Princess Alexandra Hospital Brisbane pioneers digital rollout in Australia

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Electronic medical records have replaced paper records at PA Hospital. Photo: Medical Journal of AustraliaA Brisbane hospital that completed the “difficult task” of becoming Australia’s first large-scale digital hospital has prompted revolutionary change in the way healthcare is delivered in Queensland.
Nanjing Night Net

A perspective published on Monday by the Medical Journal of Australia outlined the complexities and benefits of the digital rollout of the Princess Alexandra Hospital (PAH) from a paper-based system to digital transformation, which occurred about six months ago.

The authors of the article, from PAH, Metro South Health and UQ, said while the rollout was a “difficult task”, digital healthcare “is the future”.

The digital rollout involved transitioning from paper records to Electronic Medical Records (EMR) that are instantly updated with a patient’s records, including vital sign monitoring and electrocardiograms, via Wi-Fi.

While there was an 18 month pre-implementation stage, which included roughly 32,000 hours of training with 5384 staff, the digital conversion occurred rapidly over two weeks.

A number of dress rehearsals with mock patients were performed to test out the usability of the new technology.

Practising clinicians joined the leadership team to make sure the project remained patient and staff centred, which was “essential” for the transition, the authors noted.

“Because the digital transformation of a hospital is a clinical event, patient outcomes, rather than IT project goals, need to remain the focus,” they wrote.

“Clinical leadership is essential for this process.” Initial disruptions to emergency department

The transition was not without a number of disruptions including a reduction in the efficiency of the emergency department that saw an initial 25 per cent increase in the average length of stay, however that returned to baseline within six months.

Retrieving clinical data for large groups of patients was also more challenging than expected, the authors noted.

Patient safety was tracked by a group separate from the digital hospital project during the transition to monitor for any adverse events across a range of patient outcomes.

The authors said they did not detect any “significant harm” directly attributable to the digital transformation.

They monitored patient outcomes for the six months post roll-out and found no “significant difference in the number of rapid response team calls to deteriorating patients or cardiac arrests”.

Medications were the only significant component not included in the digital implementation at the hospital, however there are plans for it to be included as early as next year.

The article notes that while there was always going to be difficulties in the transformation, there is “no doubt that digital health care is the future”.

“There are known adverse consequences and costs accompanying digital transformation of a hospital. These can include poor physician morale, increased frustration and reduced efficiency of care — particularly in the emergency department (ED) and outpatient setting,” the authors wrote.

“However, there are many benefits to the installation of an EMR system, which include more efficient and effective care, clinical decision support and a reduction in adverse events.”

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