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Rachel Vickery, Physiopac Ltd: Moving care beyond the hospital walls (supporting notes)

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Rachel Vickery, Physiotherapist and Technical Director, Physiopac Ltd delivered this presentation at the 2nd Annual Hip Fracture Management Conference 2013. This conference is the only regional event to discuss practical innovations and improvement processes for the management of Hip Fractures in the hospital setting.

Find out more at http://www.healthcareconferences.com.au/hipfracture2013

Published in: Health & Medicine, Business
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Rachel Vickery, Physiopac Ltd: Moving care beyond the hospital walls (supporting notes)

  1. 1. Moving  Care  Beyond  the  Hospital  Walls     Slide  1:  Intro   Slide  2:   Think  about  how  you  can  start  to  shift  your  care  away  from  being  limited  to  one-­‐ on-­‐one  care  and  the  confines  of  physical  buildings.     You  have  a  wealth  of  information  that  your  patients  will  benefit  from  –  they  are   limited  in  receiving  it  if  they  only  have  a  brief  encounter  with  you.     Slide  3:   The  next  few  slides  refer  to  the  current  /  traditional  scenario  when  care  is   limited  to  physical  buildings  &  1  on  1  contact  time.     We  acknowledge  that  a  high  number  of  hip  fracture  patients  have  other  co-­‐ morbidities  and  /  or  dementia.     The  scenarios  presented  here  are  more  appropriate  for  patients  who  are  elderly,   but  otherwise  independent  or  need  minimal  assistance  with  ADL’s   Slide  4:   There  are  studies  that  show  that  patients  commonly  plateau  in  their  ability  to   achieve  previous  functional  ability  especially  post  discharge  “home”.   Often  related  to  lack  of  confidence  and  also  well-­‐meaning  “babying”  by   caregivers  /  family  members.   Slide  5:   Depression  is  also  a  common  factor  post  hip  fracture,  which  negatively  effects   healing  and  the  immune  system.     Poor  co-­‐ordination  between  stages  of  care  is  highly  correlated  with  increased  re-­‐ admissions,  medical  complication,  duplication  of  services  and  medical  errors.     Slide  6:   Individual  programs  –  nutrition,  rehab  etc  take  a  long  time  to  put  together  if  they   have  to  be  built  from  scratch  each  time.     People  can  only  learn  a  couple  of  exercises  at  once,  if  they  do  not  have  a   comprehensive,  easy  to  follow  version  of  the  program  that  they  can  keep   referring  back  to.     2  or  3  exercises  is  insufficient  to  address  the  consequence  of  a  hip  fracture,  and   more  importantly  to  INCREASE  a  person’s  functional  health  post  fracture  so  that   they  are  less  likely  to  have  another  fall  or  fracture.      
  2. 2. Slide  7:   Significant  load  on  the  main  caregiver  –  time  off  work,  their  health,  their  quality   of  life  etc.     Slide  8:   The  next  few  slides  are  to  demonstrate  how  the  same  scenario  can  be   dramatically  improved  by  overlaying  current  care  onto  myHealthpac  –  a  web   based  software  program  for  Health  Professionals  and  their  patients   myHealthpac  is  one  of  SHI  Global’s  software  programs   Meets  all  requirements  for  patient  privacy.security  of  data  etc.    Incredibly  cost   effective.  Probably  less  than  a  patient’s  hospital  meals  for  one  day!   Designed  to  “talk  to”  existing  Patient  Management  Systems,  Electronic  Health   Records  and  The  National  Health  Database.   Built  to  allow  seamless  integration  between  all  stages  of  care,  regardless  of  the   physical  location  of  the  health  professionals  involved.  Enables  all  health   professionals  to  work  together  on  the  patient’s  care  –  but  the  patient  only  ever   sees  one  plan.  From  the  patient’s  side  there  is  no  confusion  or  conflicting  advice.     Slide  9:   Users  can  use  as  much  or  as  little  of  the  platform  as  they  like.     For  example  an  individual  team  e.g.  the  hip  fracture  team,  might  use  the  existing   myHealthpac  system,  using  mostly  our  exercise  videos  and  put  their  own   relevant  information  on  the  site,  or  an  organisation  or  hospital  might  use  the   entire  platform  and  rebrand  it  as  their  own  for  example  Diabletes  Australia   Victoria  for  their  “Life”  wellness  program  of  diet,  exercise  and  information  /   learning  modules  for  patients  with  type  2  diabetes.     Slide  10:   myHealthpac  is  patient  centered.  It  enables  multiple  health  providers  to  create   patient  specific,  co-­‐ordinated  and  streamlined  information  /  exercise  plans  for   patients.  Health  providers  can  be  in  different  physical  locations,  but  can  all  see   what  the  other  Health  professionals  are  doing  if  they  have  been  invited  to  take   part  in  the  patient’s  care.     Patient’s  only  see  one  plan  –  they  just  have  ONE  webpage  to  log  in  to  where  they   see  EVERYTHING  that  they  need  relevant  to  their  care.  i.e  nutrition,  pharma,   exercise,  general  information,  appointment  reminders  etc.     Patient’s  can  invite  a  caregiver  to  be  able  to  view  their  page,  from  wherever  the   care  giver  is  based.     Slide  11   Patient  logs  in  to  their  own  web  page.  As  long  as  a  patient  is  computer  savvy   enough  to  check  their  email  they  can  use  this  system!  
