Planning an Electronic Patient Record for a Small Remote NSW Health Service
Catherine M Mahon · 2002
In small, remote facilities there is a fine line between emergency, outpatient and primary health care services and in many cases the same staff member provides all these services from the same place. The Far West Area Health Service (FWAHS) covers the largest geographic health service area in NSW. With a population of approximately 50,000 people, there is an average of 1 person every five square kilometres. Of the total population, 13% are Aboriginal and 8% are aged under 5. Basing itself on the lead of NSW Health's EHR Working Group, Maari Ma Health Aboriginal Corporation and the Royal Flying Doctor Service (RFDS) wish to develop a well-planned approach to implementing a simple electronic patient record into small remote health facilities. The FWAHS is to be contracted to assist. The steering committee, chaired by Maari Ma, with representation of all key stakeholders, governs the project. The objective is to plan for a suitable information system that can be implemented into one facility at the outset in order to identify gaps, obstacles and work practice constraints. Part of the planning process includes a methodology of staff participation. Participation in the development of accurate business practice guidelines is crucial to the success of the project. On the steering committee team are clinicians, albeit not very computer literate, who wish to improve the health outcomes for their clients. The Ferret/Medical Director interface provides an excellent information architecture environment in which to develop an implementation plan. The FWAHS has already installed a Citrix farm enabling terminal server technology to be used in the area. As the name suggests it enables all FWAHS facilities to access applications from a central server. This technology also provides the best means for the RFDS to access the information they required out-of-hours. To date the project has been successful. Governance has been established and the technology is in place. Ferret training has been undertaken. The Ferret system is currently working in one service using the terminal server technology. The enhancements and the development of good business practice guidelines will further improve the project's chance of ongoing success. The steering committee's local involvement is the key to success of the business process re-engineering. A well established implementation plan is essential to the success of this project. Extensively funded training and ongoing support, together with further development will continue to enhance the success of an electronic patient record in small remote communities. The ultimate goal is for patients to benefit by better access to information that in turn provides a platform to achieve improved health outcomes.