Innovations in Hospital Healthcare
 

Innovations in Hospital Healthcare

Exploring Virtual Hospitals, Hospital in the Home, and Hospitals Without Walls.

Advancements in technology have seen an explosion of new terms and concepts in healthcare.

In this article, we aim to demystify three innovative approaches: Virtual Hospitals, Hospital in the Home, and Hospitals Without Walls.

All three challenge traditional notions of hospitals and have potential to revolutionise patient care as they reshape healthcare delivery.

Virtual Hospitals: Remote Care

Virtual hospitals use telehealth and telemedicine technologies to bring medical care directly to patients’ homes. Through video conferencing, remote-monitoring devices, and electronic medical records, healthcare professionals can remotely diagnose, treat, and monitor patients.

Hospital in the Home (HITH): Care in Familiar Surroundings

HITH programs deliver acute-care services to patients within the comfort of their own residences. Healthcare professionals visit patients at home to directly assist with treatment but also use remote-monitoring devices and video conferencing.

Hospitals Without Walls: Care Beyond Traditional Boundaries

A hospital without walls provides healthcare services in non-traditional spaces such as community centres, nursing homes, or even workplaces. The goal is to bring medical care closer to where people live, work, and play, increasing accessibility and equity of healthcare. Multidisciplinary teams leverage technology and resources to provide more convenient and more cost-effective care.

All three models of care offer increased efficiency, accessibility and personalised care experiences. They use technology, patient-centred care, and interdisciplinary collaboration to bring healthcare closer to the individuals who need it — and can help reduce demand for beds in traditional bricks-and-mortar hospital wards.

MediRecords currently supports clients in hospital settings including:

  • My Emergency Doctor virtual teams providing Senior Emergency Physicians to Urgent Care Centres, hospitals and ambulance services across Australia
  • Victorian Virtual Emergency Department and Northern Health outpatient teams as an ePrescribing system
  • Queensland Health virtual emergency department team as an ePrescribing system
  • Queensland Health Hospital and Health Services as a billing and claiming system for outpatient clinics
  • Private hospital VMO (Visiting Medical Officer) consulting suites as an electronic health record (EHR) and patient management system.

As a flexible and scalable EHR platform with inpatient functionality in development, including medication charting, MediRecords is well placed to be the clinical system of record for models of care including HITH and Hospitals Without Walls. 

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    Big-spending Federal Budget tackles bulk billing crisis 
     

    Big-spending Federal Budget tackles
    bulk billing crisis

    Doctors and healthcare consumers are the winners in the 2023-2024 federal Budget.

    The Albanese Government’s first Budget emphasised the importance of secure, safe and efficient digital sharing of health information — albeit without mandating standards for achieving this.

    A total commitment of $101 billion in health spending will include an upgrade to My Health Record, and $3.5 billion in bulk billing incentives for common GP consultations, including telehealth and videoconference, making care more affordable.

    More than 300 common PBS medicines will be made more affordable, with Australians able to buy two months’ worth of medicine for the price of a single (one month) prescription.

    MyMedicare — a new voluntary scheme in which patients enrol with a MyMedicare general practice — will support longer GP telehealth consultations, with reduced administration for practices, at a cost of nearly $6million to the government. There’s also more than $200 million allocated under this same scheme to provide new funding packages for general practices to provide comprehensive care to patients who are frequent hospital users ($98.9m); and for Australians in residential aged care ($112.0m). 

    The key budget measures for healthcare include:
    • $3.5 billion in bulk billing incentives enabling more telehealth and video conference consultations, and free appointments for children aged under 11, pensioners and Commonwealth Concession Card holders.
    • $358.5 million for 8 additional Medicare Urgent Care Clinics to reduce pressure on hospital emergency departments
    • $98.2 million for larger Medicare rebates for long healthcare appointments, aimed at enhancing care for people with chronic diseases and mental illness.
    • $445.1 million to encourage general practices to hire multidisciplinary teams to provide team-based primary care.
    • $951.2 million to overhaul the My Health Record
    • $46.8 million for Medicare rebates for care provided by nurse practitioners, including prescriptions of PBS medications
    • $1.2 billion for community pharmacies to administer free vaccinations and support treatments for opioid addictions.
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      MediRecords in the fast lane for FHIR connectivity
       

      MediRecords in the
      fast lane for FHIR connectivity

      MediRecords will be releasing new FHIR integration pathways for clients throughout 2023, as part of our commitment to a better connected Australian healthcare system. 