  3. 3. Everything  is  printable  for  patients  without  internet  access.  Caregivers  can  log  in   to  help  patients.     Everything  that  the  patient  needs  to  access  about  their  care  can  be  access  from   this  page  –  any  general  information  put  in  place  by  the  careteam,  specific   exercises,  nutrition,  Tasks,  communications  etc     Slide  12:   A  Health  team  can  put  in  place  content  at  the  time  of  the  consult  i.e.  a  physio  can   put  some  exercises  on  the  patient’s  plan  when  they  see  them.     Most  efficient  and  powerful  way  to  use  myHealthpac  is  to  create  Carepacs  for   conditions  that  are  seem  regularly   Slide  13:   Carepacs  are  Generic  timelines,  built  as  templates,  that  dictates  when  specific   exercises,  information,  or  other  relevant  content  is  made  visible  to  a  patient   This  is  powerful  when  there  is  a  lot  of  generic  information  that  they  patient  will   benefit  from,  but  that  is  appropriate  at  different  time  points  moving  forward.  i.e.   a  patient  just  discharged  from  hospital  may  not  be  ready  for  information  about   walking  on  crutches,  or  picking  up  objects  off  the  floor,  but  would  benefit  from   this  advice  in  the  future.  Similarly,  exercises  can  be  set  up  as  a  Generic  Template   that  follows  the  “norm”  or  “post  op  protocol”  for  a  particular  procedure,  but  is   then  fine  tuned  when  it  is  used  for  a  specific  patient.    Exercises  can  be  pre-­‐ populated  with  appropriate  sets,  reps  etc  to  speed  up  the  process  further  down   the  track.     Carepacs  might  be  a  few  days  or  a  few  months  in  length.   The  Carepac  is  built  as  a  one-­‐off  in  advance,  by  potentially  multiple  health  care   providers  of  different  disciplines  and  is  then  selected  for  use  for  a  specific   patient.      EVERYTHING  from  the  Generic  carepac  can  be  edited,  added  to,  deleted   from  etc  as  relevant  for  the  patient  in  question  but  it  takes  away  a  lot  of  the  bulk   repetition  and  time  in  creating  patient  programs  and  management  plans.     Using  an  existing  carepac  it  takes  less  than  2  minutes  to  enter  a  new  patient  on   the  system,  select  the  appropriate  carepac,  and  then  get  it  underway  for  them.   Slide  14:   Any  information  can  be  added  either  as  a  word  document,  PDF  or  video.     ANYTHING  that  you  want  to  get  out  to  your  patients  and  caregivers  you  can  –   you  are  only  limited  by  your  imagination.     For  example  in  elective  surgery  we  have  teams  that  include  videos  from  the   anaesthetists,  videos  from  the  nursing  staff  explaining  what  will  happen  when   they  first  return  to  the  ward,  why  Obs  are  taken  so  frequently  etc.     The  aim  is  to  educate  and  empower  patients,  and  to  reduce  their  anxiety.    
  4. 4. The  aim  for  Health  care  team  and  organisations  is  to  increase  efficiency  of  what   they  do,  minimise  costs,  create  safer  environments  and  outcomes  for  patients   and  staff.     Slide  15   This  video  is  added  separately.    Please  watch  Hip  Fracture  Carepac.mp4   •http://youtu.be/TRCXE8hNQiI   Slide  16:   This  is  just  an  example.  It  is  appropriate  and  relevant  for  any  condition.     Slide  17:  self  explanatory   Slide  18:   Opening  care  of  patients  broader  than  just  one  on  one  time  and  physical   boundaries  of  a  clinic  /  hospital  has  changed  the  out  come  that  my  patients  get.     You  may  not  be  ready  for  something  like  myHealthpac  but  think  about  how  you   can  get  your  information,  advice  and  knowledge  out  to  your  patients  perhaps   doing  some  videos  and  putting  them  on  youtube,  or  doing  skype  consults     Slide  19:   Please  email  me  on  rachelvickery@shiglobal.com  if  you  would  like  any  help  or   advice  as  to  whether  this  would  be  suitable  for  your  team.    We  work  proactively   with  teams  and  organisations  because  we  know  many  Health  professionals  don’t   have  the  time  or  interest  in  learning  new  software  /  IT  systems.  You  don’t  have   to  be  tech  savvy  –  just  ready  and  willing  to  offer  something  better  to  your   patients.   This  is  a  brilliant  tool  for  research  also  as  every  piece  of  data  is  captured  in  a   unique  sell.  Again,  please  email  me  if  you  are  interested  in  using  myHealthpac  as   a  tool  for  research.      

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