Another question! 3DHB (Capital Coast DHB, Hutt Valley DHB & Wairarapa DHB) are looking to implement lab ordering, viewing and sign off in Eclair - similar to how it’s manage in the South Island. The sign off process is currently event-based and we’ll likely move to ordering clinician sign off.
I’d like to get some feedback on how the following are working at DHBs with similar model:
Eclair integrated with Concerto
user experience on the visual integration between Eclair and Concerto. (a demo would be amazing!)
Ordering clinician process
The event-based process works well 80% of the time. For the remainder, many hours are spent getting results to the right clinicians manually - results in the exception queue, use of reports to identify results needing reassigning, etc. The ordering clinician process in the south sounds like it would cover all the requirements, but I’m interested in whether there are any downsides. Is there any manual fixing in the background going on?
I understand the main reason event-based sign off was adopted was to allow for team work - where an RMO wouldn’t necessary want the results attached to them personally but their consultant. Sounds like ordering clinician sign off can manage this well now.
Tena koe
You may want to reach out to BOPDHB BayNavigator team as when I worked with them the system seemed robust and well thought through Baynav@bopdhb.govt.nz
Nga mihi
Grahame Jelley
Kia ora Joanna
In the SI we have fully integrated eClair into concerto, its a robust system with the concerto portal opening eclair in patient context. The view you se is the eclair view once accessed. This is all through a single sign process so no additional access required.
So this is indeed a complex problem and you are about to run into all manor of problems…not the least of which will be what that paper from the lab with results on is used for!!
The hospital setting is indeed made more complex by the fact that teams care for patients not individuals like in GP. At some time in the past a review of labs in the system that had never ever been viewed came up with numbers that terrified me.
The eOrdering tool needs to be very clever and at the end of the day will inevitably be much slower than a piece of paper.
certain groups like GP’s need auto-signoff because they sign off in their PMS’s.
In GP Sysmex has an eOrdering tool that is quite good but the requirements are much more simple as the one to one relationship orderer to reviewer is simpler.
Happy to zoom you into the SI regional éclair sitting in concerto (SI HCS) works if you want. You can also see how HealthOne fits into that as well if you like
cheers M
Word to the wise, it’s integrated via a platform from Orion health and rhapsody. I migrated eclair to the cloud for CDHB a year ago so had to deal with all that. There is a significant amount of tweaking manual and otherwise that takes place.
Ideally this would be a national effort, cost wise it would be considerably cheaper to do it once properly.
Thanks Jo
So our experience is both regional and local.
Labs:
Sign-off: Regionally we have Lab eSign-off via REGIONAL Eclair with a dashboard presentation view in HCS / Concerto on 1st logon / home-page. The dashboard is good and you can quickly add other individuals e.g. departmental colleagues as working in a group with mutual visibility mitigates the “I forgot the ‘Out of office’ issue” (for the Labs sign off) I’ll email you a screenshot. The system runs on ‘Business rules’ - there are 2 core attributes for an individual - the ability to sign off (e.g. RMOs) and the ability to have your own sign-off queue (e.g. SMO. senior reg) Business rules (NOT technical rules) determine what you sign off. Everyone with sign-off rights can sign off everything! In practice each SMO will instruct their teams. Universals are around SMO only for Histology / Cytology.
Ordering: We (NMH and SDHB) are working directly and effectively with ‘Medlab / SCL / APHG’ as our lab provider. Currently most GPs are ordering and we’re both implementing in the OPD setting. As this is via the APHG Eclair and is the bridge between the orderer and the lab internal systems, at present it is not integrated with HCS / Concerto or our PAS. This is work in progress so we can progress to Inpatients. Access is via the DHB Intranet link and utilisation is steadily rising despite the need to log on separately and enter an NHI.
Radiology:
Sign-off has just been introduced to NMH / CDHB (? the other DHBs) using the same mechanism as labs i.e. integrated into the dashboard in HCS / Concerto and via the REGIONAL Eclair
Ordering : This IS via the REGIONAL Eclair and IS integrated into HCS / Concerto. Interestingly this has caused an issue to some as, due to the HCS / Concerto set-up, you have to close the document you are looking at / working on in order to order Radiology. Once in the Radiology form you might be uncertain as to the laterality and be unable to check! We do however have a ‘Pop-Up’ window that duplicates most HCS content as a view only. However not everyone has this and it closes as you change patients.