South West Alliance of Rural Health Achieves Regional Electronic Health Record System for Clinical and Administrative Support Across the Continuum of Care

South West Alliance of Rural Health (SWARH) in Victoria, Australia, has worked in partnership with InterSystems since 2003 when it selected InterSystems TrakCare® to achieve its vision of a regional electronic health record system providing coordinated clinical and administrative support across acute, primary, and community health settings.

• Regional health information access
• Increased productivity and efficiency
• Improved coordination of care
• Reduced support overhead

With 13 hospitals and 114 sites spread across 60,000 square kilometers connected via a secure broadband network, the creation of a regional electronic health record was an early priority. The initial stage involved the establishment of a unique regional identifier for patients and the implementation of a single instance of the TrakCare Emergency module for all SWARH hospitals.
In the next stage, SWARH worked with InterSystems to extend its use of the TrakCare unified healthcare information system to implement a Clinical Information System serving the 12 hospitals. SWARH also used TrakCare’s rapid integration capabilities to interface with a legacy patient administration system and a number of external pathology providers and connect them all to the regional electronic health record.

As a result, comprehensive medical records for 200,000 patients are instantly available across the region regardless of where a patient presents for treatment, saving time and effort. Clinicians can access pathology reports and clinical risk factors online within seconds, and issue discharge summaries to general practitioners. Ward staff are immediately alerted of new test results from external pathology providers. TrakCare also supports the use of videoconferencing - estimated by SWARH to save 30 percent on its motor vehicle costs - by allowing doctors to consult with patients in remote areas while viewing their medical records online.

SWARH then embarked on the next stage of its journey with InterSystems with the purchase and implementation of the TrakCare Patient Administration System. The new Patient Administration System is configured to meet the needs of both large and small hospitals. Warrnambool Hospital, for example, has statutory reporting requirements under the Elective Surgery Information System (ESIS), a patient level collection of elective surgery waiting list data from approved Victorian public hospitals. This requires a different workflow configuration for smaller hospitals, which can manage waiting lists internally.

“TrakCare’s multisite capability allowed us to think regionally and act locally,” says Garry Druitt, SWARH executive officer. “Its flexibility to configure a workflow for a particular user group helped us to achieve our vision while still maintaining regional control over governance.”

Providing all administrative and clinical functionality within a single unified system further eases access to healthcare information and improves the coordination of healthcare delivery. Combined with the phasing out of SWARH’s legacy patient administrative system, it also reduces technical support overhead. Regular software updates from InterSystems, which continually add new functionality in all areas of the product suite, keep SWARH on the leading edge of e-health-enabled care capabilities.

“By implementing Patient Administration within the same system, we now have the power to do more with the electronic health record,” says Mr Druitt. “We are working with InterSystems to implement new clinical functionality, with electronic medication management and support for new national quality standards for clinical care at the top of the list.”

In December 2013, the electronic medication management functionality was switched on at Portland District Hospital. Serving 16,000 local residents, the hospital is the first within the SWARH network to have medication management data available across SWARH’s regional EHR. Within four months of the implementation, the pharmacy department had halved the amount of time spent reviewing medication charts. Patient safety is also expected to be improved with lower numbers of adverse events resulting from prescribing errors and allergic reactions.

“All Portland Hospital patients now have their medications ordered and administered through TrakCare Medication Management,” says Katharina Redford, SWARH divisional manager of productivity and development. “The medications they use before, during, and after hospitalization are now included in the discharge summary reconciliation.”

In the next stage of implementation, SWARH is deploying TrakCare Community Health to complete its vision of a connected healthcare environment across the region. The new functionality, provided within a unified system using a single data repository, is expected to further improve both the quality of care and the coordination of care across different settings. Further ease of use benefits and system cost savings are also expected when SWARH’s legacy community health application is phased out.

“Bringing community health on board closes the loop with a single system for healthcare delivery across the continuum of care. In the future, all the members of a multidisciplinary treatment team caring for a hip replacement patient, for example, will access the same system with functionality that facilitates the coordination of care,” says Mr Druitt.

_{TrakCare not offered in the United States.}