       

      As can be seen from our FHIR Roadmap below, we not only have established and proven options for data sharing, but we’re investing in the expansion of our Connect platform which comprises of  FHIR (Fast Health Interoperability Resources) and Connect services.

      We now have FHIR integrations with hospital systems for ePrescribing, and updating patient records. New resources in development for MediRecords 2.0 include allergies, diagnostic requests and reports, patient summaries, and inpatient charting.

      MediRecords Chief Executive Officer Matthew Galetto said the Connect platform enabled health care providers and patients to access records quickly and securely, driving better and timelier health outcomes.

      “We’re keen to see more software vendors hit the road and deliver on industry standards for interoperability, resulting in connected health care across Australia,” Mr Galetto said.

      “Some vendors seem to be waiting for a reason to modernise when the motivation should be clear — the right care at the right time, wherever you are in Australia.”

      MediRecords is part of a national consortium, led by Leidos Australia, developing a new Health Knowledge Management (HKM) system for the Australian Defence Force. This project will see MediRecords connect health records for GPs, allied health practitioners, specialists, patients, and hospitals.

      MediRecords is also supporting the Victorian Virtual Emergency Department with an integrated ePrescribing system.

      MediRecords Technical Product Lead Sanjeed Quaiyumi said 2023 would be an exciting year. “We’re working on consultation notes and can’t wait to hit other milestones on our roadmap.”

      MediRecords FHIR Roadmap

      MediRecords FHIR roadmap was last updated 01/11/23.

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        Communication the key to reducing hospital readmissions

        Communication the
        key to reducing
        hospital readmissions

        Can health tech help reduce hospital readmissions?

         

        According to a global research review, telehealth and virtual wards can certainly make a difference.

        The Deeble Institute — the research arm of the Australian Healthcare and Hospitals Association (AHHA) — reviewed international research on the role of primary care in reducing hospital readmissions.

        In its Evidence Brief no. 24, the Institute says telehealth can be used to boost general practice involvement in hospital discharges and subsequent multidisciplinary virtual care, resulting in fewer unplanned readmissions.

        Unplanned readmissions are associated with poorer health outcomes, dissatisfaction with healthcare, increased costs, and bed blockages.

        The report highlighted research that showed improved communication and coordination of care between GPs, hospitals and/or pharmacists is effective.

        “Effective interventions included … electronic tools to facilitate quick, clear, and structured (health) summary generation… use of electronic discharge notifications; and web-based access to discharge information for general practitioners,” reported the Netherland’s Hesselink and colleagues.

        Virtual wards are another way to reduce risk of hospital readmissions and improve outcomes during hospital-to-home transition, with research indicating these can be effective with specific disease cohorts but less so with non-specific, complex diseases.

        The Evidence Brief contrasted virtual wards with Hospital in the Home (HITH). HITH is a form of remote hospital inpatient care whereas virtual wards facilitate transition from hospital care to home care.

        “Compared to HITH, virtual wards typically have a higher degree of interdisciplinary care coordination and review, are simpler in design and implementation, and have a broader scope of activities,” The Deeble Institute reported.

        “Transitional care is similar to virtual wards, but usually implemented within existing systems. Virtual wards typically require a completely new care pathway and potentially new organisations to manage its implementation.”

        MediRecords Connect provides FHIR (Fast Health Interoperability Resources) and API options for connectivity with hospital systems, including patient administration systems (PAS). MediRecords is deployed as an ePrescribing system at two Australian virtual emergency departments and as an outpatient billing and claiming system for Queensland Health. New functionality enabling multidisciplinary case management and inpatient care will be released later this year.

