EMR IN AUSTRALIA THE STATE OF THE NATION Bruce Pedersen Presentation to HIC 2017 Prepared by The Checkley Group www.checkley.com.au
2 key questions 1. EMRs who s using what & where? 2. How do improve info-sharing and learn from each other? 2
Broader themes 3 1. Competition 2. Collaboration 3. Classification
Sources of data 1. Gov hospital database 2. Individuals in HISA, esp. Joe Griffiths and Greg Moran 3. Checkley team members 4. Vendors 5. State ICT staff 4
Hospitals with 70+ beds only Analysis of actual implementation as at 1 July 17 Distinguishes between Integrated EMR solutions and Digitised Medical Records (DMR) or Portals Excludes Aged Care and pure Mental Health facilities Excludes planned or halfway Does not analyse depth even very light implementations count 5
Integrated EMR vs DMR/Portal Integrated EMR DMR or Portal Presents Results YES YES Onscreen Reduces Paper YES YES Links Orders and YES NO Results Supports BMDI YES NO Supports Workflow enablement YES PARTLY Supports Clinical Pathways Supports Closed Loop Meds YES YES NO VIA B.O.B. 6
Public Hospital System 7
EMR Deployments by Total Beds QLD Public Hospitals >70 beds None 45% Cerner 47% Cerner only integrated EMR solution deployed 8 sites covering 47% of beds in category Has had challenges with changes in strategic direction Has one of the two HIMSS 6 sites in Australian public system Cerner Hyland Eric None 8
EMR Deployments by Total Beds NSW Public Hospitals >70 beds NSW only state where all public hospitals (70+ beds) have baseline EMR or a Portal Cerner dominates Market - 86% of beds HNE LHD & Justice Health use Orion portal St Vincents use DeLacey (Emerging Systems) 9
EMR Deployments by Total Beds VIC Public Hospitals >70 beds Most complex state to assess with multiple agencies Only state with >1 Integrated EMR - 36% have deployed Significant use of DMR solutions especially Bossnet A number of major EMR projects underway: Western Health - new Monash - new Eastern Health major uplift Alfred major uplift 10
EMR Deployments by Total Beds SA Public Hospitals >70 beds SA Health one quarter through EPAS rollout by bed numbers Deployment at new RAH in September will increase to well over 40% Longstanding Oacis Portal implementations at many SA sites Some limited use of Oacis for Orders as well as Results 11
Western Australia No integrated EMR Systems rolled out to date by state Midlands PPP has EHS Other States and Territories Public System Bossnet DMR at Fiona Stanley plus up to a further 17 sites Intent to build at new Childrens passed by 12
ACT CSC Medchart still in pilot Longstanding DMR NT Recent announcement re Intersystems Other States and Territories Public System Tasmania Some clinical systems but no EMR 13
Summary Position Public Hospital EMR NSW the leading state by deployments to date Expect significant movement over next year in SA, QLD, NT and VIC WA remains the laggard/luddite state Overall we are 45% of the way through putting Integrated EMR solutions across the public sector 14
Summary Position Public Hospital EMM SA the leading state by deployments to date, using Allscripts Closely followed by NSW which has Cerner and MedChart Upcoming rollouts in Metro South beyond PA in QLD MedChart in pilot in ACT 15
Private Hospitals 16
Private Hospitals Limited progress on Integrated EMR, with some exceptions: UCH Queensland has had Cerner since late 90s, includes Hervey Bay first Level 6 HIMSS site Adventist has in-house system self-assessed at HIMSS 5.3 Macquarie UH has Intersystems St Vincents Sydney developed DeLacey Emerging Systems (Telstra Health) is installing at Northern Beaches PPP in NSW and already in StJG Midlands (WA) and Ryde Rehab (NSW) St Vincent s group believed to be working on case for company-wide EMR 17
Private Hospitals (2) Vitro solution (Slainte Health) in Calvary Care across 11 hospitals Also Chris O Brien Lifehouse Sydney Meditech has strong footprint right across Ramsay but only for the PAS part of their solution Healthscope nothing consistent noted Charm EMR at Newcastle Private 18
Conclusions and Call to Action 19
Classification: how should we measure success? Simplistic Thinking Paperless Paper Lite Paper Appropriate Work Practice Thinking Workflow Enablement Documentation Support Device Integration Outcome Thinking Reduced Hybrid Record Increased Patient Safety Reduced Variation in Practice Reduced Human Effort I often say that when you can measure what you are speaking about, and express it in numbers, you know something about it; but when you cannot express it in numbers, your knowledge is of a meagre and unsatisfactory kind; it may be the beginning of knowledge, but you have scarcely, in your thoughts, advanced to the stage of science, whatever the matter may be. Lord Kelvin 20
A Call for Collaboration Obvious benefits Definitely happening now but ad-hoc Lots of reinvention of the wheel Do we need a Gartner for Health? What about HIMSS? Who should be doing this work? 21
Contact me Email: bruce.pedersen@checkley.com.au Website www.checkley.com.au Phone 1300 592 062 or 0411 146 733 22