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ERIC. A dirty word, a cute little animal or something else? HRT0713. History of ERIC. Project began in 1999 Redcliffe/Caboolture - Logan/Beaudesert consortium Praxa, BPA Group, SeeBeyond - tendered 2002 – Logan go-live 2003 – Beaudesert go-live 2002 – 2004 – Cyclone ERIC 2005 – ERIC v2
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ERIC A dirty word, a cute little animal or something else? HRT0713
History of ERIC • Project began in 1999 • Redcliffe/Caboolture - Logan/Beaudesert consortium • Praxa, BPA Group, SeeBeyond - tendered • 2002 – Logan go-live • 2003 – Beaudesert go-live • 2002 – 2004 – Cyclone ERIC • 2005 – ERIC v2 • 2006 – 2007 – Happy, Goal Oriented ERIC • 2007 – ERIC v3
What is ERIC • Unique Identifier; • Scanning; • Results reporting and verification; • Event list; • Outpatient On-line; • Identified eForms (perinatal data collection form); • Medical Records Tracking; • District Referrals Module; • Electronic Discharge Summary; • Pregnancy Health Record; • Clinical Worklists – EDS, RV, Ward List; • All Southside Sites – community health, acute hospitals, mental health, oral health.
The skeletal system • Comprises three parts • GUI – Graphical User Interface – owned and managed by Southside HSD • eGate – SunSystems product (bought out SeeBeyond) • Filenet – IBM product (contents manager, eforms manager, image manager)
Interfacing the Arctic HBCIS eLMS CESA TRACCS ACIMS
Infrastructure • WAN – Dark Fibre/10 mg; • Wireless connectivity; • LAN assessments; • Servers – back up servers/mirror servers • Off site • PC in every consulting room; • Wireless lap tops on wards – 40 beds, 3 lap tops; • Desktop PCs in wards; • Some clinical areas have one lap top pr clinician; • CDMA lap tops for off site; • Community health – 1:3 ratio.
Support • Clinical Systems Manager (HIM); • 2 X Project Managers; • Programmer X 2; • Support Manager; • Director – Clinical Informatics (HIM); • Job redesign for all core HIM roles (4).
Where to for the little penguin • ERIC has a girlfriend – ERICA • ERIC administrative RM • ERIC and ERICA have a baby • Pregnancy Health Record • ERIC Health Record • ERIC Manager • Patient information not relating to care
Where to next for the little penguin • ERIC Clinical • Barcoding; • Clinical handover module; • Bed management module; • Coding worklists;
Key Drivers for Change - 2002 • Storage – hospital plan did not include records space; • Politics and the flavour of the month; • Integration of clinical records; • Point of care records; • NOT to save money; • NOT to have an easy life; • Bad before scanning? • Equal pain to after
Cyclone ERIC • Minister switched the system on – guess what happened? • No business process redesign • Clinical staff threatening legal action • Clinical staff meeting regularly with the papers • Why did we keep it?
Key Drivers for change - 2005 • System Stabilised – but outdated technology; • Life couldn’t continue; • Luck of the Irish • Emerging leaders • ERIC v2
ERIC v2 success • Dedicated project team; • Acknowledgement of need for broader team to support – positions recruited; • Clearly identified roles for IT and HIM; • ERIC response team & a presence; • Scope control; • Project planning; • No steering committee – Strategic IM;
Benefits Realised • Problems occurring in new facilities not a problem for Logan; • Solving clinical issues and supporting clinicians through IT; • No increase in records clerks; • Never lose a record; • Integrated clinical records; • No paper lice! • Decrease in WH&S problems.
Benefits Realised • Administrative (ward) • Not filing pathology; • Not chasing records. • Space; • No records department – 6 tennis courts saved; • 500,000 records stored on ERIC. • Clinical Benefits • 99 users can view 1 record; • Integration of clinical information; • Better communication inside and outside of hospital; • Templating and better data.
Key Changes Implemented • Everything changed – the world was turned on its head; • Every business practice; • Every HIM role; • Information Management given a presence on district executive – Information Manager – not IT.
Scanning • Logan Hospital – 360 beds • Centralised scanning vs decentralised scanning • 2 Scanners – high colour resolution • Flat bed scanners • Beaudesert Hospital – 40 beds • 1 Scanner – high colour resolution • Community Centres • 1 scanner – each main facility • Other records sent for scanning
To scan or not to scan • Let’s back scan • That’s not working • Let’s back scan on demand • That’s not working • Let’s stop back scanning ???Is there a right way ?horses for courses Just PLAN and stick to it
What not to do • Wait, do nothing, give up; • Implement a scanning solution without clear direction towards an EHR; • ‘Big Bang’ approach; • Let the system outdate current technology; • Ignore the research suggesting change management is important; • Ignore the need to interface systems.
Aim to win! • Have a good support team; • Only employ passionate people; • Team must include of HIMs, IT and knowledge experts; • Govern your IT systems; • Keep up with current technology; • Build strategic partnerships with your vendors and expect an interdependency.
Aim to win! • Forms Design!! • HIM role redesign; • Ward Clerk role redesign; • Clear governance around what should/should not be in clinical record.
Costs (estimated) • Go-live - $1,000,000 + • Licensing; • Project staff; • Infrastructure; • Recurrent • Project staff; • Licensing; • Upgrades;