When Queensland's Princess Alexandra Hospital developed an integrated electronic medical record (ieMR) system, it was more than a trailblazer – it was a template for the rest of the state.

According to Executive Director PAH-QEII Network at Princess Alexandra Hospital, Dr Michael Cleary, the hospital was identified as a “lead site” in the early days of strategy for the implementation of software.

The rollout involved two stages of implementation. The first stage was in 2015, involving the clinical records system but excluding the medications management, anaesthetics and research support (MARS) modules. The second phase occurred in 2017, adding over it the more complex components of the modules that were initially left out. 

In March 2017, as the Princess Alexandra Hospital rolled out the MARS system release, it marked its place as the first hospital in Queensland with advanced ieMR capability.

“We were implementing software that needed to be tested and have gone through all the usual processes for assessment, validation for workflow, etc,” Cleary said. 

“We were looking at how it would work in the Queensland environment, within a hospital system and we felt that it was safer to roll out all the base level systems and then put the rest in as a secondary step.”

[Read more: Head of eHealth Queensland on stunning ieMR stats and a future of interstate digital health collaboration | Digital health: it’s in our DNA. Queensland Health Minister on the state’s high-tech revolution]

And it was not treated as any ordinary ICT implementation. 

“We had a different strategy – our approach was to drive this as a clinical implementation instead of as an ICT implementation because of its enormous clinical requirement. Everything revolved around improvements in patient care and maintaining patient safety and therefore, we had senior clinicians embedded in the project and process,” Cleary said.

“For example, we had four specialists involved in various components. We had quite a number of pharmacists and clinicians embedded in the teams that were designing and developing the software, effectively looking at organisational change.”

But the rollout didn’t come without its own set of challenges. 

“Very often, we had to re-engineer the way clinical systems were operating. For example, we had to move to the universal application of insulin pens, moving away from historical insulin injections,” Cleary said. 

“We also had to replace our entire fleet of vital signs monitors so that we had devices that could be integrated with the systems.” 

The team persevered through the rollout, reaping flow-on benefits that revolved around integration capabilities for a closed loop of applications.

“We’ve seen improvements in our data management, in terms of information and reporting. That has also led to changes including drawing information out of the Electronic Records System and the development of information tiles that provide a detailed summary of a particular type of illness or condition,” he said.

“These information tiles form the basis of the operations of our command centre in the hospital, around patient safety, informed clinicians, and operational management.     

“The information we’re receiving is almost real-time, as opposed to weeks or months before a report is extracted or presented to us. This lets us make practical, real-time decisions instead of reflecting on historical data and having to infer on what might needs to be done. Our digital transparency has improved as well.”

[Read more: Queensland research into hospital digital systems finds the benefits outweigh the risks | “The art of what's possible”: Queensland Government and vendors collaborate in industry-first showcase]

In addition, the new systems have reduced the administrative workload on nurses, allowing them to spend more time with patients. 

The success of the rollout for Princess Alexandra Hospital resulted in a project to digitise medical records at four other hospitals – Logan, QEII Jubilee, Redland and Beaudesert hospitals – using ieMR.

“As a consequence of the rollout at Princess Alexandra, over the last three years, we’ve implemented the same stack and systems and dominoed the same processes at these four hospitals,” Cleary said.

The deployment at these five hospitals recently resulted in Queensland’s Metro South Health cementing its reputation for trailblazing digital health innovation by being recognised as a global leader at the International Hospital Federation Awards

Queensland Health aims to deliver ieMR with advanced capability to a total of 27 sites by June 2020. 

 

As part of HIMSS AsiaPac18 in Brisbane in November, the conference is offering a hospital tour of the Princess Alexandra Hospital. Learn more here.

 

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