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Physiotherapists gear up for eHealth functionality Inner East Melbourne Medicare Local (IEMML) recently launched a pilot project to support 20 physiotherapy practices to trial electronic clinical software and other eHealth functionality. Working in partnership with the Australian Physiotherapy Association (APA), the trial forms part of IEMML’s new eHealth engagement with the allied health sector. “We’re working with two key groups: those with electronic clinical notation systems used during consultations, and those with paper-based or similar set-ups,” Sarah Lausberg, IEMML’s allied health eHealth liaison officer, said. “Our goal is to have the first group introduce eHealth systems such as secure messaging and online imaging while the second group will trial the use of clinical note-taking software during their patient consultations,” she said. “We know that moving to an electronic system is a big change for many practices so we’ve arranged a software vendor demonstration session … to introduce a range of software options. We’ll also use the opportunity to provide participating physiotherapists with information about the national eHealth record system as well as support for them to register.” Camberwell’s Back in Motion has been using and benefitting from electronic systems for some time. “Moving to an automated, electronic system has had a range of efficiency benefits for our practice,” physiotherapist and practice director Adrian Quinn said. “We now have easy access to client information from any computer, writing letters to GPs is much quicker thanks to auto-population of fields, and we can now far more easily communicate with particular subgroups of patients.”
Real-time entering and editing of clinical notes at the bedside CSC’s Healthcare Group recently won the vendors’ award in the Clinicians’ Challenge competition at the Health Informatics New Zealand (HINZ) conference in Rotorua with a readymade answer to one clinician’s needs: design a system that would allow several users to access and edit a ward round or admission note in real time, preferably using open HTML5 technology on a mobile device. The challenge, set by Hutt Valley District Health Board registrar Angus Turnbull, was aimed at allowing clinicians to create and edit patient notes at the bedside. Dr Turnbull, now on rotation at Wellington Hospital, wanted to use the ability of mobile devices and operational transformation technologies like Google Wave and Etherpad to make note-taking during ward rounds much more agile.
At the moment, ward notes are still being done with pen and paper in a folder, Dr Turnbull said. “For some emergency department patients, a laptop on a mobile trolley is used by one team member who often struggles to keep up.” In his challenge submission, Dr Turnbull wrote that while many hospitals now use EMRs for admissions and will in future likely integrate these with ward round notes through mobile devices, this still posed problems.
“We have taken a more social media approach to recording the notes, just like a person logs onto Facebook.”
It was predominantly for efficiency that Dr Turnbull made the challenge, he said. “Creating notes at the bedside is a time-limited process when you may only see each patient for one or two minutes.
“This process can result in delays as one team member must type the whole note via a portable keyboard or touch screen and impair team efficiency, and a better approach is needed given that numerous medical staff may be present,” he wrote.
“As you often have multiple team members present, allowing collaborative document editing via mobile devices can significantly improve the utility of EMR technology.”
What he wanted to see was a system that allowed several users to simultaneously edit a ward round or admission note in real time, such as one recording the history
while another records examination findings and a third corrects errors. While CSC’s Mobility Suite isn’t specifically what he envisioned, it does have much of the functionality Dr Turnbull was looking for. Brian Ackland, CSC’s software engineer behind the development of the solution, said it was an HTML-based application that currently runs on iPhones and iPads – with Android and other platforms on the drawing board – and allows clinicians to create notes, look up results and record observations while they are on the move. Dr Turnbull was looking at open platforms like Google Wave or Etherpad as they allow collaborative editing, and while Mobility Suite doesn’t use these technologies, part of the challenge for the vendors was to look at the wider context for healthcare, Mr Ackland said. Part of the collaborative editing element, in which errors can be rectified, was not available in Mobility Suite for several reasons, Mr Ackland said. “We have taken a more social media approach to recording the notes, just like a person logs onto Facebook,” he said. “You hit the comments area and you save it, and it automatically