Completing the Paperless Journey

Dr Ian WilliamsPractice Principal

Jan ChaffeyExecutive Officer

Camp Hill Medical Centre

The beginning

In 1943 the Allies developed the earliest programmable electronic computer to break the German coding machine Enigma

The year is 1954

What is this?

The year is 1956

It's a hard disk drive back in 1956... with 5 MB of storage.

In September 1956 IBM launched the 305 RAMAC, the first 'SUPER' computer with a hard disk drive (HDD). The HDD weighed over a ton and stored a 'whopping' 5 MB of data.

The journey continues

In 1975 , the first personal computer was sold - to start the machine there were 25 switches all requiring a precise sequence for the machine to work !!!!!

Our Story

The story continues

And continues...........

Camp Hill Medical Centre

Living the dream

Family Health Care since 1947 Holistic, quality lifetime care for our patients A medical home In a medical neighbourhood Quality team Quality systems Quality facilities

Camp Hill Medical Centre

Accredited General Practice – (5th round 2010)

14 Doctors 2 Practice Managers 3 Practice Clinical Nurses 1 Community Nurse 1 Diabetes Educator 2 Mental Health Nurses Consultant Pharmacist 12 Reception and Support

Staff

Visiting Allied Health Dietitian Podiatrist Psychologists (2)

Pathology

Camp Hill Medical Centre

Database of 40,000 1,250 over 75 years 1,700 under 5 years

Ten (10) consulting rooms Three (3) treatment areas Diabetes educator consulting room Community Nurse room Mental Health Nurse room Approximately 1350 consults /week

It’s all about the team!

What is a practice team?

A group of people making different contributions towards achieving a common goal

Practice Structure

Doctors

Nursing StaffClinical nurses

Administration Staff

Community Resources

Principal Doctor

R.Nurses

Practice Manager

C. Nurses

Executive Officer

Principal Doctor

Community nurse

Diabetes educator

Mental health nurses

Consultant Pharmacist

Teams within Teams

About our team:

Meet Regularly Agenda / Minutes / Action list

Develop Goals & Objectives Develop Action Plan Review Process and Outcomes Redefine Processes Always Strive for Innovation and

Best Practice

Continuity……

Continuous process Team development and strengthening Systemisation of procedures (intranet) Quality improvement framework Patient focused Outcome focused And it continues………

Our Team

The Jargon

Systemisation of your practice

Project plan driver

Hardware Getting it right! – 5

year plan Software

Choosing the best for your practice

Training Doctors Nurses Allied Health Staff

Competencies All

Support Hardware Software In-house

Risk Management Backups Passwords Firewall Virus protection

Upgrades Software Hardware

Consulting Room / Front Desk

KISS Training, training, training Templates Shortcuts Generic referrals Reminder letters Recall systems

Templates

Community Nurse Health Assessments GPMP & TCAs Diabetes Educator Mental Health Nurses Consultant Pharmacist Shared resources for the care team

Practice Systems

Information Management System Who is responsible ? and for what are

they responsible? What is your role? What knowledge do you need to fulfil

your role? Do you require additional training?

Practice – Hardware/ Software

Hardware / software contacts How many computers?

Programs on each (full audit of each workstation) Where is software stored or is it online? How many workstations Type of server(s) Printers Modems Scanners Is it documented?

Risk Management

Security of data Is it password protected? Do all users have individual passwords?

Security of server Does it have a UPS? Is there a RAID system? If there is loss of power – is it set up to

‘down gracefully’

Backup

What systems are in place? Is it manual or automatic? Who is responsible? What is being backed up?

Server (what information) Individual computers – C drive data

Backup Tested / Restore Performed Does someone check every day that

backup has been successful? Where is the backup stored?

PDSA Cycle

When there are problems!

Isolate the problem Is it hardware? Is it software? Is it operator error?

Check manuals – troubleshooting sections

Know who to call for help Stay calm!

When all else fails!

Have a disaster plan What do the doctor’s need to keep

working Script paper Referral forms Letterhead

What do the receptionists need to keep the front desk running

Manual receipts Manual bulk billing forms Manual eftpos / credit card forms

IT Troubleshooting

Remember once the computers are working again all data must be entered Clinical data Accounts/receipting data

General Practice - Snap Shot

2004 Majority of practice

have hybrid systems

2010 Almost all practices

fully electronic

Why?o Generational change

o New practitioners proficient with technologyo Different skill seto Increased expectations of technology as a reliable tool to assist in day to day running of practiceso Business caseo Competitive nature of clinicians

A Practitioner’s Perspective - 2004

Team decision Do the research

Network with other practices Talk with division Listen to the experts

Present the proposal Show the benefits

Quality records Time saver Great space saver Improved morale

It is inevitable!

A Practitioner’s Perspective -2004

Make the decision Set the date Train everyone Do it in one go! Stay positive

Support Hardware Software Practice troubleshooter

A Practitioner’s Perspective -2010

I want more! Reliability of hardware and software

No downtime ( and no my time!) Fast network Decision support (delivery of evidence to

clinician) Electronic prescribing Data mining

A Practitioner’s Perspective -2010

Electronic referrals to and reports from: Medical specialists Allied health Radiology Public hospitals Private hospitals Government departments e.g. Centrelink, DVA Workcover, Comcare

Tip: On bottom of referrals Camp Hill Medical Centre prefers to receive reports

electronically through .................

A manager’s perspective 2010

What I want Intranet

‘If it’s not electronic.........’ No scanning

Everything electronic No manual faxes –sent/received

All from computers with automatic logging and tracking

We’ve come a long way!!!

The way forward – the I’s have it!!!

Innovation Information Infrastructure Investment (time,resources) Integration Imagination Interoperability Improvement (there’s always a

better way)