Simplicity From Complexity
Judith Day
[CFO/CIO]
Eddie Harrison
[Director Information Services]
Conflict of Interest?
Cabri...
Cabrini Health
• Founded in 1948 by Mother
Cabrini
• Owned by the Missionary
Sisters of the Sacred Heart of
Jesus
• Not-fo...
About Cabrini Health
• 832 beds – 6 campuses
• 1,200 accredited specialists – majority of work done
by <500
• 4,000 staff
...
Patient
Doctor
Allied
Health
Admin
Nurse
Simplicity from Complexity
• Electronic Medical Record
• Electronic Discharge Summary
The Ultimate Goal
Simplicity from Complexity
Pharmacy system
electronic
Clinical
results
Community Care
mobility,
Nursing workflow
Order Entry Clinical Viewer
Electron...
• PAS system
• Phillips monitoring equipment – central server
• PACS system for radiology
• PACS system for cardiology
• R...
• Reluctant to change unless value to self
and patients is clear
• Limited electronic capture of medical
information
• We ...
• Limited space in the wards for IT infrastructure
• How will VMOs access from offsite?
• VMOs practise at other hospitals...
Our approach
• Make it easier for doctors to care for patients
• Instead of imposing on medical staff we wanted to support...
An opportunity appears
• iPad launched
• Rapid uptake
• Why not let the doctors buy the hardware and we concentrate on
sof...
Interface design.. Engaged with Cabrini Medical Director
• What were the key issues he had when he was a VMO?
• Each day h...
• Engaged with iSoft (now CSC) to develop a system
• Began internal HL7 interface work using eGate
• Worked with PACs vend...
WHAT IT DOES
Mobile Patient Information System
Simplicity from Complexity
One function per screen
CSC Mobility Suite CSC Mobility Suite
Simplicity from Complexity
Call up patient list at start of round
Simplicity from Complexity
Review results - biochemistry
Simplicity from Complexity
Review results - CT
Simplicity from Complexity
Patient details
Simplicity from Complexity
Emergency Dept.
Simplicity from Complexity
Other screens we use
Simplicity from Complexity
RESULTS
May 2011 – July 2012
•Go-live May 2011
•Enthusiastic response
•June 2013 – 450 users
•Doctors supply their
own dev...
• No additional resources required
• Some doctors need advice on configuring iPad
• No training manual or sessions needed
...
• CPOE – pathology test ordering
• CPOE – radiology test ordering
Further developments
• Integration with MedChart - ePrescribing
Further developments
Further developments - Observations
Simplicity from Complexity
“ I have to say that this Clinical Viewer (CSC Mobility
Suite), is quite simply the best IT development that I
have ever s...
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Judith Day and Eddie Harrison simplicity from complexity

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Judith Day and Eddie Harrison delivered the presentation at the 2013 eHealth Interoperability Conference.

The 2013 eHealth Interoperability Conference program is a balance between updates on state-wide interoperability projects, health service eHealth project case studies, and discussions of overarching principles such as information governance, data standardisation, and the future direction of eHealth in Australasia.

For more information about the event, please visit: http://www.informa.com.au/eHealth13

Published in: Health & Medicine, Business
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Judith Day and Eddie Harrison simplicity from complexity