        MediRecords is also integrated with the Coviu telehealth platform for streamlined virtual consultations.

        Top three Technologies that reduce hospital admissions:

        Further reading

        ‘A wonderful day’: telehealth to become permanent

        Improving Patient Handovers From Hospital to Primary Care

        Consumer adoption of digital health in 2022: Moving at the speed of trust

        PARR++ is dead: long live predictive modelling

        Impact of ‘Virtual Wards’ on hospital use: a research study using propensity matched controls and a cost analysis

        Applying the Integrated Practice Unit Concept to a Modified Virtual Ward Model of Care for Patients at Highest Risk of Readmission: A Randomized Controlled Trial

        Effect of post-discharge virtual wards on improving outcomes in heart failure and non-heart failure populations: A systematic review and meta-analysis

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          MediRecords 2.0: New ways to Care, Connect and Engage
           

          MediRecords 2.0: New ways to Care, Connect
          and Engage

          MediRecords 2.0 is the most comprehensive overhaul of our electronic patient record and clinic management system since we launched in Australia in 2016. While there have been many product updates over the years, MediRecords 2.0 is designed to use screen space better, streamline workflows, reduce administrative burn-out and support shared care.

           

          MediRecords Head of Product Jayne Thompson says, “Innovation is as important to us as it is to our customers”. The 2.0 product update reflects this philosophy, introducing best-in-class user experience design and other client-driven enhancements, while reinforcing the foundations for next generation digital health connectivity.  

          Having grown beyond its origins as Australia’s pioneering, cloud-based practice management system, the MediRecords platform is now underpinned by three pillars: Care, Connect and Engage. Each of these will gain major new features during 2023.

           

          Care

          The MediRecords Care pillar contains core clinical features such as patient records, ePrescribing, appointment management, investigations, billing and claiming, correspondence, and assessments. New Care functionality will include: 

          • Case Management – Members of a designated Care Team can view and update client case notes. This is particularly valuable where care is shared between a multidisciplinary team working from separate locations or across different shifts. For example, mental health practitioners can collaborate with GPs and rehabilitation specialists as patients progress towards a safe return to work. 
          • Group appointments – Patients will be able to book and join group sessions or classes. This feature will enable group therapy, family consultations and community health programs, with providers able to message an entire group or individual group members. 
          • New mental health and readiness for work assessment templates are being added, including the Glasgow Coma Scale. 
          • Single provider view of appointments: Clinicians practising across multiple clinics won’t have to jump between them to view their appointments. Appointments across multiple sites will be consolidated in a single view. 
          • New communication capability: Real time chat with team members will be available throughout MediRecords, making it easier to message team members on the fly. Our new Comms bar will also provide shortcuts to SMS, email, alerts, and notifications. 
          • Inpatients – In a major new premium* feature, MediRecords will be able to support complex care, including inpatient admissions, detailed charting, clinical escalations, progress notes and Discharge Summaries. 
          • Our Letter writer tool is having a makeover and will be even easier to use, with highly requested new functionality, such as digital signatures. 
          • We’ve added industry-leading means of recording Consent (or denial of consent) and made it easier to add attachments to patient records. 
          • Custom fields and Tagging can be used in patient records, creating new and innovative ways to capture information, search records and report on data. 

           

          Connect 

          Many clients are familiar with our Connect site. MediRecords was an early adopter of FHIR (Fast Health Interoperability Resources) and API technology and new options for using these to share data are on the way. We have proven integrations with patient monitoring devices, patient-reported outcome and engagement measure systems (PROMs and PREMs), dictation technology and partner products. MediRecords is built on the SNOMED-CT-AU data coding system, which makes the data we share cleaner and primed for analytics. 

