Clinical health systems in the 21st century

By John Connole
Tuesday, 23 October, 2012



Russel Duncan, CEO emerging systems


Russel you have been working in health system technology for over 20 years, what changes do you see happening in the industry?


There is a big shift towards the clinical aspects of health information technology now that most back office activities have been implemented. Health industry and government are now seeking to improve benefits in terms of safety, efficacy and patient outcomes. This is supported by the Australian Commission on Safety and Quality in Health Care standards.


Today, we have the introduction of Individual Health Indicators (IHI) which will enable the Personally Controlled Electronic Healthcare Record (PCEHR), allowing individuals to have greater control of their own information. This will require more effective clinical systems management technologies to be implemented in healthcare facilities and in the community.


Our tablet enabled technology is also in demand within the hospital and out of hospital sectors. Clinicians have differing needs for accessing clinical information requiring a range of devices including iPads, Android and iPhones.


Why did you establish Emerging Systems?


As the Director, Information Systems for a large acute care hospital, I felt that IT systems needed to focus more on supporting the clinical care of patients rather than financials and back office components. I also became acutely aware that clinicians were requiring a more holistic approach to technology.


An opportunity to design and build a clinical health system became available in the late nineties. The overwhelming criteria was to have a system that was affordable and acceptable for clinicians, hospital and health administrators and which supported improved patient outcomes. This became the framework for our Emerging Health Solutions (EHS) Clinical Information System which is now deployed in major public and private health institutions.


Your system has been implemented in government and private sector hospitals, what has been the acceptance from clinicians?


We have been involved in a large public sector implementation of our EHS system which has provided consistency of practice, which the organisation was seeking, across multiple sites. The implementation has a consistent source of information available across the enterprise. Clinical personnel can now securely access information which they could not before.


The reduction in duplication of effort is very positive for staff while the time taken to complete assessment forms has significantly reduced. This allows staff to spend more time with their patients rather than on paperwork.


The transfer of knowledge required to effect a safe clinical handover is available in real-time by any clinician. Our system has met union acceptance in that state for workforce management.


What do you see as the vital aspects of a successful implementation?


It is critical that clinicians today are empowered to solve problems which they see within the organisation. The philosophy of asking “How can this process be more effective” needs to be adopted throughout the organisation. The success of our implementations lies with the organisations themselves tailoring the system to suit their needs and not Emerging Systems’.


Training and change management play a critical part in successful implementations and needs to be provided for adequately, bearing in mind that this is one of the most significant outlays. Many large organisations have not invested heavily enough in training to the detriment of the implementation.


What do you see as the future for Clinical Information Systems?


We are in the middle of the future, as I see it. There is an increased focus on the patient and satisfying their needs. We are now on the crest of the first wave of this thought process around patient centric thought and the second and third waves will be arriving in quick succession.


The ability for individuals to participate in their own healthcare outcomes is evident and the internet has created forums for people to seek out more information.


There are also sectors that have been ignored such as mental health and aged care. There is much to be gained in addressing the IT needs of these sectors and which will benefit society as a whole.

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