ePrescribing system to benefit thousands of Northern cancer patients

eHealthNews.nz: Clinical Software

ePrescribing system to benefit thousands of Northern cancer patients

Thursday, 6 June 2024

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NEWS - eHealthNews.nz editor Rebecca McBeth

Health New Zealand Te Whatu Ora Northern region has designed and implemented a new oncology and haematology e-prescribing and administration solution, benefiting more than 5,400 cancer patients a year.

The digital project, called Raurau Ngaehe will be used by about 600 clinicians working across Health NZ’s Northern region, delivering around 40,000 treatments every year.

Middlemore Hospital haematology was the first service to go-live in August 2023, followed by Waitematā haematology in October 2023 and Northland haematology and oncology in November 2023.

Te Toka Tumai Auckland cancer and blood medical oncology was onboarded in May this year, treating 100 patients a day, and Auckland haematology is planned to implement in July followed by paediatrics in September.

Developed on indici from Valentia Technologies, it replaces a paper-based system for prescribing cancer treatments like chemotherapy for both adults and children.

Health NZ clinical lead Dean Croft says having a single regional system that can be used on a digital tablet at the point of care will enable more Local Delivery of Oncology (LDO) centres, allowing patients to receive care closer to home.

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“Being on the same regional platform is great because patients move between Auckland and Northland and some have their chemotherapy prescribed in Auckland, then administered closer to home in Counties Manukau or Waitematā. Now everyone is looking at the same prescription and you can simply change the location of the treatment,” says Croft.

Previously, prescriptions were being emailed between hospitals, making it difficult to keep a complete patient record.

“For me, it provides visibility and accessibility to the service record and I can log in from anywhere,” he says.

Raurau Ngaehe also reduces the potential for human error as the system automatically calculates and rounds doses, and potentially reduces wastage of chemotherapy drugs, he says.

The application has taken two and a half years to build with around 50 developers from Valentia working alongside 10 subject matter experts from haematology, oncology, and paediatrics.

Stephanie Crabb, Health NZ senior project manager, data and digital Northern, says the system has been designed using SNOMED CT for data capture and FHIR for near real-time data exchange, making it the first CanShare standard system in NZ.

It is integrated with the NZ ePrescribing System, uses New Zealand Medicines Terminology for the naming and coding of drugs, and an integration with the northern region clinical portal means patient treatment summaries are automatically created and visible so nurses no longer need to scan them.

“We had some very nervous stakeholders in the beginning because it is a relatively high risk treatment, so we started with a limited number of patients and transitioned quite slowly,” Crabb says.

“We got a great response from the doctors, nurses and pharmacists and our implementations are getting better each time.”

A clinical working group was established early to show future users what was being built and how it would work, so there were no major surprises at go-live.

Crabb says input from senior clinical and informatics leaders Richard Sullivan, Karl Cole and Lara Hopley was key to determining what was critical to the initial build.

This involved deprioritising some items that were ‘nice to have’ in order to keep the project on time to go-live last August.

The ACT-NOW protocols were also implemented as part of the technology go-live. These provide national definitions for chemotherapy treatment in New Zealand, meaning data can be shared securely from hospital information systems to a new national chemotherapy database.

Croft says, “the aim is to get granular data that can be used to do really in depth equity analysis and start to highlight regions or patients or diseases where we need to take a closer look.”

This development has increased ACT-NOW data coverage nationally from 40-70 percent.