          • We now have FHIR integrations with enterprise products such as hospital patient administration systems (PAS) and scanned medical record software. This means a patient record created or updated in MediRecords can be pushed up into hospital systems, ensuring consistency of records and supporting better patient safety. Current options include allergies, medication requests and dispense notifications. 
          • New FHIR resources to be added throughout 2023 include referrals, diagnostic requests, diagnostic reports, and vital signs.  

           

          Engage 

          MediRecords has already connected over 60,000 patients to healthcare records via our patient mobile app. This enables consumers to book appointments, see medication information, receive reports and educational resources, and access and store personal health documents. We’re taking this to the next level in 2023 with an entirely new patient engagement platform. This will include new features such as:  

          • Real time surveys and forms 
          • Clinical assessment and observations data for remote monitoring 
          • In-appointment chat functionality 
          • Secure web access to personal health data. 

          Frequently asked questions

          MediRecords 2.0 is an overhaul of our current platform rather than a new product. All existing customers will transition to 2.0. Sticking with the old MediRecords format will not be an option.

          We will perform the update remotely. Users won’t have to download or do anything.

          We have done our utmost to preserve familiarity and usual behaviour within the MediRecords application, but the new layout may take some adjustment. To help with this, we have been providing Lunch and Learn sessions for clients. Please reach out to our training team if you have any further questions, training.success@medirecords.com.

          Development will finish in March. Rigorous testing will follow before pilot sites switch to 2.0 in late April. Once we have considered their feedback, we’ll finalise the date for general release and shout it from the rooftops to let you know. 

          If you are a current client, please contact your Account Manager if you would like to be a test pilot for these new features. Limited places are available.  

          MediRecords 2.0 is an upgrade of your existing system and will be covered by usual licence fees. However, some of the optional new features will be Premium products and require additional fees. Details will be published as soon as possible. 

           

          For other questions, please email support@medirecords.com.

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            Federal Government digital health upgrade grants on the way

            Federal Government digital health upgrade grants on the way

            Update: 24 April 2023

            New details are now available on the Strengthening Medicare General Practice Grants.

            Grants of $25,000, $35,000 or $50,000 are available depending on practice size. The grants will be administered by your local Primary Health Network (PHN) or the National Aboriginal Community Controlled Health Organisation (NACCHO). To take advantage of this funding, complete a grant application sourced via your PHN or NACCHO.

             

            MediRecords welcomes the news that Federal Government grants aimed at helping to enhance digital health capability for Medicare general practices and Aboriginal Community Controlled Health Services (ACCHS) will become available from April. 

             

            General practices and ACCHS will be eligible for one-off grants of up to $50,000 for innovation, training, equipment, and minor capital works under three categories:

            1. Enhance digital health capability – Accelerate moves to a more connected healthcare system that meets future standards;
            2. Upgrade infection prevention and control arrangements – Ensure infectious respiratory disease (e.g. COVID, influenza) patients can be safely seen face-to-face; and/or
            3. Maintain and/or achieve accreditation against the Royal Australian College of General Practitioners (RACGP) Standards for General Practice to promote quality and safety in health care.

            The grants were an election promise from then opposition leader Anthony Albanese in May 2022. The Strengthening Medicare – GP Grants Program was subsequently allocated $220 million in the October 2022 federal budget.

            Medicare general practice grants will be administered by local Primary Health Networks (PHNs) and ACCHS grants by the National Aboriginal Community Controlled Health Organisation (NACCHO). Practices and health services owned or operated by a state, territory or local government agency are ineligible.

            MediRecords Chief Executive Officer Matthew Galetto welcomed the move and said he hoped it signalled a shift to better data connectivity between GPs and the broader health care system.

            “We would like to see incentives for general practices to switch to the cloud, given the environmental, security and interoperability benefits that flow from leaving behind legacy software and hardware systems.”

            Mr Galetto said the grants program was an opportunity for the Federal Government and PHNs to drive industry-wide reform and boost adoption of new technology platforms.

            “Just as PIP (Practice Incentives Program) grants helped shift GPs from paper-based systems to electronic, this grant funding should seek to do the same for next generation interoperable technology.”

