EMR at the RCH

November, 2017

Outline

• Brief description of EMR implementation at RCH

• Benefits program

• Future benefits

Prior to go live….

April 30th 2016 – “big bang”

EMR Background

• Significant Tender Process

• Clinical Engagement in process

• RCH Staff seconded to project

• Significant internal/external governance

• Budget $48.3m ($23.9m Government)

What was included in our EMR?

Mobile applications

Portals – patient & family

Sharing care

2012

2017

Health Information & Management

Systems Society

EMR Project Governance

RCH EMR Executive Committee

RCH EMR Steering Committee

RCH Board Finance Sub-Committee

RCH Board

Department of Health Assurance Committee

EMR Committee Existing RCH Committee External Committee

Communications

Patient Portal

Audit and Finance

TrainingBenefits

Realisation

Change &

Adoption

Clinical Advisory

Research Advisory

Business Intelligenc

e

Cut-over Planning

Technical Advisory

Go live – 30th April 2016

• 30 clinical systems replaced or integrated

• 2600 computers checked / updated

• 3700 staff trained – over 20,000 hours

• 24/7 Command Centre for 4 weeks

• 4206 Help Desk jobs logged

• 400 RCH staff super users

• 18000 Whats App messages

Success factors

1. Executive sponsorship

2. Clinical engagement

3. Users wanted the system from beginning

4. Project set up right

5. An effective methodology

6. Program director/project manager

7. Project team

8. Vendor

9. Learn lessons

10.Go-live readiness planning

• Expected benefits

harvested: $102 mill over

10 years

• Scaled up from 2016/17 (yr

4)

Benefits – the business case

• 10% increase in private patient revenue (admitted patient fees, private

practice fees and prosthetics)

• 5% increase in outpatient revenue

• Revenue associated with a 50% decrease in medicare rejections

Cashable Benefits: Improved revenue

• 87% reduction in transcription of letters

• Savings from ‘sunsetted’ software

• 32% reduction in pre-printed form costs

• Reduction in EFT – scanning staff, database support staff

• Reduction in reagent costs in pathology

• Reduction in medication costs

Cashable benefits – Reduction in costs

Patient care – less interventions

• 5.50% reduction in number of tests

• 2.8% reduction in number of MI exams

• 2.1% reduction in medication costs

Medication safety

• 30% reduction in prescribing errors

• 22% reduction in overall medication errors

Benefits - productivity

2015/2016 2016/2017 Variance

Number of multiday stay patients

21322 21062 -1.23%

Number of same day patients 23357 27593 15.35%

Average LOS 2.64 2.56 -3.12%

Number of outpatients 184705 193679 4.6%

Benefits – quality and safety

• 14% less patient deaths

• 32% less cardiac arrests

• 33% reduction of outpatient waiting lists through improved

management through EMR.

• 4.22% increase in immunisations for inpatient who are overdue

• 27% reduction in median time between arrival and discharge time in

ED due to increase availability and accessibility of information for

doctors

Benefits – quality and safety

Connecting with our families and other

health communities

• 5902 My RCH Portal users

• 1572 using the mobile app

• 583 records were accessed by Community providers

• Monitoring and reducing low value interventions for common

paediatric conditions

• Proactive management of clinical deterioration

• ‘Good to go’– improving access and flow through ED and inpatients

• Rapid improvement program in Specialist Clinics

Future Benefits

Thank You – Questions?

Andrew.Whittingham@rch.org.au