Anyone using or aware of apps to capture clinical activity? We’ve always struggled to capture the various bits of clinical workload which should be counted (& funded!) but currently isn’t. It’s all become more important with the increase in Telehealth and non-contact episodes. Fine when an event is captured by our PAS but there’s a lot that aren’t (especially ad hoc phone calls and emails with patients, etc).
Would have to be super easy/efficient & preferably integrated with PAS/clinicals for clinicians to use such a thing.
Looking forward to hearing about any solutions out there.
While our PAS can capture the patient activity you describe (WebPAS – via encounters) we (at HVDHB and CCDHB) have built an app to make this super easy for busy clinicians (AHAC – Allied Health Activity Capture). There is also a barcode-based Australian solution in use at BOPDHB (ABC).
Without wanting to be a worrywart, I’d suggest that the “there’s an app for that” approach is particularly harmful here. It is indeed enticing to desire—and even create—an app to harvest uncaptured communication and extra clinical workload.
But think of the downside, which you’ve already hinted at. Not only will there inevitably be a proliferation of ad hoc solutions, used differently by everyone, but the app approach will end up being:
Difficult to maintain;
Time-consuming and workflow-disrupting to use;
Spotty in its coverage, and poorly adapted to later changes.
Use of something like this would seem fine as an initial ‘ranging’ or ‘benchmarking’ exercise, but even here, the tendency will be for it to become bedded down, leading to the above problems. A wiser approach might be to go through the pain of integrating these activities into the institutional workflow, and having the measurements flow from this—naturally.
That’s why it’s important to anticipate this functionality when changing to a new system. The system is the app.
So in GP land all the clinical activity could probably be easily measured. Consultations already have timers on them and I would imagine you could design a SQL to measure prescribing time and a health measurements entry time along with classifications time but the hospital system does not have the equivalent in terms of a PMS and there it rests. Seems strange secondary care lags behind primary care considering GP’s fund their own software (ultimately from patient fees). Its the same problem when it comes to being paperless in the secondary system. Nowhere to put stuff that really works well in an integrated way. Maybe Cortex in Canterbury will eventually fix this after more development.
seems to me hospitals should have run with GP systems in the mid 90’s and then they would at least have the elements of a basic medical record and would have been heaps cheaper than what is currently in place which is a filing cabinet for summary records (eDs’s clinic letters) etc which are written from a service (not holistic) perspective with links to lab and radiology services. Maybe its not to late to have a RFP for a modest (cost wise) NZ hospital medical record. I hear people saying "but hospital;s are specialist services we need lots of special records. Sure a GP system will never run a linac machine but that clearly needs to be a special bit of kit. Normal day to day hospital care needs
encounter records
classification (stuff about me or badly called problem) lists
health measurements
tasks
recalls
etc
and these are in GP systems in a nice tidy package
Just saying
M
At BOPDHB we have the ABC barcoding system to capture allied health activity and it can capture more detailed data on indirect activity and more specific interventions.
Like Paul and many other DHBs we have WebPAS system to capture clinical encounters for outpatient clinics.
Interoperability (for community and outpatients) between the two systems has been an issue and we have done quite a bit of work to match the encounter data to activity data. Inpatient activity matches accurately to the PAS data.
Hope this helps- happy to chat off line if you have specific questions.
As someone that interacts a lot with administration teams, i hear a lot of complaints about this subject. This seems to be the forgotten part of any system and it tends to fall to the administration staff to fill the gaps in the processes, chasing outcomes from First Appointments and subsequent follow ups( or as 2020 has kindly given us) finding out if a telehealth appointment actually took place. That’s wasted FTE hours, lost revenue and data where a system would really help.
Any developers out there must ensure that the administrative parts of their system are as good as the clinical one. As we move to more data driven systems, don’t forget that that data has to be inputed first. The administration core is essential and the last thing that needs to be overlooked… Shall get off my soapbox now
scope run away indeed but in the end it ties in. No record= no measurement if you want the measurement to fall off the back of clinical work not be in some sort of afterthought process such as filling in a form.
Lawyers must be great at measuring work (by the looks of my bill ) i wonder how they do it. maybe by an afterthought process which of course the time taken they can add to the bill.
Merry Christmas
You read it better than me Martin - I was about to go on about the options for adding to our systems when working mobile, eg the evolution app - do a rest home round and enter details from the phone. I forgot how far behind our poor colleagues are in secondary world! Poor sods…
Wouldn’t it be nice if we could just build (and pay for) this once and then have the whole country use it in every DHB? That is dreamland I know, with the plethora of telehealth and EHR tools out there and the myriad ways they are being used across the country. Oh, and the patchwork of Microsoft tool uptake as well! I certainly can see this working well locally if you’ve got the kit.
This type of admin data is dead simple - we just need to build it in, eh? I do find it interesting that most US systems are built specifically to capture this type of admin data and then have the clinical stuff bolted on (not always very well), whereas we have the opposite problem!
) i wonder how they do it. maybe by an afterthought process which of course the time taken they can add to the bill.