            “This is bigger than improving the My Health Record. There is an opportunity to follow the United States example and provide genuine connectivity of digital health records for patients, from primary to tertiary care.”

            MediRecords is a true cloud electronic health record system featuring global standards-based interoperability and SNOMED-CT-AU clinical coding. MediRecords pioneered cloud practice management software in Australia and is now used by general practitioners, specialists, multidisciplinary clinics, hospitals, and government departments.

            Practices considering using their grant to upgrade to cloud clinical software are welcome to reach out to MediRecords. We provide onboarding services including training, data migration and configuration of electronic prescribing, telehealth integration, Medicare claiming and more.

             

             
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              8 health-tech trends to watch in 2023
               

              8 health-tech trends to watch in 2023

              Tim Pegler

              Tim Pegler - MediRecords Senior Business Development Manager

              The pandemic years have been actioned-packed for health-tech. What have we learned and what can we expect from 2023?

              1. The cloud is (still) coming 

              Based on conversations with customers, the market is increasingly aware of the security and infrastructure benefits of shifting to cloud. So why is the transition so slow? Partly because the healthcare industry is often understaffed, time poor and therefore change averse. The good news is that those who embrace fresh and more flexible technology rarely look back.

              Speaking of shiny and new…

              2. Robots are here to help 

              Staff shortages due to illness, burnout and pandemic-related workforce changes necessitate doing more with less. We can expect automation to play a bigger role in repetitive tasks, and robots to play support and even investigative roles.

              Exhibit A: Robot dietitian RMC adds robot dietician (thetandd.com)

              Exhibit B: Robot meds Mayo Clinic picks up stake in startup making pill-sized robot (beckershospitalreview.com)

              Exhibit C: AI bed management NUHS’s AI platform predicts bed state 2 weeks in advance | Healthcare IT News

              Exhibit D: Robot cleaning crews Cameron employs robots to super clean facilities | Heraldrepublican | kpcnews.com

              The automation trend also means…

              3. Lock in telehealth

              Virtual and remote care are generally cheaper than hospital beds (How to implement a virtual ED in 10 weeks – Wild Health Summits : Connectivity) and more consumer friendly than queuing for in-person care (see The cost and carbon savings of telehealth, quantified (beckershospitalreview.com)). Virtual mental health care, in particular, appears to be cementing its role. However, digital literacy and equitable access to technology, including Internet coverage, can be barriers to care.  Successful virtual care hinges on having accurate information, tools and help whenever needed so…

              4. Maybe it’s time to make new friends

              Difficulty accessing developers and tight tech budgets mean partnering can be the faster (and cheaper) path to product enhancement, in contrast to D-I-Y builds. Which means…

              5. Interoperability is king

              Products designed for integration have a strategic advantage over those that have not committed to interoperability at their core. Speaking the same language helps and Fast Health Interoperability Resources (FHIR) (Welcome to the HL7 FHIR Foundation) are the way to future-proof your health tech. Another interoperability truth is…

              6. Clean data counts

              Making sense out of a hotchpotch of data dropped into a free-text box is time consuming and painful for data analysis. Storing information in a logical, consistent and correctly coded format (MediRecords uses SNOMED CT AU SNOMED CT-AU and Australian Medicines Terminology June 2022 Release | Australian Digital Health Agency) helps the data wranglers do their thing. Quality, clean, actionable data has value and needs to be kept safe because…

              7. Cyber attacks are on the rise

              US data shows ransomware attacks more than doubled from 2016 to 2021 (JAMA Health Forum – Health Policy, Health Care Reform, Health Affairs | JAMA Health Forum | JAMA Network). The UK and Australia are also under siege. Minimising risk is mandatory and, while no system is risk-free, cloud technology allows you to outsource security management and those never-ending software updates so you can concentrate on core business.  This is important because…

              8. Change is gonna come

              Australian governments are still exploring how to introduce systemic change following royal commissions into aged care and mental health services (Victoria). Royal commissions are ongoing into disability, and defence and veteran suicide. The Australian Digital Health Agency is promoting collaboration and reform. NSW is working on a Single Digital Patient Record (SDPR). Victoria is moving toward a health-information exchange system, connected to a statewide Mental Health Client Management System. Queensland is pursuing better health information connectivity and remote monitoring options. Tasmania has a digital transformation strategy underway. There are versions of virtual emergency departments emerging across Australia…

              Buckle up. 2023 could be a wild ride.

