Newborn enrolment boosted by NES integration

eHealthNews.nz: Interoperability

Monday, 23 October 2023

Share |

NEWS - eHealthNews.nz editor Rebecca McBeth

Rotorua Area Primary Health Services (RAPHS) has increased its newborn enrolment coverage by 26 percent over the past year after integrating its shared care view for Rotorua Hospital with the National Enrolment Service (NES).

Chief executive Kirsten Stone says non-enrolled patients are high users of hospital services, and support for whānau with newborn children is a priority to initiate access to care, health, and wellbeing services right from birth.

RAPHS was close to the bottom of the national league table for newborn enrolment at the end of 2022, but is now ranked fifth. Stone says this is a direct result of collaboration between primary and secondary care providers and use of information to drive improvement.

The primary health service provides a shared care view to Rotorua Hospital ED called PatientWise. This started in 2010 as a way to look up a patient’s GP and has developed over time to include clinical information such as demographic details, problem codes and medications.

You’ve read this article for free, but good journalism takes time and resource to produce. Please consider supporting eHealthNews by becoming a member of HiNZ, for just $17 a month.

Hospital users can now also see clinical encounter notes from the GP’s practice management system over the past 90 days, and there is functionality for secure messaging with the usual GP.

Until recently, only information on RAPHS enrolled patients was available, but an integration with the NES, which provides up to date national enrolment and identity data for people enrolled with any practice nationally, means hospital clinicians can identify those patients who live locally, but who are not enrolled with a GP.

A new referral pathway into the RAPHS Koiora team, which includes community nursing, clinical pharmacy, mental health and social care; allows the hospital to refer these patients without a GP and especially those with complex health and social needs, to RAPHS for follow up care including support to enrolment.

Stone says this process has significantly increased enrolment with general practice, particularly for priority patient groups.

“Our focus on supported enrolment has lifted enrolment for Māori by 3 percent and Pasifika by 4 percent over the last year, even though practice books have largely been closed during this period,” she says.

In parallel RAPHS has a clinical service for transitional care post hospital admission.

“This is for those who are not well served by the system: that do not have a GP, or practice books might have been closed so there is not any follow-up care. We have the hospital and the primary care team working together to make sure those really vulnerable cases do not fall between the cracks.

“Even before Covid-19, the unenrolled population were identified as high users of health services or hospital services, and there has been a whole range of initiatives looking at that,” Stone says.

“The Covid period and emergency housing initiative put massive extra pressure on the health sector in Rotorua by introducing around 5000 people into quite a small system, and not all of them had a GP. With practices under stress with national workforce shortages, GPs also have less capacity to take on these new patients.

“This approach is joining the circle to ensure the technology, the information, and service providers are working together.”

Data scientist Justin Sherborne says the web-based tool PatientWise was built in-house and is also being used by the local out of hours care provider and some pharmacists.

He says the integrated nature of the tool makes it easier for clinicians to identify non-enrolled patients as they already use it to see the patient’s primary care clinical information.

If a hospital clinician looks up a patient it sends an automatic notification to the GP, which Sherborne says they love as they then know they patient has presented at hospital.