Questions and Answers
Frequently Asked Questions (FAQ):
1. What is an EMR System?
An EMR is an electronic record of health-related information regarding patients that can be gathered, managed and consulted by authorised clinicians and staff within a health care organisation.
EMRs have the potential to provide substantial benefits to patients, clinicians and health care organisations. EMRs can facilitate workflow and improve the quality of patient care and patient safety.
Once the EMR System has been implemented, patient medical records will be created, stored and retrieved electronically. Paper-based patient medical records will be gradually phased out over time as more electronic information becomes available; kept for historical purposes only.
2. What EMR are we implementing?
We are early in our EMR journey and to date it has been less about the vendor or product and more about planning; learning from successful EMR implementations elsewhere and identifying tangible benefits. We understand the essential functionality that a Monash Health EMR system must be able to deliver.
Through an extensive clinical engagement process, Cerner has been identified as the software platform that will be used by Monash Health.
The platform is composed of core module such as a clinical data repository, clinician portal for computerised order entry and results, medication ordering and administration management, clinical documentation, clinical decision support and key specialist modules such as Critical Care and Emergency Department.
3. Will an EMR impact patient safety?
Patient safety is paramount. An EMR will improve patient safety and assist clinicians in providing world-class healthcare. It will dramatically improve the capture of clinical data and access to information at the point of care.
It will establish standardisation of format, content and terminology to provide a consistent interpretation of patient information.
Our EMR will be closely aligned to the National Safety and Quality of Health Service (NSQHS) standards, and all project decisions will consider the impact on the system on patient safety and quality of care. This is an exciting project, which will form part of Monash Health’s journey from ‘Good’ to ‘Great’.
4. How long will it take to deliver?
A 10 year roadmap has been mapped out to a ‘paper-light’ environment, in line with current world’s best practice. The EMR Program will be delivered in stages, starting with the foundations in Stage 1 of:
- Clinical Data Repository
- Computerised Order Entry (including Medications, Pathology and Imaging)
- Clinician Portal for results viewing
- Clinical Documentation
- A Medication Administration Record
- Selected specialist modules starting with Critical Care and Emergency Department
- Medical Grade Network with wireless capability
- Outpatient encounters and specialist modules will be implemented in later stages
- The journey to excellence never ends
5. How would a patient’s journey change with an EMR?
‘Lisa’ is a patient at our new Monash Children’s Hospital. In the future world, all of Lisa’s information resides in a single database. The nurse at her bedside makes notes on a medical grade tablet utilising medical grade wireless.
Lisa’s doctors use a Workstation on Wheels (WoW) for ward rounds and input directly to her medical record, right there, at her bedside.
Results from pathology and radiology are available in the system – in real time; and the results automatically chart and alert those results with an escalation process and graphing ability. Visiting consultants use their mobile to access information anywhere at any time.
There are no errors in medication, because her allergies reside with all of her data in the same system; clinical decision support enables a warning system.
There are no transcription errors and the 35% error rate of handwritten Patient Identification number transcriptions, has been abolished.
When Lisa is well enough to go home, her GP will receive a timely, accurate discharge summary which will be transmitted to the National Patient Record/MyHealth, which her parents will be able to access.
Researchers will use her de-identified data to identify and translate new forms of treatment.
6. Who will lead the EMR Program?
The EMR Program will be led by clinicians; they need to choose, own, use and continually improve the system. IT and other functions will be supporting stakeholders.
The implementation of the EMR will not be a technical installation but a process transformation of the patient journey – strong Clinical Leadership is essential.
Everyone will need to work together to make this successful.
7. What Key Performance Indicators (KPI) will tell us that the EMR Program has been successful?
A full benefits realisation strategy to ensure benefits are thoroughly measured and delivered will be created as part of the EMR Program. The high level Key Performance Indicators that will be measured include:
We see improved patient, staff and community satisfaction and experience measures
- We use information to drive research and clinical improvements
- We have reduced medication error and adverse drug events
- We are able to reduce length of stay for specific groups
- We have improved response times for care to deteriorating patients
- We have reduced surgical infections and readmissions
- We are able to rapidly develop innovative models of care to improve outcomes
- We can provide complete discharge summaries to patients and care providers
- Our medications costs have reduced
- We use less paper in our clinical settings
- We scan less
- We have reduced unnecessary diagnostic imaging andpathology testing
- We see increased time efficiency for our clinical staff
Contact the program team at EMRProgram@monashhealth.org