Gold Coast Integrated Care translating the talk into action Helen Cooper & Emma Hossack
Speakers Helen Cooper Emma Hossack Managing Director Chief Executive Managing Director, Gold Coast Integrated Care, Gold Coast Hospital and Health Service President, Medical Software Industry Association Immediate Past-President, International Association of Privacy Professionals ANZ, Chair Strategy and Growth ANZ Director, ScriptWise Chair, Australian Stem Cell Foundation
Translating the talk into action International Lessons - UK, Canada, Scotland. Professor Trish Greenhalgh Lessons for Australia and why we need Dead Philosophers. Digital Health Ecosystem multi-layered local national technical cultural.
Heading Heading Australian Digital Health Ecosystem & Extensia s Role PATIENT Heading Patient and Provider Benefits Timely access to health information improves decisions Transparency of information empowers patients self management & reduces risk of adverse reactions or conflicting prescriptions Better coordination between providers - better outcomes & efficiencies Less duplication of tests & patient history is less frustrating & saves time and money Managed Shared Record Use & Benefits FLINDERS TOOLS e.g. HealthPathways HOSPITAL SYSTEMS SPECIALIST SYSTEMS PHARMA SYSTEMS ALLIED HEALTH SYSTEMS PERSONAL HEALTH APPS PAPER SYSTEMS RADIOLOGY & PATHOLOGY SYSTEMS GP SYSTEMS COMMUNITY SERVICES Managed by the community, which is determined by geography, disease or specific desirable health outcomes Bespoke Branding, Templates, Registration process, what information is captured & reporting metrics designed by the community with results being immediately available Links with the national systems when users require All providers including those without software systems to contribute and access the record with customised templates to improve care co-ordination National System - PCEHR Use & Benefits EXTENSIA S COMMUNITY MANAGED SHARED RECORD Government My Health Record Large national database designed by the government to achieve national health planning & bio-surveillance & reporting The Commonwealth Government determines what information is captured and from what systems for a nationally consistent dataset Automatically uploads MBS and PBS data As a national system it is not designed for care co-ordination it cannot and should not be all things to all people. It forms a national foundation and allows industry to provide ongoing innovation through other parts of the digital health ecosystem
A new direction Australian Digital Health Agency
Integrated Care Program A 4 year Proof of Concept Founded on the notion that care coordination, planning and patient advocacy is best achieved in collaboration with GPs, supported by specialists, multidisciplinary teams, non government organisations and private sector allied health professionals. Coordination Centre General Practice Patient and Family
The Gold Coast Integrated Care Population ~730k GCHHS Patient Population ~63k In Network Patients 1303 Cohort Patients ~130k General Practice Patient Population Data from 22 Jul 2016
GP Managed One Care Team Holistic Healthcare Integrated Health Records Integrated Services Rapid Response 24 x 7 Phone Support
Reactive Proactive Holistic Healthcare Holistic Assessment Disease Registers Patient Management Dashboards Population Based Ambulatory Care Hospitalisation Disease Population Risk Management
Managing Holistic Healthcare Action Plan Disease exacerbation End stage disease Falls Dementia Cognition Nutrition Etc. Holistic Assessment Disease Registers Diabetes COPD CHD CKD Pre-hospitalisation MAU Length of stay Post Discharge Patient Management Dashboards of Hospitalisation Population Based Ambulatory Care Referrals Management Rapid Response Hospitalisation Disease Drive down unscheduled, avoidable hospital admissions
The information dilemma There are increased risks to the delivery of healthcare as patients have to repeat their information to multiple healthcare providers across organisations as systems are not linked. Multiple provider centric management plans exist for a patient which leads to patient confusion. Many systems contain vital pieces of healthcare information however, most is not accessible at the time of healthcare delivery. Information in systems is not kept up to date and healthcare may be delivered based on out-dated information. There is no common/standard language in use throughout any of these records which means apples are not always compared with apples.
Why GCIC chose a community-based Shared Care Record All healthcare providers and patients can see the same information and all can contribute to, and work from, the one care plan. All care team members (as nominated by the patient) are able to access, view and contribute to the patient s shared care record. A healthcare event summary is provided by a healthcare provider to the shared care record such that all members of the patient s care team may view it when next delivering healthcare to that patient. System configuration is based on the community s needs facilitates the integrated healthcare delivery model
Timeline Sep 2014 Business Case Approved 2014 2013 2014 2015 5 Mar 2015 Medical at My Centre Nerang 11 Mar 2015 Broadbeach Medical Centre 19 Mar 2015 Gold Coast Medical Centre 2015 30 Apr 2015 Hope Island Medical Centre 30 Apr 2015 Homeworld Helensvale Medical Centre 2016 2 Mar 2015 Shared Care Record Live 22 May 2015 Coomera Village Medical Centre 25 May 2015 Runaway Bay Doctors Surgery 26 May 2015 Robina Town Centre Medical Centre 28 May 2015 Gold Coast GP Super Clinic 11 Jun 2015 Health HQ 26 Jun 2015 Olsen Avenue Medical Centre 26 Jun 2015 Doctors At Coomera 5 Aug 2015 Labrador Park Medical Centre
Integrated Health Records 14 2 50 1 General Practices Public Hospitals Other Healthcare Service Providers Ambulance Service As nominated by patients Longitudinal Community Health Record Go Live: March 2015 RecordPoint 1444 110 1303 Patients Clinical Users General Practitioners Data as at 22 Jul 2016
Shared Care Record Content > 90 Structured Document Templates Configured 29,788 Event Summaries uploaded to the Shared Care Record 1,165 7,123 Inbound HL7 Interface from QH Systems Outbound Medical Objects Interface to GPs Initial Health Summaries General Practice Event Summaries
General Practice Usage Per Month 50 60 General Practitioners 20-25 Nurses
Patient Usage 147 of the 1303 (11.3%) Patients have accessed their record Some are avid readers Some have just looked around and not returned Reasons Age of Population Access / Skill for technology
Hospital Use Hospital use remains low Further integration with Hospital Systems is required The GCIC Clinical Team are the primary interface between General Practice and the Hospital
Concluding thoughts We are live with a community shared care record that is assisting care providers to improve patient care across the acute and primary care sectors Our experience over the last two and a half years is: If you want to integrate care and you can build local trust, you will do it irrespective of policy and funding. Professor Martin Connor Executive Director Centre for Health Innovation GCHHS and Griffith University