When the Gold Coast Hospital and Health Service undertook a project to improve care outcomes for people with complex and comorbid conditions and keep them out of hospital, it needed GPs, hospital clinicians and patients to all have easy access to the health information they needed to see.
The HHS, which takes in Gold Coast University Hospital at Griffith University and Robina Hospital, chose Extensia’s RecordPoint to work as a ‘hub’ providing access to data held in GP, specialist, pharmacy, allied health, hospital, pathology and radiology platforms.
“Getting information in the right format to patients and care providers at the right time should be simple information logistics,” Extensia founder Rob Kelly AM said.
“But healthcare provides particular challenges. Patients who are most in need of care from multiple services are often the least likely to be able to access it. Providers are also busy and because their clinical systems don’t seamlessly communicate, all parties responsible for a patient’s care are usually not connected. This results in avoidable hospitalisations, and this is what the Gold Coast Integrated Care program was designed to address.”
Working with 14 general practices and a combined total of 140,000 patients (about 25 per cent of the Gold Coast population), the GCIC team determined that 1303 patients were at high risk of hospitalisation within the next 12 months.
Extensia’s shared care record was essential in helping the team provide those patients with coordinated care.
It easily integrated with GP practice systems, including Best Practice and MedicalDirector, and was also accessible through the hospitals’ clinical systems.
It provided visibility for clinicians and carers of their patients chronic, complex and co-morbid conditions, such as diabetes, chronic obstructive pulmonary disease, and chronic kidney and heart disease.
During a four year trial, the GCIC worked closely with the high risk patients to reduce their presentations to ED and admissions to hospital.
The program evaluation found the GCIC had enhanced care and coordination of services and was valued by patients and healthcare providers.
Electronic communications that enhance information management were also found to be essential to effective and efficient care coordination.
BENEFITS OF EXTENSIA’S SHARED HEALTH RECORD
Improved quality of care for patients
Reduced duplication of services by improved monitoring and care coordination
Improved patient and family knowledge enabling self-managed health
Improved knowledge of health services
Reduced risk of hospital admissions and unnecessary readmissions
Increased practice capacity to manage patients with chronic or multiple conditions.
Coordinated care for chronic disease
User security and authentication
Interface to desktop clinical systems
Centralised, hosted, shared EHR
Patient consent management.
HOW DOES EXTENSIA ENABLE COORDINATED CARE?
Extensia clearly displays information from along a patient’s care continuum by integrating with primary, secondary and tertiary health software and non-clinical software systems.
Its ease of use encourages genuine collaboration between healthcare providers for care planning, which is why it has been deployed in Indigenous health, aged care, clinical trials, disabilities care, and chronic disease management in metropolitan, regional, remote settings. It has also been used to share information and enable coordinated care between state-run hospitals and Commonwealth-funded primary care systems.
By aggregating data, Extensia also fuels innovation by improving the functionality of health apps, AI, machine learning, mobile devices and emerging technologies.
Meanwhile, each Extensia community is able to have its own tailored consent model and data governance oversight.