Long term programs are underway to migrate NSW and Queensland Public Hospitals to an integrated Electronic Medical Record (eMR) based on the Millennium platform from US firm Cerner.

As the cornerstone of Queensland' State eHealth strategy, delivery of an eMR will build on the large number of electronic solutions the department has already delivered in specialty clinical areas including; mental and oral health, patient discharge, endoscopy, intensive care, emergency department, radiology, pathology, anaesthetics and a patient information viewing system.

Following significant involvement from the clinical community during the comprehensive planning and testing process, the first release of the eMR application will be implemented in five Queensland hospitals commencing late this year and will include document scanning and children’s growth charts.

The second release of the ieMR, to go to a total of nine hospitals, will build on the first release and deliver pathology and radiology orders and results, alerts and adverse reactions and clinical documentation.

Further releases will include the delivery of structured clinical notes.

Ray Brown, Chief Information Officer, Health Services Information Agency, Department of Health, said, "The ieMR is the next step for Queensland’s public hospitals in moving from paper-based patient charts toward electronic medical records."

Currently a project is underway within the Department of Health to deliver an electronic Document and Records Management System (eDRMS) platform that can be used by Hospital and Health Services, the department and associated care providers. The platform will be delivered in two stages with the first stage due to be available in August this year.

The design and build of the eDRMS platform is being undertaken in partnership with Hewlett Packard and will allow for the sharing of corporate documentation across Queensland’s public health system to be managed in a highly secured way.

As part of the project, an implementation partner-panel arrangement is being established to give Hospital and Health Services, and prospective users, a level of flexibility in configuring their version of the platform to ensure it suits specific business requirements.

NSW Health

NSW Health has completed the first phase of a long-running program to migrate public hospitals across the state to an integrated electronic medical record (eMR) system based on the Millennium system. (The Millenium system currently comprises FirstNet in Emergency, SurgiNet in Operating Theatres and PowerChart in wards).

Currently almost 80 hospitals are using the system. The aim is to eventually replace paper medical records with an electronic record which provides decision support to clinicians and tracks and details a patient’s care.

Implementation of the first phase commenced in 2008 with the aim of enabling electronic documentation in emergency departments, a significant amount of electronic documentation in theatres, and some in the wards. This included electronic ordering of imaging and pathology, allergy alerts and a series of reports.

Completed in late 2011, this first phase also provided access to information about a patient’s previous visits to hospital since 2007.

The second phase of the eMR Program is now underway and involves significant infrastructure and software upgrades, replacing paper-based observation charts with electronic versions, providing additional electronic functionality to wards and delivering an electronic handover process for Junior Medical Officers (JMOs). It will also see voice recognition implemented in a number of public hospital emergency departments, based on pilot outcomes.

As well as implementing a number of clinical applications on behalf of NSW Health, HealthShare NSW also manages corporate support functions including payroll and accounts payable.

In 2011/2012 HealthShare NSW introduced a new invoice scanning and processing solution which utilises KOFAX scanning software and integrates with NSW Health’s Oracle financial management system. The solution is designed to simplify, streamline and support an automated, paperless accounts payable environment and allows invoices to be easily tracked and managed electronically.

The use of KOFAX scanning software enables the automatic extraction and scanning of documents sent via email and fax with minimal manual intervention, improving the accuracy and efficiency of the invoice payment process.

The invoice scanning and processing solution offers the following features and functionality:

• User visibility of all invoices and associated supporting documents from the time they are scanned. All scanned documents are available to view as an image and are retained with the paid record in the Oracle Financial Management Information System;

• An action history is recorded in the system to provide a record of any action relating to a particular document. Action history for paid invoices is retained in an archive database should there be a need to access this information;

• Electronic workflow is used to progress documents along the approval chain to ensure that approval is provided by the delegated officer with an appropriate level of financial delegation.

HealtheNet

HealtheNet is live in Greater Western Sydney and currently provides information sharing across the region’s local health districts and primary care providers.

Once HealtheNet is connected to the national system it will provide NSW Health clinicians with access to a greater range of clinical information including:

• Electronic discharge summaries from other private hospitals across Australia

• GP and specialist e-referrals

• GP shared health summaries

• Pharmaceutical Benefits Scheme (PBS) information

• Australian Organ Donor Register information

• Australian Childhood Immunisation Register (ACIR) information

• Medicare Benefits Schedules (MBS) procedures

• Medicare /DVA benefits information

• Advanced Care Directive Custodian Record information.

HealtheNet will be gradually deployed to other local health districts, with South Eastern Sydney and Illawarra Shoalhaven currently underway.

HealtheNet has been implemented as a collaborative consortium consisting of HealthShare NSW, Nepean Blue Mountains Local Health District (LHD), Western Sydney LHD, The Children's Hospital at Westmead, Western Sydney and Nepean Blue Mountains Medicare Locals, Primary Care and Community Network and a range of industry partners.