0
Case Study: Point of Care Testing and
using Mobile Technology in the Hunter
Area HiTH Service
Presented by: Simone Dagg
Hu...
Todays Presentation
• Brief over view of GNC CAPAC Service
• Outline the journey of a GNC HiTH
Anticoagulation client, Mr ...
HNE Local Health District – 8 Clusters
HNE Local Health District – 8 Clusters
CAPAC Catchment
Area
The pink line represents
the geographic boundary
for the CAPAC service.
Within 1 hr driving time
from...
Images of our region
The CAPAC Umbrella
HAH
Pre-Hospital
Health / COPs
partnership
6 week
program
TACP
Post - Acute
Enablement /
ACF
avoidance
...
CAPAC model
• One team / multidisciplinary
• Avoids delays in access to other providers
• Improved responsiveness
• Access...
CAPAC Organisational Structure
TACP case
co-ordinators
TACP program
manager
Service
Manager
CAPAC
Medical
Director
CAPAC
S...
Anticoagulation Service
• Diagnosis such as DVT, PE, AF, TIA / stroke
• Warfarin loading in conjunction with “Clexane”
• C...
Point of Care Testing (POC)
• Home based INR testing is a core component of
the CAPAC HiTH service
• POC testing was intro...
Mr CAPAC
• 64 year old gentleman, chest pain, palpitations,
atrial fibrillation
• New to warfarin
• Referred from hospital...
Why POC ?
• Ability to dose at visit - elderly clients with hearing, sight or
cognition issues
• Less painful and less inv...
CoaguChek® XS
• Small hand held device
• Easily transported in insulated bag
• Requires drop (8 µl) of capillary blood,
• ...
CoaguChek® XS Plus system
• Touch screen technology
• Built-in QC
• External liquid QC
• Internal storage of results (2000...
Mobile Computing-The Need
• Rising demand on community based services
• Expansion and evolution of community based service...
Mobile Technology
• Mobile computers
– GNC utilises the Clinical Health Information
Enterprise (CHIME) for documentation
–...
Mobile Computing
• Compact design, light weight, adequate screen
and keyboard size
• Sufficient internal memory and graphi...
E-scheduler
Anticoagulation – E-scheduler
Anticoagulation Spread Sheet
HNE Health LHD Home Page
Clinical Applications
E-scheduler Links
Mobile Computing Challenges
• Type of computer required to ensure quick
processing and support of information
• SIM – inte...
Mobile Phones
• WHS - clinicians work in isolation and the mobile phone is an
important aspect of keeping safe
• Messaging...
Mr CAPAC - Discharge
Take Home Messages
• Advances in technology combined with HiTH
development has allowed us to “do things differently”
• POC...
Questions ?
Upcoming SlideShare
Loading in...5
×

Simone Dagg, Hunter New England Health - Case Study: Point of Care Testing and using Mobile Technology in the Hunter Area HiTH Service

3,348

Published on

Simone Dagg, Hunter New England Health delivered the presentation at the 2013 Hospital in the Home Conference.

The Hospital in the Home Conference is a nurse oriented program packed with comprehensive case studies to improve HITH services and maximise hospital efficiency throughout Australia.

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

Published in: Healthcare, Technology, Business
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total Views
3,348
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
1
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

Transcript of "Simone Dagg, Hunter New England Health - Case Study: Point of Care Testing and using Mobile Technology in the Hunter Area HiTH Service"

