in the world during this global health emergency. But this significant result was achieved despite our low-level digital health capabilities. The policymakers and frontline workers in our country fight COVID-19 blind, without the essential tools provided by a fully-integrated digital health system.

Nationally-integrated digital health systems provide real-time aggregated data that support better decision-making. In a health crisis, this is important at a national level as it can inform policy-makers swiftly of cluster development and offer rapid insight into whether treatment methods are proving effective or ineffective. At an individual hospital level, digital systems are equally vital in emergencies, allowing for secure communication, instantaneous all-staff updates, and streamlined testing procedures.

A 2015 report compared how advanced countries were in their use of IT to optimise health outcomes. The report identified seven stages of adoption, with Stage 7 representing advanced and holistic use. The analysis revealed that the vast majority of hospitals in New Zealand have only low-level digital health capability – sitting at Stage 2 of adoption or below. While some progress has been made in the years since the report was authored, it has not been widespread.

Stages	NZ EMRAM Score Distribution (2015 Q2) N=40	Care Improvement by EMR Adoption Clinical value potential of each EMR Adoption Model Stage
Stage 7	0.0%	Paperless environment enabling data continuity to deliver and manage patient care for all hospital services and supporting coordinated care delivery  Optimized quality of care and patient safety  Optimized clinical operational and business process efficiency
Stage 6	0.0%	Optimized diagnostic and care delivery efficiency by standard treatment protocols; Further reduction / elimination of medical errors  improved patient safety; Reduced / eliminated paper-based documentation and dictation and transcription costs; Improved billing and coding
Stage 5	5.0%	Elimination of film reduces costs and need for storage space, image sharing works faster and more efficiently, redundant imaging can be avoided
Stage 4	0.0%	Improved care delivery efficiency and reduced medical errors with CPOE
Stage 3	0.0%	Optimised collection of nursing and clinical information; Standardized care delivery  first improvements of care quality
Stage 2	92.5%	Optimised access to diagnostic results, sharing of patient-information
Stage 1	2.5%	Improved key dept. operations and access to diagnostic information
Stage 0	0.0%	Low clinical value; mainly patient administration and hospital management

Fig.1 NZ EMRAM Score distribution across 40 hospitals as on 2015 Q2, vs. Care Improvement by EMR adoption. European Hospitals EMRAM Maturity Overview

The threat of COVID-19 is still live. On June 20, the World Health Organisation said we were entering a “new and dangerous” phase of the pandemic, while local leaders continue to warn that a second wave is still possible. Experts are also predicting that the rate of pandemic occurrence will increase - with another global emergency likely within decades, not centuries.

New Zealand has been a hero and an example to follow during the Coronavirus crisis. But our chances of replicating these results in future emergencies is only strengthened if we choose to embrace digital health technologies today.

To learn more about the adaptation of EMR systems, watch the webinar ‘EMR, a strategic sustainable approach’ now On Demand.