Completing the Paperless Journey

Completing the Paperless Journey Dr Ian Williams Practice Principal Jan Chaffey Executive Officer Camp Hill Medical Centre

The beginning
In 1943 the Allies developed the earliest programmable electronic computer to break the German coding machine Enigma

The year is 1954

What is this?

The year is 1956
It's a hard disk drive back in 1956... with 5 MB of storage. In September 1956 IBM launched the 305 RAMAC, the first 'SUPER' computer with a hard disk drive (HDD). The HDD weighed over a ton and stored a 'whopping' 5 MB of data.

The journey continues
In 1975 , the first personal computer was sold - to start the machine there were 25 switches all requiring a precise sequence for the machine to work !!!!!

Our Story

The story continues

And continues...........

Camp Hill Medical Centre

Living the dream
Family Health Care since 1947
Holistic, quality lifetime care for our patients
A medical home
In a medical neighbourhood
Quality team
Quality systems
Quality facilities

Accredited General Practice – (5 th round 2010)
14 Doctors
2 Practice Managers
3 Practice Clinical Nurses
1 Community Nurse
1 Diabetes Educator
2 Mental Health Nurses
Consultant Pharmacist
12 Reception and Support Staff
Visiting Allied Health
Dietitian
Podiatrist
Psychologists (2)
Pathology

Database of 40,000
1,250 over 75 years
1,700 under 5 years
Ten (10) consulting rooms
Three (3) treatment areas
Diabetes educator consulting room
Community Nurse room
Mental Health Nurse room
Approximately 1350 consults /week

It’s all about the team!
What is a practice team?
A group of people making different contributions towards achieving a common goal

Practice Structure Principal Doctor R.Nurses Practice Manager C. Nurses Patient Executive Officer Principal Doctor Community nurse Diabetes educator Mental health nurses Consultant Pharmacist Doctors Nursing Staff Clinical nurses Administration Staff Community Resources

Teams within Teams

About our team:
Meet Regularly
Agenda / Minutes / Action list
Develop Goals & Objectives
Develop Action Plan
Review Process and Outcomes
Redefine Processes
Always Strive for Innovation and Best Practice

Continuity……
Continuous process
Team development and strengthening
Systemisation of procedures (intranet)
Quality improvement framework
Patient focused
Outcome focused
And it continues………

Our Team

The Jargon Hardware Software Gigabyte RAM POP 3 Router MHz Hub Floppy Disk

Systemisation of your practice
Project plan
driver
Hardware
Getting it right! – 5 year plan
Software
Choosing the best for your practice
Training
Doctors
Nurses
Allied Health
Staff
Competencies
All
Support
Hardware
Software
In-house
Risk Management
Backups
Passwords
Firewall
Virus protection
Upgrades
Software
Hardware

Consulting Room / Front Desk
KISS
Training, training, training
Templates
Shortcuts
Generic referrals
Reminder letters
Recall systems

Templates
Community Nurse
Health Assessments
GPMP & TCAs
Diabetes Educator
Mental Health Nurses
Consultant Pharmacist
Shared resources for the care team

Practice Systems
Information Management System
Who is responsible ? and for what are they responsible?
What is your role?
What knowledge do you need to fulfil your role?
Do you require additional training?

Practice – Hardware/ Software
Hardware / software contacts
How many computers?
Programs on each (full audit of each workstation)
Where is software stored or is it online?
How many workstations
Type of server(s)
Printers
Modems
Scanners
Is it documented?

Risk Management
Security of data
Is it password protected?
Do all users have individual passwords?
Security of server
Does it have a UPS?
Is there a RAID system?
If there is loss of power – is it set up to
‘ down gracefully’

Backup
What systems are in place?
Is it manual or automatic?
Who is responsible?
What is being backed up?
Server (what information)
Individual computers – C drive data
Backup Tested / Restore Performed
Does someone check every day that backup has been successful?
Where is the backup stored?

PDSA Cycle

When there are problems!
Isolate the problem
Is it hardware?
Is it software?
Is it operator error?
Check manuals – troubleshooting sections
Know who to call for help
Stay calm!

When all else fails!
Have a disaster plan
What do the doctor’s need to keep working
Script paper
Referral forms
Letterhead
What do the receptionists need to keep the front desk running
Manual receipts
Manual bulk billing forms
Manual eftpos / credit card forms

IT Troubleshooting
Remember once the computers are working again all data must be entered
Clinical data
Accounts/receipting data

General Practice - Snap Shot
2004
Majority of practice have hybrid systems
2010
Almost all practices fully electronic
Why?
Generational change
New practitioners proficient with technology
Different skill set
Increased expectations of technology as a reliable tool to assist in day to day running of practices
Business case
Competitive nature of clinicians

A Practitioner’s Perspective - 2004
Team decision
Do the research
Network with other practices
Talk with division
Listen to the experts
Present the proposal
Show the benefits
Quality records
Time saver
Great space saver
Improved morale
It is inevitable!

A Practitioner’s Perspective -2004
Make the decision
Set the date
Train everyone
Do it in one go!
Stay positive
Support
Hardware
Software
Practice troubleshooter

I want more!
Reliability of hardware and software
No downtime ( and no my time!)
Fast network
Decision support (delivery of evidence to clinician)
Electronic prescribing
Data mining

Electronic referrals to and reports from:
Medical specialists
Allied health
Radiology
Public hospitals
Private hospitals
Government departments e.g. Centrelink, DVA
Workcover, Comcare
Tip: On bottom of referrals
Camp Hill Medical Centre prefers to receive reports electronically through .................

A manager’s perspective 2010
What I want
Intranet
‘ If it’s not electronic.........’
No scanning
Everything electronic
No manual faxes –sent/received
All from computers with automatic logging and tracking

We’ve come a long way!!!

The way forward – the I’s have it!!!
Innovation
Information
Infrastructure
Investment (time,resources)
Integration
Imagination
Interoperability
Improvement (there’s always a better way)

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Completing the Paperless Journey

by Stat Health on Sep 29, 2010

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Completing the Paperless Journey — Presentation Transcript