CSA01ecare

e-Care (Version 1)

e-Care is a multidisciplinary Clinical Management System, which has, as its core, the ability for health care units to manage and record patient care, utilising the latest in evidence-based practice and best practice standards - regardless of where this is developed.

HealthSolve Pty. Ltd.

HealthSolve Pty Ltd, a proudly Australian-owned company based in Adelaide, nominates for the Consensus Software Awards 2001.

HealthSolve has invested in excess of $2 million in the development of a point-of-care, Clinical Management System, “e-Care”, which has recently undergone successful Beta Testing at the Hunter Area Health Service in New South Wales.

e-Care is a multidisciplinary Clinical Management System, which has, as its core, the ability for health care units to manage and record patient care, utilising the latest in evidence-based practice and best practice standards - regardless of where this is developed.

e-Care is innovative in that it uses true n-tier architecture, allowing ease of implementation and allows clients with choices around the database to be used.

Significant innovation has also been introduced, with an extremely rich feature set which will provide clinicians with easy access to all information on the patient treatment, history and future activities with a few simple clicks from one major screen. Simplicity of use was very high on clinician’s priority lists when we undertook our initial research, and the results of the Beta Testing confirm we have achieved this, and have, in many areas, exceeded user’s expectations in this regard.

Another key innovative feature of e-Care is its scalability for Healthcare settings. Competing products, all of which are produced by US multinational software houses, have no interest in smaller healthcare units. e-Care has been designed to make it both affordable and implementable in all healthcare units of all sizes, from small Aged Care facilities, to the very largest tertiary hospitals.

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e-Care is a very important development for the Health Software industry in Australia. HealthSolve has produced a product, which will be used in global markets. Not only will the e-Care system provide an important import replacement, but it is already being exported to the US, where it will be used to replace the ExcelCare product in that market. The skills, capability and expertise developed by HealthSolve in the development of this “cutting edge” system are second to none.

HealthSolve is committed to extending e-Care beyond its first release, which was launched at the National Health Informatics Conference (HIC2000) in early September 2000, and has commenced work on developing a dynamic Clinical Assessment tool, which will extend the reach of the system beyond the walls of HealthCare units to include GP practices, providing access to patient data across a variety of healthcare settings, and more importantly, across the continuum of care.

As a multidisciplinary tool to be used by all clinicians at the point of care, allowing Clinicians to record and monitor all care activities on a real time basis;

To cover the continuum of care or patient episode from Accident and Emergency or pre admission clinic to inpatient stay to the hospital in the home and outpatients; and

To be appropriate for a diverse range of clinical areas, including Rehabilitation, Extended Care and Psychiatric to General Medical and Surgical areas to Intensive Care.

Unique in that it has been wholly designed and developed in Australia and encompasses a wide variety of features, which are not available within other healthcare systems.

In early 1998, HealthSolve successfully obtained a R&D Start grant from the Federal Department of Industry Science and Resources. Since that time, HealthSolve has engaged a number of leading consultants and academics to research the needs of the health information technology market to ensure that e-Care would meet the industry’s needs.

HealthSolve commissioned two major studies to assist in the development of e-Care:

In July 1998, HealthSolve engaged Professor Philip Darbyshire (Chair of Nursing, Department of Nursing & Midwifery Research and Practice Development, Women’s and Children’s Hospital) to research the views and understandings of nurses and midwives in relation to various aspects of health care informatics; in particular clinicians’ understandings and perspectives of patient information systems and other clinical ‘IT/Computing Systems’ with which they were familiar.

The study comprised a number of phases, including an extensive review of the literature related to nurses’ perceptions and experiences of using patient information systems.

The second stage of the study involved conducting a series of Focus Group interviews with a wide range of Nurses and Midwives from a variety of geographic locations across Australia and clinical specialties.

This study is significant in that it actively sought the views and perspectives of nurses and midwives who are currently using today’s computerised systems.

The challenge for HealthSolve was to build a tangible partnership with clinicians, as well as IT Managers and Healthcare executives, in order that users can be more active partners in the next generation of Clinical Information Systems. We believe that we have met that challenge.

2. Professor Pearson & The Joanna Briggs Institute for Evidence Based Nursing & Midwifery

The second major study undertaken by Professor Pearson and The Joanna Briggs Institute for Evidence Based Nursing & Midwifery had a number of objectives, including:

1. to identify the most frequently used nursing interventions in the acute care setting throughout Australia; and

2. to establish what best available evidence exists to support these interventions and examine the feasibility of developing and maintaining a suitable database for this purpose.