  1. 1. Case Study: Point of Care Testing and using Mobile Technology in the Hunter Area HiTH Service Presented by: Simone Dagg Hunter New England Local Health District Greater Newcastle Cluster Community Acute Post Acute Care HiTH Program Manager May 2013
  2. 2. Todays Presentation • Brief over view of GNC CAPAC Service • Outline the journey of a GNC HiTH Anticoagulation client, Mr CAPAC, and the use of mobile technology to support his episode of care: • Point of Care (POC) testing • Mobile Computing • Clinical applications (E-scheduler, spread sheets, Intranet) • Mobile Phones
  3. 3. HNE Local Health District – 8 Clusters
  4. 4. HNE Local Health District – 8 Clusters
  5. 5. CAPAC Catchment Area The pink line represents the geographic boundary for the CAPAC service. Within 1 hr driving time from Newcastle CBD. 1500 km2 catchment area (land area only). Covers Local Government Areas of Newcastle, Lake Macquarie and Port Stephens
  6. 6. Images of our region
  7. 7. The CAPAC Umbrella HAH Pre-Hospital Health / COPs partnership 6 week program TACP Post - Acute Enablement / ACF avoidance 12 week program HITH Warfarin Stabilisation Acute infections Heart failure COPD Rapid response Orthopaedic Early Discharge
  8. 8. CAPAC model • One team / multidisciplinary • Avoids delays in access to other providers • Improved responsiveness • Access to a variety of skills • Acute and aged care • Catchment / geographical allocation • Pooled resources • Greater flexibility with leave
  9. 9. CAPAC Organisational Structure TACP case co-ordinators TACP program manager Service Manager CAPAC Medical Director CAPAC Service Development Co-ordinator Medical Registrar CAPAC Nurses RN’s ENs AINs OT Physiotherapy Dietician Social worker Administrati on Assistants HAH program manager CAPAC Technical Assistant s CAN Role Allied Health Team Leader HITH program manager HAH case co-ordinators
  10. 10. Anticoagulation Service • Diagnosis such as DVT, PE, AF, TIA / stroke • Warfarin loading in conjunction with “Clexane” • Clients requiring re-stabilisation of INR and Warfarin dosing • Combination of POC and formal testing • Use age adjusted protocol for Warfarin dosing
  11. 11. Point of Care Testing (POC) • Home based INR testing is a core component of the CAPAC HiTH service • POC testing was introduced in 2006 • POC testing, uses a capillary blood sample • Validated procedure using comparative results to those obtained from venous blood samples and laboratory tested • POC INR testing is convenient, safe, acceptable to clients, increases efficiencies in health care delivery
  12. 12. Mr CAPAC • 64 year old gentleman, chest pain, palpitations, atrial fibrillation • New to warfarin • Referred from hospital for anticoagulation induction and dose stabilisation • Reported to have poor access • Lives 45 minutes from base • POC testing commenced from 1st visit
  13. 13. Why POC ? • Ability to dose at visit - elderly clients with hearing, sight or cognition issues • Less painful and less invasive – excellent for for clients with poor venous access and needle phobias • Distance- large catchment area • Enables more visits - nil need to drop bloods, dosing completed at visit, quicker procedure • Client acceptability • Cost effective alternative • Increasing usage in GP practices ensures transfer of care seamless
  14. 14. CoaguChek® XS • Small hand held device • Easily transported in insulated bag • Requires drop (8 µl) of capillary blood, • Easy to use and it provides a precise PT/INR result usually in less than 1 minute • Competency developed for clinicians • Currently upgrading machines
  15. 15. CoaguChek® XS Plus system • Touch screen technology • Built-in QC • External liquid QC • Internal storage of results (2000) • Ability to identify clients and staff • Comments field for each test • Code keys preloaded (60) • Ability to inter face with local labs
  16. 16. Mobile Computing-The Need • Rising demand on community based services • Expansion and evolution of community based services – Including the GNC CAPAC/ HiTH service • Increasing client complexity • Access to accurate and timely information • Optimisation of clinical time • Existing paper based system time consuming, bulky and error potential due to transcription • Improve communication between services • Increased client involvement in their episode of care
  17. 17. Mobile Technology • Mobile computers – GNC utilises the Clinical Health Information Enterprise (CHIME) for documentation – Ability to access clinical applications – Anticoagulation spread sheet – E-scheduler • Mobile phones
  18. 18. Mobile Computing • Compact design, light weight, adequate screen and keyboard size • Sufficient internal memory and graphic components to support programs • Internal modem • Long battery life • Docking station
  19. 19. E-scheduler
  20. 20. Anticoagulation – E-scheduler
  21. 21. Anticoagulation Spread Sheet
  22. 22. HNE Health LHD Home Page
  23. 23. Clinical Applications
  24. 24. E-scheduler Links
  25. 25. Mobile Computing Challenges • Type of computer required to ensure quick processing and support of information • SIM – internal vs external modems • Black spots in coverage • WHS issues – Transporting devices – Suitable home environments • Battery life • Varying levels of clinician acceptance and computing knowledge
  26. 26. Mobile Phones • WHS - clinicians work in isolation and the mobile phone is an important aspect of keeping safe • Messaging medication orders as second check • Messaging results of POC testing • Ability to communicate with support staff while still with clients
  27. 27. Mr CAPAC - Discharge
  28. 28. Take Home Messages • Advances in technology combined with HiTH development has allowed us to “do things differently” • POC testing is safe, reliable, efficient, less invasive and has a high level of client acceptance • Mobile computing allows “in time” documentation, access to clinical applications to support clinicians in providing timely, accurate and safe care for HiTH clients • Future directions for HiTH services includes telehealth to support staff esp medical with remote medicine issues
  29. 29. Questions ?
  1. A particular slide catching your eye?

    Clipping is a handy way to collect important slides you want to go back to later.

×