NSW Community Health Review

 
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Q6-Please make any comments about the value of and/or improvements to Community Health information systems and information management

  1. User friendly. Able to obtain useful data
  2. The implementation of a statewide information system which is available to all CH workers would be the ideal. CHIME has been partially rolled out but has limited access because of agreements between CHIME and the end user. This is not satisfactory. One assessment only for any client accessing the health system for the first time!!!!!!
  3. Availability of community health information systems and information management publications are limited, so, therefore comments are not backed by perusal of same.
  4. Rural is still paper based and has separated record keeping by different clinicians. Inadequate whole-of-life information available.
  5. Many community based services lack access to computers and information systems
  6. Hard to comment given little progress seen to date with inconsistent approach state-wide and reduction in budgets making it difficult to progress with what is required/needed.
  7. One system please that arrives not more promises and hot air!!
  8. The Community health systems need to be linked to the hospital systems. If a client is in hospital, has an alert etc, these things should be automatically flagged on community systems. Community systems need to be able to collect data, develop reports, send reports electronically, improve communication between stakeholders eg GP, other services, specialists, other health workers etc. The technology is there to improve communication systems, but it appears no one is willing to spend the time or dollars to improve the systems - it is in the too hard basket.
  9. Continuation of the rollout of CHIME or its expected replacement due in 3 to 5 years. Rollout made mandatory for all Area Health Services with funding to do so from NSW Health. Where CHIME has been implemented it has had significant benefits in coordination of care for clients; eg ACAT, Community Nursing, CAPACs etc are able to read each others clinical notes across multiple sites and locations. The current iteration of CHIME does lack some functionality such as ability to easily attach PDF files, scanned notes. Current clinical note editor needs the ability to have form controls to enable smart forms. Usability issues need to be resolved such as management plan functionality and scheduling function added to diary.
  10. The State needs one data base that is a surveillance and recall system. This will assist with early identification and intervention. a care plan assigned at birth, that lasts a lifetime.
  11. Health information systems need to be shared across the state to reduce duplications and improve treatment
  12. Community Health would benefit from a fully functional integrated inefficient information system that could be used by all services for the benefit of the clients to streamline service delivery and prevent duplication of services, However to my best recollection that has been the aim since the early 80s
  13. Having access to clients notes that have just come out of hospital would be of great benefit, like a follow through or continuation of a service to the client.
  14. Community Health services should all fit under the same governance arrangements in Area Health Services and have clear lines of accountability to the Area Executive. Sexual Assault and Child protection Service require Area based coordination through an Area Manager.
  15. A statewide information system that is implemented across all areas to assist in improving the management of information
  16. This would be extremely valuable and data systems should be statewide like Department of Community Services and NSW Police. Need electronic files like Mental Health have so that accurate statistics can be extracted. Need a proper system for recording data about children in out of home care and 'family' files. Policies about record management need to be statewide.
  17. A standardised CH information management system is the lynch pin to ensuring that clients can be provided with holistic, integrated care that involves if necessary clinicians, GPs and external agencies i.e. community transport. Will also allow clinicians to focus on delivery of services and not meaningless data collection. Data collections should be reviewed to ensure that it is appropriate meaningful and reflective of the clinicians service delivery. Funding opportunities could then be supported with real and meaningful data.
  18. Information systems need to be networked with the tertiary care environment so that information about clients/patients is able to be accessed at all levels of health service for seamless care provision
  19. If we are going to spend time doing surveys they need to a least be meaningful! What do we do with the results, do we change practice because of that information, if the investment isn’t there to change the system it is a waste of time.
  20. Too much time needed for administration and not enough time for clinical work.
  21. Improvements are needed in the interfacing of the various forms of data management. There seem to be so many electronic data capture systems in use that workers need to be experts in every system, with the systems being poor in reaching across system type.
  22. The CH information system should as a basis include, the usual demographic details, reason for service, what is the service provided, the time it takes including travel time (relevant in rural areas), It should be electronic, palm pilot type interface, perhaps connection to main computer to download data collected at time of service.
  23. Need to enhance staffing levels in line with population growth and demand. Current focus is on hospital/acute services rather than prevention and/or longer term investment in other issues
  24. There are currently a number of information systems operating across Community Health Centres eg. CHIME, ACCESS. There is no one system that can retrieve information with the press of a button. An example where this is problematic is when other agencies such as DoCS require information about a client through the use of a S248, and it cannot be obtained in an efficient and timely manner. If there were one system operating throughout an Area at minimum, this could add value and service.
  25. more storage space required. Electronically based MR system so all information pertaining to client can be accessed.
  26. incorporate a mechanism for mobile phone text message appointment reminders in subsequent editions of CHIME and CERNER
  27. A system is need which provides useful data, is standard across the state so all data is the same. Is easy to use. Can contain the entire record, including digital input (photos, voice recordings) Interfaces with other systems, eg IPM, other services databases so staff do not have to double enter.
  28. Computer based client record systems are a fundamental misuse of clinician’s time - reducing client services by 10 to 25%. If you want it to work then increase admin support and clinical support staffing (eg Allied Health assistants)
  29. CHIME sucks, it is an appalling indictment on health management that such a clumsy, ineffective and user-unfriendly piece of software can be promoted as a solution to anything.
  30. CH information urgently needs to interface with GP and hospital information
  31. In consultation with community health workers, develop an information system that records relevant information and can be used to generate statistics about service provision.
  32. It is important that information systems communicate especially between GPs/Hospitals and community health services.
  33. I believe that Department should make a decision as to what system is to be used instead of allowing individual AHS to determine their preference, This will continue to impeded effective and efficient communication systems
  34. Easy (not to time consuming for clinicians) and well structured IT system consistent across all services, which will allow for data gathering as well as evaluation of treatment/services offered, would be beneficial.
  35. consistent data systems and management.
  36. useable information that is extracted to inform and confirm practice
  37. File systems need to be electronic and linked with hospital files eg like Westmead Children's hospital
  38. As the current DATA system doesn't seem workable, scrap it and install something which is. A year ago I had 1 page of monthly stats in paper format. Now I have daily computer entry, 2 paper format forms and 1 weekly paper form. Its very demoralising having to allocate so much time to the collection of these stats. They will never correlate to each other as the questions are all different.
  39. Should be the same/format procedures for all centres. All centres should have voice mail. Lack of basic facilities/resources to give service, eg often no cars so staff have to cancel full day of appointments at outlying centres. Bad time management to attend meetings when 3hrs travel each way involved, not allowed to stay over night. Make use of teleconferencing which all outlying areas have access to - city people to have a better idea of distance for rural people and realise the advantages of teleconferencing and time saving. The staff dealing with the public are an asset lets make their work life easier not petty stuff such as no paper-haven't paid bills, no plumber etc.
  40. Include the ability to identify people experiencing homelessness.
  41. A state wide IT Information system is badly needed. How can CH justify its position when data is so poor, systems so poor, user support so poor? Current systems are not robust or indeed valid when individual interpretation can be so vast. Real concrete, validated information will allow CH to literally stand up and be counted in real terms as to the values, and true workload that most clinicians undertake.