In studying these objectives, it was hoped that The Joanna Briggs Institute may establish, at least in part, the feasibility of a common data set of interventions embodied in a computerised decision support system, to be used across a number of institutions and supported by the best available evidence.

It became apparent that a clinical decision support system should reflect the activities that are actually occurring within the given field of practice. With this in mind, e-Care was designed to incorporate the documentation of actual activities performed.

In addition to the two major studies discussed above, prospective clients have been involved in developing and reviewing the specifications for e-Care from inception through a series of focus groups, representing a wide area of clinicians from across Australia. This process led to the development of the prototype of e-Care, which was demonstrated to key clinicians across Australia to seek their feedback. This feedback was then incorporated into the final product design.

To ensure that the e-Care development team is aware of emerging trends within the healthcare industry, a high emphasis is placed on the company and staff being members of a wide variety of clinical, management and IT organisations, as well as attending related conferences.

The e-Care Clinical Management System is designed to provide clinicians from all disciplines, with a tool to facilitate planning, recording and management of clinical care. Through the use of a defined database of standards of care applied to patient’s treatment plans, the system also facilitates projection of staff requirements, costing of staff and material resources, and monitoring of patient outcomes which, in turn, provides evidence for practice review.

The e-Care system incorporates the use of electronic referrals, order management, clinical pathways and variance analysis. The system is a relevant tool for clinicians with the ability to replace the paper record, in the long or short term, with all management benefits derived from the clinician’s use of the system to manage care.

e-Care has been wholly designed and developed within Australia by HealthSolve, and is, we believe, a huge success story for the Australian Health and Information Technology industries.

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e-Care Assessment module breaks new ground in providing clinicians with the ability to create assessment tools that reflect the most up to date methods and practices as well as tools that suit their own clinical practice. A patient history can be recorded via a very simple user interface, as it is being taken, producing a documented summary that is instantly made available to other clinicians. This leading edge functionality reduces clinician time spent documenting patient examinations, reduces the need for patients to be asked the same questions repeatedly by different clinicians and provides greater access to up to the minute clinical data.

The e-Care Pathways and Care Plan function enables patient care to be managed electronically using all the available patient information to feed dynamic clinical decision support. This function is unique to e-Care and accurately reflects patient needs and practice.

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The e-Care alerts and allergies functions link known patient details such as allergies, drug sensitivities and alerts related to medical condition with the patient plan of care. This provides real time decision support for clinicians so that potentially detrimental actions can be avoided.

Communication between clinicians regarding patient care is of the highest priority to provide high standards of care. e-Care provides on line referrals with the ability to send requests for referrals/consults to clinicians or departments, which are able to be integrated with existing email systems.

e-Care allows the recording of a patient’s current problems / needs which can then have specific interventions attached, feeding into the plan of care. This increases clinician efficiency by reducing documentation and providing links from evidence based medicine into current practice.

Progress notes are a collation of clinician and system-generated documentation based on care provided, resulting in more accurate, concise and legible documentation with reduced clinician input.

e-Care Discharge Summaries bring all relevant patient information together in user defined letter templates providing a unique streamlined approach to creating discharge letters. The function removes the need for clinicians to search through patient records to find all required information to pass on to other health care professionals such as the General Practitioner or community supports.

Outpatient management enables users to access a patient's record outside of an admitted episode and continue to record data for the patient.

e-Care utilises its unique care planning methodology to provide up to the minute accurate patient acuity data that predicts future staffing requirements.

e-Care provides online links between any system defined activity or intervention and site policies/procedures or education/research material stored locally or on an intranet/internet. Clinicians are able to access these resources on line from within the patient’s record thus linking clinical interventions to the evidence that supports that practice.

Quality management allows a site to define how and when patient outcomes should be reviewed.

This function will then prompt users to enter the required data when appropriate so that an accurate record is created of patient progress against selected patient outcomes. Outcome results can also be used to feed back into the development and maintenance of standards of care.

The costing module provides an up to date user definable view on staff and resource costs.

e-Care provides a suite of standard reports covering both patient and management data that can be produced at one point rather than having to combine and massage data from different systems.

