出版社：Utrecht University, Maastricht University, Groningen University
摘要：Sydney Children’s Hospitals Network (SCHN) is the largest network of hospitals and services for children in Australia. It is a public service of NSW (New South Wales) Health, part of the NSW Government. The NSW geographic area serviced is 800,628 square km, with a population of 7,861,100 people, but children come from across Australia for the expert care SCHN provides. SCHN cares for 151,000 children every year, with over 50,000 inpatient admissions and over 1.1m outpatient encounters. More than 65% of these presentations consist of patients who have an established relationship with SCHN due to the complex/chronic nature of their diagnosis(s). SCHN wanted to connect with their outpatients, to inform/support changing care needs, to improve patients’ understanding of their conditions and to connect information across providers. All patients have providers locally outside the network, so SCHN wanted to support the patient as the conduit of their information, ultimately improving the care experience and health outcomes. SCHN had a vision of giving patients a digital record they could interact with meaningfully, centered around them. This digital vision would address several care delivery challenges : inefficient communication missed appointments managing changing conditions and medications lack of a shared record The digital vision became a co-design project with SCHN’s consumers, named the “Memory” project. The vision became reality in May 2017 with the successful trial of the “My Health Memory” (MHM) smartphone application. The first iteration of MHM allowed patients and carers to: Efficiently manage appointments and minimise care delays : receive new and updated appointments (including telehealth links straight to device) automatically from the EHR to their app request reschedules from their app receive appointment reminders, ensuring they come to appointments, are ready for care, and can find their way with digital wayfinding instructions staff can asynchronously review and reschedule requests via a request list and rebook Exchange clinical data to support care : access discharge summaries, care plans and reconciled medication lists from their app. push education to the app Communicate securely : clinical staff can securely message patients/carers from their workflow, and patients/carers can respond from their app. communications are automatically saved as a progress note in the EHR, eliminating manual documentation trial group implementation was a success resulting in a hospital wide implementation March 2018. Metrics achieved include : 80% of eligible patients registered (from trial group) Outpatient clinic No Show rates decreased by 74%. 8,748 messages sent between MHM and the EHR resulting in 30% fewer outpatient calls to nursing staff Reduction in secondary sources of truth for patient communication, reducing iatrogenic risk. 94.9% of app users have rated MHM as being useful in the care of their child. over 7,000 EHR documents shared to the app Over 6,000 activated users (October 2018) The 6 month MHM app roadmap includes; patient/carer uploaded documents and document sharing. Surveys with EHR integration & integration to Australia’s My Health Record. Sydney University have commenced a study On the MHM app titled Leveraging e-Applications for Patients (and families).
