Clinical Support and Specialist Clinics
During the EMR Phase 2.1 design workshops, feedback from key stakeholders helped the EMR team to better understand the complexities surrounding the proposed move of community referrals (in paper or BOSSnet) and appointments (in iPM), including reporting, to the EMR as part of the EMR Phase 2.1 implementation.
The EMR team listened when advised of the complexities around community referrals and appointments, as opposed to the more straight-forward specialist clinics referrals. Through this feedback the EMR team understands the need to spend longer on the ambulatory referral design to ensure the build is tailored to suit the unique requirements.
As a result, a decision has been made to remove these workflows from the EMR Phase 2.1 scope, and to commence a separate project which will allow the detailed analysis required to ensure this functionality is tailored to the unique community referral workflow requirements.
This is a chance for the EMR team to investigate the administrative workflows in more detail and ensure they are properly scoped and the requirements understood. The undertaking of this project after EMR Phase 2.1, will allow the EMR team to develop greater experience in the unique referral workflows and to better support affected clinicians and administrators and their requirements.
What will still be delivered in the EMR Phase 2.1 scope?
Clinical documentation went live as planned with EMR Phase 2.1. You are now able to document all the assessments and care provision for your patient throughout their enrolment in your service, enhancing continuity and visibility.
You can document in the EMR in the same way as other Western Health clinicians – bringing consistency across the organisation and an opportunity for other clinicians to view your notes. All clinicians using the EMR have access to the full picture of care.
In summary, clinical workflows are still in scope for EMR Phase 2.1, you are able to view and input patient information, but administrative workflows will not be in scope.
What’s staying the same as what you do now?
Internal referrals to your services will remain the same. They will be sent, received and triaged on paper or BOSSnet – this is the only clinical activity not in the EMR following the Phase 2.1 Go-Live.
External referrals continue to be scanned in to BOSSnet, which is consistent with external referrals for Specialists Clinics Outpatients. They will be triaged the same as now, on paper for BOSSnet.
All scheduling of appointments and reporting of contacts remain in iPM.
Specialist Clinics VINAH reportable clinics were implemented as part of EMR Phase 2.1 in July 2023. This includes iPM clinics & contacts.
Any clinic that is non-reportable, yet utilised the iPM Outpatient Clinic or contacts functionality, has also transitioned to the EMR for Registration and Scheduling functionalities.
Community Clinics have gone live with Clinical Documentation on EMR but Registration and Scheduling remain on iPM.
Yes, Healthdirect is still utilised as the Telehealth Video Consultation platform following the EMR Phase 2.1 implementation. Any activity previously recorded in iPM for Telehealth consultations has moved to being completed in the EMR.
External referrals will still be scanned into BOSSnet. The EMR project team is still working though the workflow for the management of external referrals including manual paper workflows and clinical triage.
No, all internal referral will be completed and managed electronically via the EMR, this will also include clinical triage of internal referrals.
Outcomes will still be required however these will be completed electronically in the EMR thereby joining the clinician and administrative workflows together.
Yes, BOSSnet is still utilised as the scanned medical record for Outpatients. The project will work towards moving as many workflows as possible to the EMR. ‘What Goes Where’ documents will be provided which clearly outline where you will find and complete workflows within Outpatients and other areas.
All outpatient progress notes will be completed in the EMR once EMR Phase 2.1 has been implemented.
Yes, Phone Dictation will still be available as per the current process.
Yes, areas using Enlighten are continuing to use it following the EMR Phase 2.1 Go-Live.
Yes, there is a calendar view option which allows the clinician to see all appointments for a future week or day.
Yes, comments placed by administrative staff will be visible, some comments must be hovered over to see the full details entered.
Ambulatory Organiser is a comprehensive display of scheduled appointments for ambulatory providers. It provides a snapshot of a single day’s appointments, including appointment gaps and appointment times and details, patient information and status, outstanding items to be completed at each visit, and meaningful use reminders. Each status will be colour coded to easily identify those patients who are yet to arrive, those who are waiting to be seen, and those who have completed their consultation.
PowerChart Ambulatory is similar to the current PowerChart used in inpatients but includes specific Outpatient information. Clinicians will have personalised documentation for specialty workflows where each display can be customised to make the most required clinical information available for that specialty.
PowerChart Ambulatory gives clinicians access to shortcuts, including common radiology and pathology orders for ease of required diagnostic tests. This solution also assists clinicians in managing medication orders and reconciliation of home medications.
Similar to the current PowerChart used in inpatients, documentation templates are available that pull in outpatient specific information to allow the clinician to quickly document patient progress.
Yes, in the scheduling function when booking an appointment you are able to change the duration of appointment outside of the duration initially set for the appointment type.
The Service Management Stream (SMS) looks different in the EMR. This appears in the form of specialties with the SMS as the prefix. This specialty acts as the triage, waitlist and referral filter and for any appointment management allowing areas to manage referral and appointment tasks only relevant to their clinics.
In Scheduling in the EMR there is a function called ‘location grouping’ which can replicate the iPM Day Clinic view currently utilised for patient arrivals. Patients can also be checked in using the Scheduling book appointment view.
Yes, this will still be used in the function of scheduling however it is built as drop down boxes in the EMR. This includes requesting an interpreter.
Allocation of the MBS item number previously on the patient paper outcome slip is now completed electronically in the EMR.
Processing of the MBS billing is not completed within the EMR. This will be completed in the new billing application being implemented by Finance called CBS Charge Pro. For further information please contact email@example.com
Yes, the only change will be patient correspondence letters for Outpatient areas, which moved to the EMR in July 2023. You will continue to use BING (Easy Post Mail Room) to distribute.
The complete Cerner EMR Patient Administration System (PAS), including Patient Registration, will be implemented in EMR Phase 2.2.
All Outpatient referral management including wait listing and appointment management – scheduling, arrivals and outcome management, is now completed in the EMR.
Patient registrations are still being completed in iPM with this including new patient registrations and changes to any of the details within the Patient Registration screen in iPM e.g. update of patient demographic, personal carers, insurance and GP information.
This EMR module provides the ability to schedule an outpatient appointment.
Appointments can be scheduled against a named clinician, specific role e.g. Respiratory Registrar or equipment and rooms.
Appointment types are attached to specific clinics and linked to locations to prevent any scheduling errors. Allocating the outcome of a clinic, similar to what was previously done on an outcome slip, can be completed via an order in the EMR that adds the request to a list to be scheduled by clerical staff.
This is the Registration module that was implemented in the EMR Phase 2.1 Go-Live. This is used to capture and view information needed for outpatient administrative workflows.
This registration module also includes Outpatient Referral and Waiting List Management functions including clinical triage. A function called Registration Worklist is used to assist with registration and scheduling task management.
Below are the links to watch demonstrations of the solutions. A Western Health account is required to watch these demonstrations.
- User – firstname.lastname@example.org
- Pass – Your WH Login password
If you have difficulties accessing these demonstrations, please email the Acting Project Manager, Specialist Clinics – email@example.com
- Ambulatory demonstration (PowerChart Ambulatory)
- Registration/Scheduling demonstration (Person Management Office) https://westernhealth.sharepoint.com/:v:/s/EMRPhase2.1SharedDocuments/Ec7l7cHA-fxHrknRV2JL1E0Bkq0cmteS4t1QXAtA9BG4RQ?e=6ez4Dz
- Referrals demonstration (Scheduling Appointment Book)
The outpatient space has the following clinics in the EMR
- Perinatal Mental Health
- SP Child and Adolescent Psychiatry Service
As part of EMR Phase 2.1, Mental Health provisions will include referrals, scheduling and clinical documentation for these clinics.