  42. Community Health appears to be neglected in favour of hospital based spending.and or budgets As a profesional clinician. eg. I have been denied personal access to internet due to cost.$200?? This makes it very difficult to provide a professional service to clients.

  43. It woudl be very useful to have a universal infomation system

  44. CHIME is really useful, very happy with CHIME, fast, efficient, provides useful and meaningful data.  Assists to manage the client record and have easy access to clinical notes from other disciplines etc (when relevant to the care you are providing)

  45. need to be able to have systems that talk to hospital systems - eg CHIME and Obstetrix

  46. Very important.  Need unique patient/client identifier and common IT infrastructure to manage IM and client files.

  47. I think efforts are being made to ensure the most efficient systems are becoming available. Inconsistencies exist accross AH's.

  48. CHIME is fabulous and really helpful in collating the data for subsequent analyses.  It is also great in terms of housing a clients medical records, it is easy to see what other services have been accessed, treatment provided etc and vastly improves continuity of care - avoids duplication.

  49. Making communication standard and accessible throughout community and

  50. They are woeful at present. We need a flexible system that delivers all the criteria we need to report on for specific program funding

  51. these need to be managed by information specialists. They are becoming too  complex and intrusive on clinical /professional service delivery. They do not currently get accessed effectively for practice improvement or service delivery decisions in my 25 years community health experience.

  52. IT systems have slowed intake processes and increased waiting time for patients to be seen by community nurses. Not helpful at all unless all community nurses have immediate access to new referrals by having their own computer (laptop) and access in their vehicles.

  53. access to  adequate clerical staff to support systems and   IT systems that work in multipe sites/settings

  54. Get rid of CHIME as clinical nurses spend TOO much of their time filling it in when they could be attending to the clinical needs of patients.  I have been told as much as 2 hrs per shift is spent on this antiquated system.  2 hrs per nurse per shift is a lot of clinical hours when you do the maths.

  55. This is vital. No need to explain, it's as important as info systems in the hospitals! Needs to reflect the value of the different ways of working in CH, eg health prromtoion and communty development, not just to do number-crucnhing OOS. There needs to be a way of describing the  "non-bums on seats" work.

  56. Information management needs to be less time intensive and m,ore ofcused on measuring client outcomes

  57. good data collection, intergrated information sharing and efficent upto date information across all health and community care services

  58. Paperwork and reporting takes up a large amount of clinical time and reporting requirements are contiually growing. It would be useful to reduce the amount of time spend on this.

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