emr at the rch - hfma · rch board finance sub-committee rch board department of health assurance...
TRANSCRIPT
EMR at the RCH
November, 2017
Outline
• Brief description of EMR implementation at RCH
• Benefits program
• Future benefits
Prior to go live….
April 30th 2016 – “big bang”
EMR Background
• Significant Tender Process
• Clinical Engagement in process
• RCH Staff seconded to project
• Significant internal/external governance
• Budget $48.3m ($23.9m Government)
What was included in our EMR?
Mobile applications
Portals – patient & family
Sharing care
2012
2017
Health Information & Management
Systems Society
EMR Project Governance
RCH EMR Executive Committee
RCH EMR Steering Committee
RCH Board Finance Sub-Committee
RCH Board
Department of Health Assurance Committee
EMR Committee Existing RCH Committee External Committee
Communications
Patient Portal
Audit and Finance
TrainingBenefits
Realisation
Change &
Adoption
Clinical Advisory
Research Advisory
Business Intelligenc
e
Cut-over Planning
Technical Advisory
Go live – 30th April 2016
• 30 clinical systems replaced or integrated
• 2600 computers checked / updated
• 3700 staff trained – over 20,000 hours
• 24/7 Command Centre for 4 weeks
• 4206 Help Desk jobs logged
• 400 RCH staff super users
• 18000 Whats App messages
Success factors
1. Executive sponsorship
2. Clinical engagement
3. Users wanted the system from beginning
4. Project set up right
5. An effective methodology
6. Program director/project manager
7. Project team
8. Vendor
9. Learn lessons
10.Go-live readiness planning
• Expected benefits
harvested: $102 mill over
10 years
• Scaled up from 2016/17 (yr
4)
Benefits – the business case
• 10% increase in private patient revenue (admitted patient fees, private
practice fees and prosthetics)
• 5% increase in outpatient revenue
• Revenue associated with a 50% decrease in medicare rejections
Cashable Benefits: Improved revenue
• 87% reduction in transcription of letters
• Savings from ‘sunsetted’ software
• 32% reduction in pre-printed form costs
• Reduction in EFT – scanning staff, database support staff
• Reduction in reagent costs in pathology
• Reduction in medication costs
Cashable benefits – Reduction in costs
Patient care – less interventions
• 5.50% reduction in number of tests
• 2.8% reduction in number of MI exams
• 2.1% reduction in medication costs
Medication safety
• 30% reduction in prescribing errors
• 22% reduction in overall medication errors
Benefits - productivity
2015/2016 2016/2017 Variance
Number of multiday stay patients
21322 21062 -1.23%
Number of same day patients 23357 27593 15.35%
Average LOS 2.64 2.56 -3.12%
Number of outpatients 184705 193679 4.6%
Benefits – quality and safety
• 14% less patient deaths
• 32% less cardiac arrests
• 33% reduction of outpatient waiting lists through improved
management through EMR.
• 4.22% increase in immunisations for inpatient who are overdue
• 27% reduction in median time between arrival and discharge time in
ED due to increase availability and accessibility of information for
doctors
Benefits – quality and safety
Connecting with our families and other
health communities
• 5902 My RCH Portal users
• 1572 using the mobile app
• 583 records were accessed by Community providers
• Monitoring and reducing low value interventions for common
paediatric conditions
• Proactive management of clinical deterioration
• ‘Good to go’– improving access and flow through ED and inpatients
• Rapid improvement program in Specialist Clinics
Future Benefits
