Sharing the Shared Clinical Portals - time to put our clinical voices into the papers that will be tables - I’ve noticed a fair few CIOs suddenly going - but where does it fit on my priority list
Don’t know how others prioritise - and that would and should be a different thread so we can discuss that
but as I think it’s high clinical value and should be minimal technical work - well the simplest way should be
I would hope it shoots up the priority list
What is your “clinical one liner” for why this is a good idea?
Instant access to all national computerised clinical information for “my” patient - means I’m better informed, they have to repeat themselves less - and the time I have with them is spent concentrating on them and their questions, not on trying to glean information and piece it together. That improves the patient experience immensly
Ease of cross-reference and removal of necessity to duplicate investigations (e.g echo from another DHB where nobody can locate the written report) means I can better inform my patient and colleagues on why I am giving that particular advice. This also avoids me having to copy and paste screeds of documents to make sure they are all gathered in “my” letter, making it chunky, clunky and therefore poorly understood.
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Ability to view other DHBs’ solutions to Pt info visualisation problems which may inspire us to [ahem shamelessly copy/steal ahem] improve our own solutions
A beautiful Haiku. I THINK I MIGHT be close to landing a small start - a shared data set of growth charts across the south Island and the central region which some have heard me blather about. WIll let folks know how things roll.
While I share the enthusiasm for cross visibility from DHB to DHB, I think that primary care to hospital and vice versa visibility is the bigger issue… and is unfortunately more complex .
Yes, aiming for information visibility aX all the sectors of healthcare nationally should be the bigger picture goal, but to get there we need sub-goals, right? …So if all of us lobby for this stepping stone, seeing as it is actually within grasp, surely it would be easier to get to a bigger goal eventually. Or am I being naive?
I think that Lara is aiming for full visibility into each other’s clinical portals - without any fancy integration or direct data sharing as Mat is looking at. Just a way to look at the patient in the mess that is the other area’s portal. It is completely analogous to looking at the notes from St Elsewhere in that it will take ages to find anything. But at least it will be in there somewhere.
I love Ruth’s Haiku!
My one liner:
Patients expect us to be able to access records from around the country, as they know that their care will be augmented massively; they are shocked when they discover that we can’t.
Hey N,
You’re right, my understanding of Lara’s proposal is a read only view from each regional portal into each other regional portal.
It’s totally doable, and totally worth doing. I think it’s a great idea.
Lara, I seem to remember that Kate Reid was a backer of this idea. If so, now that she’s gone, is this something we need to take up with the Orion team again? Niru Rajakumar is the man who we seem to work with the most, but I think he represent the North Island only and is in place until a new GM is appointed. Is that right?
Most definitely have a plan - starting with MVP - portal into portals concept paper presented to our “information governance group” - welcome to use it IGG Paper Template.doc (419 KB) and now shared with Rebecca - eHealthNews newsletter - which quotes the idea https://www.hinz.org.nz/news/news.asp?id=427894 in @richard.corbridge blog (oh dear I see he does not have access to our site - maybe @NathanK or @pacharanero would like to add him so he can see all the good he is responsible for :))
I must admit to two ulterior motives to placing this
To help Rebecca with her article “selling” the idea - nice to have “real clinical quotes” and would rather they were not all mine!!
To help me in future - as I have noticed the CIOs starting to say things like “well my dance card is quite full, where does this fit among all the other priority stuff we are doing”
So once again - a plea to discuss how we prioritise and keep informed of ALL the other work that is going on within our hospitals/regions - let’s start another thread on those two different but very interrelated issues
Northern Region we have “testsafe” which is a clinical portal with all discharge summaries and regionally shared documents (prob about 80% of all documents) and our eclair “diagnostic result repository” so all labs, rads, gastro, resp, ecg…etc etc generated by the four DHBs
GPs have access via “single sign on” from their PMS
Pharmacists have access
private hospitals have access both for clinicians and admin - they get signed by the CMO to take on audit and disciplinary action
All have “proximity” fences - when access outside - they get a “please explain why/break glass reason pops up” and they get audited
for all access - same name get a please explain
outside fences - look at reason and subsequent encounters - and can get a please explain (it’s not a sine qua non or a 100% reaction)
we send random patients invitations to see who has accessed their records
we feel this is reasonably robust - but have started discussing - what do patients feel / think about this
What do they expect
Will our access survive if we have a massive data breech/privacy issue?
Totally agree Nathan. we did a recent survey of 50 pts asking them how they felt about clinicians using technology at the bedside. Most of them seemed to indicate that they didn’t know why we were asking and assumed it was already happening. none of them had concerns about safety and security of data and commented that provided more clinicians could see their information and it meant they would get good care that it was the right thing to do!
Have however just had a different problem to solve - and I had about 10-15 of these in my 10 years of doing the job - ie not frequent - but they bite and I don’t have a good solution
A patient request to NOT send the
Operation note
Discharge summary
Clinic note
Radiology report
to their GP
We could “stop” this particular one - but then point out that the GP can come in via testsafe and see it anyway
ie within our region - should the patient request an “opt out” from the “normal” DHB process
we come unstuck and can’t actually give them what they want
How are the rest of us handling this situation ? - will start a new thread on this as I think it will distract from the Unite message - but am keen to know how others are handling this issue
We are just discussing that now in our DHB but to be honest I’ve bailed out of that discussion and dropped it in the lap of the CMO. Personally I think withholding of information by patients should be possible but they should have their lead clinician spend some time discussing with them the implications.
And we LOVE the ability to see into the the CWS @Ruth_Large - it is so useful at the point of care - ( especially when discharge summaries, results and clinic letters don’t always make it to the GP)
This is where dynamic patient consent could be a consideration. Patients having the ability to opt in, opt out, change who has visibility and access. Patients having the ability to change their consent settings over time.
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