Digital Hospitals Program
Queensland’s population is turning silver. Additionally, chronic conditions are becoming more pervasive and the consumer expectations are changing. Hence, programs like the digital hospital are necessary.
A ‘paper light’ approach, digital hospitals seek to digitalise traditional hospital processes. Electronic medical records, for example, allow a patient’s medical records to be created, stored, accessed, and shared electronically. Other innovations such as automation and integration can add value to clinicians and patients. Hospital processes become streamlined, easier to manage, timely and can be better managed to improve patient services.
Queensland’s electronic medical record (ieMR) program is exemplary. Part of a broad program of work designed to meet the department’s strategic plan, vision and objectives for the Queensland health system. The ieMR program is a key component of the department’s overall eHealth Investment Strategy. It is hoped that by June 2020, 27 hospitals will fully implement their ieMR solution.
As much as there is intent to digitise hospitals because of the various benefits attached to it, the actual cost of developing and implementing ieMR is higher than what was forecasted in the 2016 business case for it. Unintentional consequences might arise should the level of investment need to be reprioritised.
Alongside are questions about the speed which the program is being rolled out at, user engagement and its related risks, and issues of data access and security.
Nevertheless, electronic medical records provide timely, accessible and legible information about patients at the point of care. It also provides the foundation for future transformations in health care delivery, like the ability to gain greater insights and decision support from the system’s data to improve the quality of patient care and operational efficiencies.
Findings from the Report
Cognisant, the Queensland Audit Office has published a report of how well Queensland Health has planned and is delivering its digital hospitals program. The audit also assesses whether the intended information-sharing and patient benefits have been realised.
The report highlights the benefits of the system and makes some recommendations to improve governance when ieMR is realised in completion. Several findings are made known in the audit.
First, reduced unplanned readmission rates have direct benefits to patients.
Second, staff can access clinical information faster.
Third, patient records are more legible.
Fourth, in Cairn and the Princess Alexandra hospitals, inappropriate pathology testing is reducing.
Fifth, in Townsville, targets for inpatient length stay are shortened.
Sixth, ieMR is improving health service delivery and patient outcomes.
Seventh, stakeholders believe that investing in the digital hospital rollout is an investment in quality and patient safety.
Eighth, as the program is rolled out throughout the state, more benefits are expected.
Recommendations by the Queensland Audit Office
On top of that, eight recommendations have been made.
For the Department of Health and the hospital and health services which have implemented the ieMR solution, the report recommends that they continue working to identify the actual cost of implementation and operation.
For the Department of Health, seven recommendations are offered. These make a call for a review of how costs are managed, organisational governance, performance measures, consistent refinement to the business intelligence strategy and approach, and improvements to the preventative security controls of ieMR user accounts.
For all hospital and health services participating in the ieMR program, an additional list of four recommendations are made. Similar to the above, cost handling remains as a suggestion. Additionally, there are recommendations to improve database management and monitoring for a security breach, and transparency in reporting dis-benefits to the program for future learning and modification.
Chief Clinical Information Officer, Dr Keith McNeil, said, “Technological advances and continuing improvements are providing new opportunities which could not have been foreseen even two years ago, but our increased focus on ieMR’s clinical capability will ensure our patients can access these opportunities, now and in the future.”
The full report can be found here.