              About MediRecords

              MediRecords is a FHIR-enabled, true cloud clinical platform with ePrescribing and telehealth integrations. MediRecords supports GPmultidisciplinary and specialist clinics across Australia and is working with Queensland Health, the Victorian Virtual Emergency Department and the Australian Defence Force on innovative models of care delivery. Please book a demo if you’d like to discuss solutions for your business.

              Want to dive deeper? Further reading below:

              2023 predictions: Health tech suppliers give their verdict (digitalhealth.net)

              What health tech trends CIOs are focused on in 2023 (beckershospitalreview.com)

              Virtual everything, asynchronous care, sustainability: Healthcare innovation predictions for ’23 (beckershospitalreview.com)

              CMIOs on what to project for 2023 (beckershospitalreview.com)

              Digital Health Review of the Year 2022

              MR.R4.CORE\Home – FHIR v4.0.1 (medirecords.com)

              Report: Telehealth accounts for about 10% of outpatient visits | MobiHealthNews

              The King’s Fund interoperability report highlights relationships and tech (digitalhealth.net)

              Russian hacking group ‘KillNet’ targets US healthcare (beckershospitalreview.com)

              2023 forecast: 7 big-picture goals for hospital leaders (fiercehealthcare.com)

              Top 10 hospital and payer trends to watch in 2023 | Healthcare Finance News

              National Digital Health Strategy and Framework for Action | Australian Digital Health Agency

              Digital Health Transformation – Improving Patient Outcomes 2022-2032 | Tasmanian Department of Health

              DOH-Strategic-Plan-Nov-2022-update.pdf (health.qld.gov.au)

              victorias-digital-health-roadmap.pdf

              Single digital patient record set to deliver vastly improved patient experience | eHealth NSW

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                Great New Features Added in 2019

                Great features added in 2019

                Great New Features Added in 2019

                Great features added in 2019
                Matthew Galetto MediRecords banner

                Matthew Galetto

                Here’s a sample of a few of the great new features we added to MediRecords in 2019…

                Patient Engagement

                TeleHealth

                Telehealth Consultations

                MediRecords partners with Coviu to deliver a seamless Telehealth Consultation experience for providers and patient’s. Begin from the appointment book or waiting room.
                2 Way SMS

                2 Way SMS & Email

                Patient’s can confirm appointments direct from an SMS or Email appointment reminder. Updates are then reflected in your practices appointment book in real-time.

                Improvements to your day

                Simplified Claiming

                Simplified Claim Resubmission

                Resubmitting a failed claim has never been simpler. MediRecords users can now edit and resubmit rejected invoices directly from the claiming dashboard.

                The originally failed invoice is archived and the appropriate adjustment made.
                Appointment Enhancements

                Appointment Enhancements

                MS’ sent from the appointment book can now be non appointment related. You can free text the content or simply select another SMS template to be used.
                Your SMS balance is now visible from this screen so you can text and send with confidence.

                Partners & Integrations

                Clinivid Logo
                In August this year, MediRecords partnered with Clinivid to provide a secure alternative for mulotidisciplinary care teams to communicate, share advice and files for improved holistic patient care.
                StanfieldIT

                Stanfield IT

                MediRecords partnered with Standfield IT in September to help practices leverage the best technology has to offer and bring their entire practice operations to the cloud. No more servers, no more paper just 100% pure cloud
                Matthew Galetto MediRecords banner

                Matthew Galetto

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