March 2014 Newsletter
The purpose of the CareConnect portfolio is to bridge the information gaps between primary, secondary and community care settings, bringing together clinical data to ensure better, sooner, more convenient healthcare.
Below is an update of achievements for 2014.

3 big milestones
for the eReferrals Project
Major System Upgrade
On March 1 the Regional eReferrals Management System was upgraded. This set the platform for the next stage of eReferrals, which is eTriage and Grading.
As well as the new technical infrastructure, over 140,000 existing patient eReferrals were migrated to the new version.
The upgrade resulted in some changes to the way referrals were processed in the hospitals which caused some disruption for a few days, but with lots of support from the Project Team on the floor, this has quickly settled into a ‘new way of doing things'.
New Forms
There have been three new services added to the eReferrals Forms Library that GPs can send to:
  • Older Peoples Health
  • Allied Health
  • District Nursing
See also our latest Open Letter to GPs outlining the new developments and ongoing improvements in eReferrals
Online Triage in Hospitals commences
On March 17 we turned on e-Triage for our first DHB service teams: CM Health ORL, Paediatric ORL and Rheumatology and WDHB Paediatric Medicine and Paediatric Cardiology.
Triage is the process of clinicians determining the priority for patients to be seen in outpatient clinics for a first specialist appointment. Doing this electronically enables the process to be done anywhere, anytime rather than relying on the transport of paper referrals across sites. It also enables timely information to be transmitted back to the referring GPs. Better, Sooner, More Convenient!
We will be rolling out eTriage across further clinical teams until complete across the Auckland metro region. Clinicians who have started using eTriage have reacted positively to the new system.
“eReferrals has the potential to maximise efficiency in the Paediatric referrals department. It allows timely triage of referral along with the opportunity to communicate directly with the referrer. It will reduce the amount of paper flowing in and out of the department which will increase efficiency. It is user friendly.
Having used the program over the last 3 weeks we have noted a few small changes in order to fine tune the programme to fit with our department.
Overall we are very happy with the program.”

Sue Thomsen, Clinical Nurse Triager, Paediatric Medicine & Cardiology, WDHB

Our Waitemata Paediatric Triaging team: Valda Sanders, Erin Black and Sue Thomsen
"eReferrals are a great boon for patients and their carers. Grading (which is very straightforward) within 24 hours of receipt, and with over half the 42 rheumatology referrals received in the last two weeks having brief "notes" messaged to patient's GPs regarding further tests, or recommendations for treatment to start before the clinic appointment, it could be argued that it is unethical not to use e referrals for requests for consultation"

Peter Gow,
Consultant Rheumatologist and Clinical Director ARHOP, CM Health

"This is a game changer. Another move closer to having information flow in real time which will reduce the need for a large proportion of referring."
David Grayson,
ORL Specialist, CM Health


eHealth Ambassadors - What are they?

Papatoetoe GP Karl Cole is one of the newly appointed
eHealth Ambassadors.
In his words:

The eHealth Ambassadors are working closely with the National Health IT Board throughout 2014 to encourage more GPs to establish portals in their practices. An IT Board survey indicates that 15 to 20 percent of general practices have or are in the process of implementing patient portals. The aim is for half of all general practices to be offering a patient portal by the end of 2014.
Dr Cole has been offering a Patient Portal access from his GP Patient Management System to all his enrolled patients. One of the major drivers was to improve the post consultation communication, using store and forward methods rather that phone calls or letters. He has never liked the practice of " if you don't hear from us it must have been ok" method of follow up, as sometimes it can mean "you didn't hear from us, because the results were sent to the wrong place". The portal is not more than improving on the current practice to patient communications, replacing separate telephone, email and print out channels
Many have been concerned about who owns the record. Dr Cole doesn't think the concept of record "ownership" is useful, as it more like a trustee relationship. All patients have a right to access information that is about them, and have a right to view this. The Patient Portal does not allow the patient to delete records. The Practitioner has responsibilities of guardianship of the record and owns the process and structure of the record but not the content.  The advantages of greater patient assess to information about them, has helped to demystify medicine and will help increase self management. Just like when first using TXT messaging in practice to patient communication it has required careful discussion with the patients to understand what it is and what it isn’t. So far there has been a great response from the enrolled population.

