3 Key Learnings from Implementing HITH at St. Vincent's Health Network Sydney
Transforming Healthcare with Digital Solutions
In the fast-evolving world of healthcare, staying ahead means continuously refining how we deliver care. One of the most rapidly adopted initiatives to come out of recent years is the Virtual Hospital in the Home (vHITH) model.
At SVHNS, the vHITH program leverages CareMonitor as a Community Electronic Management Record (cEMR) platform. Madison Stone, Virtual and Digital Health Manager at St. Vincent's Health Network Sydney (SVHNS), and Deepak Biswal, Founder and CEO of CareMonitor, shared their insights from implementing Virtual Hospital in the Home (vHITH) at SVHNS during their presentation at the Digital Health Festival in Melbourne.
In this article, we share the three main takeaways from SVHNS and CareMonitor's implementation partnership to give you a head start in your own transformative digital healthcare initiatives.
Key Learning 1:
You Will Encounter Resistance
Building Organisational Capability
Implementing any new technology in a healthcare setting is bound to face resistance, and HITH was no exception.
When SVHNS decided to roll out this innovative model, they knew it would take time, energy, and effort to build the necessary capabilities within the organisation. Clinicians, who are focused on delivering care, often find it challenging to invest time into learning new systems unless they see the clear benefits.
Securing Executive Buy-In
Madison and her team quickly realised that securing executive buy-in was critical. Initially, the project was perceived as a small-scale initiative, focused solely on HITH services with a 30-bed base. However, to ensure its success, it became evident that the project needed to be recognised as a business priority, requiring comprehensive executive support.
Creating Governance Structures
Strong governance structures played a pivotal role in driving the project's progress. Establishing an executive steering committee and a dedicated working group for remote patient monitoring brought together essential stakeholders. These structures enabled the organisation to assess impact, evaluate risks, and make informed decisions, fostering a sense of inclusion and managerial support crucial to the project's success.
Key Learning 2:
Data Integration Is a Challenge
Data integration is really important, particularly when various systems are in place but it’s also hard. The SVHCN and CareMonitor teams worked together to meticulously determine the key requirements essential for successful system integration. Acknowledging the complexity and time-consuming nature of data integration at the outset, they persevered through the challenges, which ultimately proved worthwhile.
Data Discrepancies
Upon reviewing the vHITH data, particularly during the COVID period when CareMonitor was used as a standalone platform, a significant discrepancy of 899 records was discovered between vHITH admission data and the profiles created in CareMonitor. This discrepancy highlighted several challenges faced during the integration process.
Challenges and Source of Truth
One of the substantial challenges was identifying the correct source of truth for patient data. There was confusion among clinicians about whether the information in CareMonitor or the PAS was accurate. This confusion impacted the integrity and accuracy of patient data. It's important to know what the source of truth is, which system is going to ride over which system, and to have a structure and plan for maintaining data integrity among the multiple systems.
Resolution Through Integration
The integration successfully solved the problems of data discrepancies and source of truth confusion. Now, two systems communicate seamlessly, with PAS established as the single source of truth. This integration has significantly improved the safety and quality of remote patient monitoring by ensuring data integrity and accuracy.
Key Learning 3:
Use the Solution Before You Change It
Initial Reactions to System Changes
Initially, the urgency to address the pressing needs of COVID-19 patients led SVHNS to implement changes rapidly, often without thoroughly testing all functionalities. While this immediate response was necessary, it also led to unforeseen challenges and the need for rapid adjustments.
The Shift to a 'Watch and Wait' Approach
As the urgency subsided, SVHNS transitioned to a more deliberate approach. The team began prioritising a 'watch and wait' strategy, allowing them to observe how the platform performed with its default settings before making any custom modifications. This shift enabled them to uncover the true capabilities of the system without the complications of hastily added features.
Benefits of the Deliberate Approach
By adopting the 'watch and wait' method, SVHNS realised several benefits. They found that many initial perceived needs were addressed by existing functionalities, avoiding unnecessary changes. Furthermore, this approach facilitated more thoughtful and efficient task prioritisation, leading to improved project outcomes and better stakeholder satisfaction.
WATCH: 20-min co-presented session at Digital Health Festival, 2023. Deepak Biswal, Founder and CEO CareMonitor & Madison Stone, Manager, Virtual & Digital Health Team St. Vincent’s Health Network Sydney.
St. VINCENT’S HEALTH NETWORK SYDNEY x CAREMONITOR: SHARED CLIENT/ PLATFORM PARTNER LEARNINGS
Insights
Building Trust and Credibility
Building trust and credibility within the organisation was essential. Deepak emphasises, "Any technology implementation is a partnership. It was incumbent on us to support Madison in building that trust and credibility within the organisation." This support was provided by working in an agile manner, responding swiftly to evolving needs.
Enhancing System Capabilities
The transformation from the initial state to the current robust system reflects a monumental shift in how patient data is recorded, handled, and accessed. This change has not only enhanced current service delivery but also set the stage for future advancements, providing a solid foundation for ongoing improvements.
The system integration work has yielded substantial results. Initially, there was a significant discrepancy of 899 records between actual VHITH admissions and the profiles in CareMonitor.
This discrepancy arose due to the absence of PAS (Patient Administration System) integration, necessitating manual creation of patient records. Consequently, inaccuracies in patient demographic information were common, and clinicians lacked comprehensive patient information. This issue undermined the integrity of clinical records, as there was no single source of truth between PAS and cEMR.
The integration has since rectified this problem. With CareMonitor records now unified with the PAS as the single source of truth, up-to-date vHITH records are accessible anywhere at any time, improving both safety and quality of care while improving data integrity and reducing risk.
Defining Success
While metrics are often used to define success, the most significant achievements transcend data. The transformation from the initial state to the current robust system reflects a monumental shift in how patient data is recorded, handled, and accessed. This change has not only improved current service delivery but also set the stage for future advancements.
Future Directions
The focus is on chronic disease cohorts within the HITH service, building trust and credibility with clinical teams while fostering a digital mindset across the organisation. Embracing the digital era in healthcare is essential for ongoing improvements and innovation.
Conclusion
Implementing HITH at SVHNS has provided valuable insights into the challenges and strategies involved in digital healthcare transformation. By understanding the resistance to change, addressing data integration challenges, and adopting a deliberate approach to system changes, SVHNS has successfully enhanced care delivery and set the stage for future advancements. For healthcare professionals looking to integrate digital health technologies, these key learnings offer a roadmap to success.
Interested in exploring the potential of digital health technologies further? Get in touch!
The future of healthcare is digital, and together, we can achieve remarkable outcomes.