Two of Australia’s digital healthcare pioneers have achieved a major milestone, not only for themselves but nationally.
UnitingCare Queensland’s Saint Stephen’s Hospital in Hervey Bay and the Royal Children's Hospital (RCH) outpatient service division in Melbourne have both attained HIMSS Electronic Medical Record Adoption Model (EMRAM) Stage 7 accreditation for IT maturity within their organisations, becoming the first two Australian healthcare providers to achieve this status.
HIMSS Analytics, the EMRAM validator, said both organisations achieved the international benchmark that measures a healthcare provider’s use of advanced IT for their improvement in patient care.
Saint Stephen’s Hospital Chief Clinical Informatics Officer Patricia Liebke said the motivation to reach EMRAM Stage 7 was built off its success in being the first healthcare provider in Australia to reach EMRAM Stage 6 in 2014.
“Since 2014, we’ve had new leadership, we had to implement a few new solutions on the way, as well as outsourcing our pharmacy department and our IT infrastructure while still trying to maintain this digital hospital,” she said.
“Reaching Stage 7 was a lot harder than we thought it would be. It involved a lot more adoption through engagement with our end users and making the solutions meaningful to our clinicians.
“The steps along the way was about having the vision and knowing why we’re doing it, and also involving the clinicians to tell us their needs so that we could optimise our solutions to meet them.
“Moving forward, we want to continually keep adding new functionalities and keep improving our digital strategy as the technology is an enabler for us to provide better quality care.”
RCH Chief Operating Officer Jane Miller said moving up to O-EMRAM Stage 7 is a testament to the work that the hospital is doing not only for its young patients and clinicians, but also to engage with parents and guardians of its patients.
“We’re providing them with the tools necessary to take a more active role in their child’s treatment and care. But on our end, we need to be mindful about managing the risks, such as keeping their information safe because they’re kids,” Miller said.
“The EMR implementation was a clinical transformation project, not an IT project, for us. It was about using the EMR to improve access, reduce harm, provide better care coordination, amplify the consumer’s experience and deliver sustainable health services.
“But our progress doesn't end with reaching O-EMRAM Stage 7. We want to continue to push the boundaries, drive the benefits and extend our EMR functionality to deliver on our strategic vision, which is to deliver great care.”
HIMSS Analytics Global Vice-President John Daniels said a physical review of their systems was done on-site, demonstrating that their EMR capabilities are live, operational and surpassing the capabilities that they achieved in Stage 6.
“In Stage 6, we’re not necessarily looking for pervasiveness of use. We want the organisation to at least demonstrate that they have implemented the capabilities in some parts of the organisation. So basically, setting the foundation which they can then optimise and expand on in Stage 7,” he said.
At Stage 7, HIMSS Analytics expects technology and process redesign capabilities to be throughout the organisation and used constantly.
“If it’s a hospital, they’re using it in all their wards, in the emergency departments, etc. If it’s an outpatient practice, they’re using it in all of the clinics across specialties. The other differentiating factor between Stages 6 and 7 is that an organisation becomes more dependant on information technology in the work that they do for patients,” Daniels said.
These factors include: having some business recovery, business continuity, or disaster recovery capabilities in place to prevent failure of systems; security capabilities; meeting information exchange expectations with other organisations that patients get their care from; and having the beginnings of an analytics strategy.
“Stage 7 of the model represents an organisation that is virtually paperless. They’ve eliminated their dependency on paper to document care, write medication orders, or any other types of medical orders. And they’re capturing discrete structured data digitally from their electronic systems and using it to help them with decision making at various levels of the organisation. We want them to begin moving towards a data-driven decision-making ability.”
But Daniels said it is not only about technology – it’s about how these organisations use technology to achieve goals and objectives. To get validated at Stage 7, an organisation has to present three case studies which demonstrate accomplishments achieved by implementing EMRs.
He highlighted the case of RCH’s outpatient service, which showed an impressive, complex care hub that leverages EMRs and other technology to help manage the complex cases of patients with serious medical conditions.
“For example, in one case, it was able to use the EMR tool to see all of the care (monitoring, support, etc.) that’s provided to a patient with cerebral palsy and multiple other conditions. It was able to monitor not just the healthcare of the patient, but also the social support structure for this patient,” Daniels said.
“EMRs allowed it to have a clearer picture of everything going on with this patient, which in turn enabled it to make the best possible decisions to ensure the patient gets the best possible care. It would not be able to have that high-level of support had it not been for the EMRs implemented.”
Daniels said the two healthcare providers will serve as a “beacon for the rest of the country” that other organisations can look to for best practice in how they leveraged the model and technologies and applied them in a practical way.
“It’s a lot of work, not only because you have to build the infrastructure needed to support an electronic environment, but you can’t just simply automate paper-based processes. Clinical care delivery processes need to be redesigned to better leverage the power of IT,” he said.
In Australia, HIMSS Analytics aims to accelerate the use of information and technology to drive the transformation of healthcare.
“We’re beginning to see a real focus on the country coming together to leverage technology from a national perspective. Our hope is that we can continue to support the effort with the Federal Government, state governments and local municipalities to establish a strategy that elevates and accelerates the use of technology across the entire country,” Daniels said.