Members of Eastern Health: Angliss Hospital, Box Hill Hospital, Healesville & District Hospital, Maroondah Hospital,

Peter James Centre, Turning Point Alcohol & Drug Centre, Wantirna Health, Yarra Ranges Health and Yarra Valley Community Health

Members of Eastern Health: Angliss Hospital, Box Hill Hospital, Healesville & District Hospital, Maroondah Hospital,

Peter James Centre, Turning Point Alcohol & Drug Centre, Wantirna Health, Yarra Ranges Health and Yarra Valley Community Health

Implementation of an EMM

system in a subacute and

palliative care facility

Megan Zigomanis

Lead Pharmacist

About Eastern Health

• 7 hospitals

• Various residential care facilities, community

based facilities and community health services

• 1301 beds

• In 2011/2012

o140,743 acute inpatient admissions

o3728 sub acute admissions

o141,251 emergency presentations

o169,992 outpatient services

Background• Lead agency for the Cerner Millennium clinical system

as part of the HealthSMART initiative by the state of

Victoria

• ‘Release 1’ went live at Eastern Health in August 2010

and included electronic medication prescribing on

discharge, results viewing, allergy and alert entry and

discharge summaries. It was implemented across the 7

campuses over the next 12 months

Background• Planning for ‘Release 2C’ at Eastern Health commenced

mid 2011. Release 2 was being led by 2 other health

services in Victoria and included electronic ordering and

administration of inpatient medications as well as

electronic ordering of pathology and radiology tests

• The HealthSMART program ceased at the end of June

2012 and the State continue to provide support services

for the agencies with production systems

Background• The Eastern Health Clinicals project

underwent rebranding as part of the of the overall ICT strategy of the organisation and this was planned to coincide with Release 2 activities

→

Scope and roll out plan• The decision was made at Eastern Health that

the sub acute / palliative care facility would be

the first site to go live. This allowed:

– more time to work through scope decisions for

specialist areas in the acute facilities

– more time to explore build options for complex

medications that would not routinely be used in sub

acute and palliative care

Governance

Site engagement• Members of the team were based at the

go live site for nearly 3 months prior

• This allowed for:

– Relationship building with key stakeholders

– Multidisciplinary workflow development

– Development of clinical champions

– Increased ad hoc training opportunities

Training and education• An online e learning system was not available at

the time so:

– Medical and pharmacy staff were trained in a one on

one capacity

– Nursing staff and allied health were trained classroom

style

– a ‘super user’ system was employed to assist with go

live and ongoing support once the project team left

the site

Go live and on site support• ‘Go live’ occurred at the end of November 2012

• It was a staged approach with each ward over a two day

period and one week apart

• A command centre was set up to manage the

deployment

• Twice daily meetings were held with all stakeholders to

discuss the progress

• Project team members were rostered on site in a

declining fashion for a 4 week period

Organisational Challenges• Translating theory into practice

• Communicating to senior management the magnitude of the change

• Standardisation and communication of existing organisational policy

• Communicating the magnitude of the effort to develop, maintain, and monitor the newly implemented system

• Turnover of project team members

System Challenges

• State wide footprint

• Functionality available

• An internationally developed system

• AMT catalogue nomenclature

• Managing dual systems

Benefits• Order legibility

• Order completeness

• Single record across campuses

• Remote access for clinicians

• Multiple access to the patient record

• Integration to pharmacy and radiology systems

Lessons learned• All project members should be familiar with as

many aspects of the system as possible

• Medical input is crucial from the start

• An e learning system is needed to allow the

training resources to be directed elsewhere

• The whole of the organisation needs to be

engaged not just the go live site

Acknowledgements

Thank you to all the members of the ehCare@eastern team for making this

implementation possible and to the change and clinical transformation team

for their assistance in preparing for today’s presentation.

Questions?