  1. 1. Simplicity From Complexity Judith Day [CFO/CIO] Eddie Harrison [Director Information Services] Conflict of Interest? Cabrini is client of CSC No personal commercial relationship with CSC in any form Simplicity from Complexity
  2. 2. Cabrini Health • Founded in 1948 by Mother Cabrini • Owned by the Missionary Sisters of the Sacred Heart of Jesus • Not-for-profit Public Benevolent Institution Simplicity from Complexity
  3. 3. About Cabrini Health • 832 beds – 6 campuses • 1,200 accredited specialists – majority of work done by <500 • 4,000 staff • 75,000 episodes of care annually • 23,000 ED attendances • 44,000 surgical operations • In house pathology, radiology & pharmacy Simplicity from Complexity
  4. 4. Patient Doctor Allied Health Admin Nurse Simplicity from Complexity
  5. 5. • Electronic Medical Record • Electronic Discharge Summary The Ultimate Goal Simplicity from Complexity
  6. 6. Pharmacy system electronic Clinical results Community Care mobility, Nursing workflow Order Entry Clinical Viewer Electronic Medication Management, RFID, bar-coding Clinical Decision Support Electronic Medical Record deployment Electronic Medical Record plan 1 2 3 4 5 6 7 Electronic Medical Record Electronic Medical Record Clinical and Doctor empowerment via mobile devices at the point of care Ref: US Model 7 stages, Appendix B
  7. 7. • PAS system • Phillips monitoring equipment – central server • PACS system for radiology • PACS system for cardiology • RIS for reports • Pathology system which is SAAS • How will we integrate all this data? Simplicity from Complexity Problem 1….so many systems
  8. 8. • Reluctant to change unless value to self and patients is clear • Limited electronic capture of medical information • We have a paper based medical record • Limited budgets and competitive pressures Simplicity from Complexity Problem 2…. How do we engage VMOs
  9. 9. • Limited space in the wards for IT infrastructure • How will VMOs access from offsite? • VMOs practise at other hospitals as well. How do we make it simple? Simplicity from Complexity Problem 3…. Build it and they will come?
  10. 10. Our approach • Make it easier for doctors to care for patients • Instead of imposing on medical staff we wanted to support them • Provide tangible benefits • Design a system that is simple, easy to use and that makes life better • Flexible, incremental roll-out • Get it right then see what users want next • First - design a way to link clinical results to the patient record • Avoid high cost, high complexity and high risk solutions Simplicity from Complexity
  11. 11. An opportunity appears • iPad launched • Rapid uptake • Why not let the doctors buy the hardware and we concentrate on software and network? • Focus on the interface Simplicity from Complexity
  12. 12. Interface design.. Engaged with Cabrini Medical Director • What were the key issues he had when he was a VMO? • Each day he would arrive at the hospital and get his patient list • Go to the ward and try to find the medical record • Look for printed results – hope they are there. • If not there, need to access multiple systems for pathology and radiology • Need to call theatre for sessions and bookings He was defining the interface Simplicity from Complexity
  13. 13. • Engaged with iSoft (now CSC) to develop a system • Began internal HL7 interface work using eGate • Worked with PACs vendors to build interfaces • Worked with RIS vendor to build interfaces • Worked with Pathology SAAS vendor • Worked with Phillips • Agile development cycle with Cabrini medical director reviewing at each stage • Engaged a few VMOs to test , trial and champion Simplicity from Complexity Integration work
  14. 14. WHAT IT DOES Mobile Patient Information System Simplicity from Complexity
  15. 15. One function per screen CSC Mobility Suite CSC Mobility Suite Simplicity from Complexity
  16. 16. Call up patient list at start of round Simplicity from Complexity
  17. 17. Review results - biochemistry Simplicity from Complexity
  18. 18. Review results - CT Simplicity from Complexity
  19. 19. Patient details Simplicity from Complexity
  20. 20. Emergency Dept. Simplicity from Complexity
  21. 21. Other screens we use Simplicity from Complexity
  22. 22. RESULTS May 2011 – July 2012 •Go-live May 2011 •Enthusiastic response •June 2013 – 450 users •Doctors supply their own device •Most results now viewed via iPad Simplicity from Complexity
  23. 23. • No additional resources required • Some doctors need advice on configuring iPad • No training manual or sessions needed Support required Simplicity from Complexity
  24. 24. • CPOE – pathology test ordering • CPOE – radiology test ordering Further developments
  25. 25. • Integration with MedChart - ePrescribing Further developments
  26. 26. Further developments - Observations Simplicity from Complexity
  27. 27. “ I have to say that this Clinical Viewer (CSC Mobility Suite), is quite simply the best IT development that I have ever seen anywhere in healthcare.” Cabrini Anesthetist Simplicity from Complexity

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