         COMING SOON:
Regional Visit View

The Regional Visit View displays Inpatient, ED, Outpatient,Theatre, Mental Health and Radiation Therapy appointments at the 3 Metro Auckland DHBs.
Release of Regional Visit View into CareConnect TestSafe is planned for May.
Media Mention
'DHBs move to share online health records'
- Pharmacy Today March 2014 (Subscription required to view full article)
..."Paving the way was the Northern Region DHB group, which started making lab results and dispensing records available to all community pharmacies through TestSafe CareConnect programme in 2010.  The three Auckland DHBs have since added a wealth of other clinical information to TestSafe.  A survey of users including pharmacists shows a third of respondents use TestSafe daily and a third using it weekly, according to the website for the TestSafe project.
Satisfaction was also high with the majority of respondents saying that being able to access patient information through TestSafe enhances cooperation."

CarePlanning Workshop
CM Health convened a Care Planning workshop on Monday 31 March.  Attending were clinicians from across  Counties Manukau.  Other DHBs are watching closely with a view to standardising the care plan templates.  Agreement was reached on the heading components of the Shared Care Plan template.
Mental Health using Shared Care
GPs from Otara Family and Christian practice see Counties Manukau Tamaki Oranga inpatients for regular GP services.  The Shared Care program will enable enhanced communication between the clinical staff at Tamaki Oranga and the GPs for the enrolled patients.

It seems like a long time coming, but with funding now signed off by all 4 Northern Region DHBs, we are excited to get underway with planning and implementing our Proof of Concept for what will be 'first of kind' dynamic CareConnect Clinical Pathways.  8 GP practices have self-selected for the 12 week trial period.
The practices are: Marsden Medical Clinic, Avondale Family Doctors, Hokianga Medical Centre, Bush Rd Medical Centre, Eastside Doctors, Pakuranga Medical Centre, Milford Family Medical Centre and Whangaparoa Medical Centre.
What is a Clinical Pathway?
A set of steps that describe a patient journey through the healthcare system in a way that best utilises the available multidisciplinary resource and applies best evidence to aid in decision-making at each point of intervention.

The POC pathways will be specific to your patient and dynamically integrated into the clinicians workflow in real time during a consultation.

What Pathways are we electronically enabling?
  • COPD
  • Gout
  • Iron Deficiency
  • Dyspepsia
  • Cognitive Impairment
If you would like more information about the Proof of Concept, contact Meg Smith, GAIHN  (Greater Auckland Integrated Health Network)

Successful Upgrade
Completed 20/3/14
CareConnect TestSafe was successfully upgraded across the Northern Region.  The Upgrade delivered new server hardware to make TestSafe more robust and scalable as the user base grows. (In the first quarter of 2014, new users have doubled against the same period for 2013)
Anecdotal evidence shows that the performance is already greatly enhanced with one GP stating that 'Testsafe felt like part of my PMS, it was so fast.'

And from one of our Partner DHB's:

"Congratulations on the successful upgrade of TestSafe/Eclair to the Auckland region. A huge achievement.
Could you please extend a big thank you from Waitemata to the team who worked on this. We appreciate that the complexity and scale of the environment made this a project that demanded expertise, attention to detail and collaboration across many stakeholders. I am particularly pleased with the implementation of load balancing between the two data centres, significantly increasing the resilience of the environment for the region.
Well done and I hope your team have the chance to celebrate this milestone."

~ Stuart Bloomfield I CIO I Waitemata DHB

  • 49,500 dispensed pharmacy items are on average loaded every day
  • 100% of contracted pharmacies are contributing data
  • 7.5 MILLION DHB documents have been uploaded

For  further enquiries about the CareConnect  portfolio, eMail:  CareConnect Liaison.