For many years doctors and nurses working in hospital wards have made do with the traditional functionality of a whiteboard for recording patient data. As healthcare continued to evolve, however, it became clear to the South West Alliance of Rural Health (SWARH) that a faster and more accurate tool was needed.
SWARH, which encompasses a mix of public health agencies, non-government organisations and medical clinics in Victoria, covers an area of about 60,000 square kilometres stretching from just west of Melbourne to the border of South Australia, with 180 sites.
In 2008, then SWARH developer (now business analytics manager), Jacob Beard, began conducting in-house research and analysis of the current processes, looking to develop a platform to quickly lodge data while retaining the option to manipulate it later and keep records.
“With previous methods like a whiteboard, you rub it off and it’s gone; the data is no longer retrievable,” Beard said. “There was definitely potential for patient risk.”
Beard developed a smartboard tool, the development of which was outsourced to Hewstone IT in 2010. He said the tool needed to digitally replicate the manual business process as closely as possible to make it easier to transition.
“We also had to integrate with the core patient management system to auto populate these boards with the current ward lists. So a patient’s data is admitted to the patient management system, then that data automatically transfers across to the board or screen to which metadata can be added — for example, dietary requirements or general ward notes.”
The tool also needed a backup mechanism to retrieve data deleted from the screen. Beard, in a team of three, developed .NET-based software that can run on any computer. SWARH uses a 32-inch TV attached to a small-form factor PC.
SWARH has implemented the platform across 16 wards across its largest member, Barwon Health, located south west of Melbourne. It has 22 sites, including a 400-bed acute hospital and 600-bed age and rehabilitation facility, all of which are manned by 6000 staff. There is one system per ward centralised in the nursing station. A newer version includes a 70-inch capacitive touchscreen at Barwon’s mental health division. It went live in early November and is in its final stages of testing.
The system implemented in the 16 wards has an auto-populating feature; as patients are admitted to the ward via the core patient system, the information changes on-screen.
“The difference between that and the mental health system is that the latter is semi-automated so it takes a snapshot of all the patients admitted to the mental health ward and puts them in a drop box on the side of the screen,” he said. “They then manually touch the screen to assign the patient to a team. “It’s a different setup to a medical or surgical ward which have, say, 30 patients assigned to a ward. In mental health, they may have 30 patients assigned to a team within a ward.”
The smartboards have increased data accuracy by 15 to 20 per cent, Beard said, due to the visibility of information.
The system does not require independent sign-on, instead having a general log-in for the entire ward. It does, however, take a data snapshot every 30 seconds to determine changes and who made them. It also logs about three weeks of data as a backup in “a rolling archive” that is instantly recoverable.
The smartboards have increased the visibility and legibility of ward occupancy lists and have the scope to include e-health records in the future. Beard stresses the importance of selling the idea to the business first, ensuring stakeholders are consulted on the design and processes.
“We’ve found all wards have their own way of doing things and it’s a matter of getting all those different opinions together and forming a useful central data set that everybody can use,” he said.
The centralisation of data sets remains challenging and Beard is keen to see more standard metadata as part of future implementations.
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