This function enables on line management and real time views of patient movements and specific patient details including admission date, admitting/treating Doctor, diagnosis, and diet.

The physical location can be managed from this view including functions to hold and close beds/rooms, move patients between beds in a location, manage bed/room details such as number of beds, accessories and gender.

e-Care provides the ability to allocate patients to staff for a period of time (shift) creating an ongoing electronic record of staff to patient assignment as well as defining each staff member’s patient worklist on a day-to-day basis.

This function allows staff rosters to be accessed from an interface to a rostering system or direct entry of staff into the e-Care system itself.

The e-Care PMI/ATS functions record patient demographics, NOK and contact details and enable patients to be registered, admitted, transferred and discharged.

This affords e-Care the flexibility be used stand alone or integrated with an existing dedicated PMI / ATS system. This is another innovative feature, which allows e-Care to be scalable from small to large organisations.

The rostering interface will provide staff numbers and names for determination of actual costs as well as staff allocation, where a rostering package exists at a site.

e-Care utilises a purpose built security engine optimised to cater for the stringent health information privacy requirements which enables a user's access to be defined down to the individual function level with read or write access.

The system also incorporates an emergency logon that can be activated when required to comply with the requirements of AS4400 Personal privacy protection in health care information systems.

It utilises industry standard protocols such as HL7 messaging, and ICD10 coding and makes use of open database technologies like Sybase Adaptive Server and Microsoft SQL Server.

e-Care takes advantage of current distributed computing technology to deliver a powerful and scalable solution. Client workstation can communicate with the application server using DCOM or COM over TCP/IP connections.

The clients can connect to the application server across a local area network, or remotely via a wide area network (frame relay, ISDN, standard dial-up connection, or private point-to-point technology).

This flexible scheme will reduce the total cost of ownership of the system by allowing an organisation to minimise the number of expensive server class machines required to deliver a solution across geographically dispersed sites.

This module will include the capability for clinicians to place orders to a variety of service providers, track the progress of such orders, and view the results, online.

It utilises industry standard protocols such as HL7 messaging, and ICD10 coding and makes use of open database technologies like Sybase Adaptive Server and Microsoft SQL Server.

e-Care was successfully launched at the Healthcare Informatics Conference in Adelaide in September 2000.

e-Care will be marketed both nationally and internationally. Very aggressive sales targets have been set for the next 3 years. The national focus will be via direct sales to both public and private sectors, and the international focus will be via channels of distribution.

It has to be taken into account that e-Care was only recently launched. Therefore no new clients are using the product as yet. However, existing users of the legacy product Excelcare on which fundamentals e-Care was built constitute more than 23 hospitals countrywide. This equates to more than 15000 users.

e-Care is actively promoted within the existing client base with very positive results. The first sales are expected in the first quarter 2001.

International sales are being promoted via specific channels of which EDS with their CHAPS partner program has been partnered, and similar arrangements are being finalised with IBM, KPMG and Compaq.

HealthSolve Pty Ltd a proudly Australian-owned company with its headquarters in Adelaide has developed an innovative new Clinical Management System, the e-Care Clinical Management System for use in the global Health Industry.

HealthSolve was established in Adelaide in 1996 and now has offices in Adelaide, Sydney, Melbourne and Canberra, in conjunction with its sister company, Protech Australasia.

Our staff are our key strength and encompass a very broad range of Information Technology and Health Industry skills and expertise. Over the past 18 months, we have grown from a staff of 8 to 17. We also have a strong network of external professional consultants, including professors, senior clinicians and former senior health administrators, who work closely with us in the applications research and development area for the Health Industry.

HealthSolve is well placed to become a major player in providing total solutions and services to the Australian and global health information technology market.

To assist the Health industry become more effective in the provision of care, through the provision of a suite of best of breed intelligent software solutions and professional services.”

HealthSolve will remain substantially Australian-owned and stand out as the most successful solution provider in the Health industry throughout the Asia-Pacific region. Our success will be measured principally by client satisfaction, profit, innovation, quality of our solution, fulfilment of our team members and challenges accepted and won.”

e-Care (Version 1)

Brian Smith, General Manager
smith.brian@healthsolve.com.au

Douglas Barnard

Business Development Manager

barnard.douglas@healthsolve.com.au
HealthSolve Pty. Ltd.
(08) 8236 0400
www.healthsolve.com.au