eHealth News, South Africa

Worcester Hospital: the Country’s Unsung eHealth Centre of Excellence?

Worcester Hospital has undergone extensive eHealth refurbishment over the past year to improve administrative efficiency in numerous clinical departments.

Worcester Hospital - EHN

Worcester Hospital in the Western Cape has undergone extensive eHealth refurbishment over the past year to improve administrative efficiency in numerous clinical departments.

Head of the Clinical Unit in the Department of Surgery at Worcester Hospital, Dr Riaan Duvenage, is the mastermind behind the eHealth project. He started developing an electronic administration system for the hospital’s Surgery Department in 2006, and has since been managing, updating and extending the use of the interactive surgical clinical portal to other departments.

eHealthNews initially reported on Dr Duvenage’s innovative work in July 2014 where he explained how his eHealth system has benefited his department and shared his plans to duplicate the system in other departments of the 277 bed general specialist hospital. Fast forward to over a year later and there has been significant progress.

Worcester Hospital

Dr Riaan Duvenage

Since the beginning of January 2015 Dr Duvenage has customised online operation reports for the Surgery, Gynae and Orthopaedic Departments that allow surgeons to enter the operation report onto the system and send it to the consultant. All the information is automatically stored in the database and can be accessed via a searchable web frontend.

Dr Duvenage recently rolled out live dashboards for the same three departments. “Several clinical and demographic parameters, which we are required to monitor, are displayed in real-time on the dashboards. The graphs are updated from the databases each time the live stats or dashboard page is opened and is current up to the last entry, which essentially means up-to-date live data,” said Dr Duvenage.

“For example, we can now, in seconds, check on trends in a number of operations: where patients are referred from, outcome of admissions and various other parameters,” continued Dr Duvenage.

Another recent addition to the eHealth system is a web-based emergency theatre list. “We implemented a 24 hour emergency theatre on the 1st October 2015, and to ensure correct and fair use by all specialties, I’ve adapted the Provincial Emergency Theatre Triage system for online use,” said Dr Duvenage.

The system allows users to book patients on the emergency list from their smartphones via a QR code, eliminating the need for them to physically go the theatre or phone in order to book emergency theatre cases. “Data validation ensures that correct patient details and triage colour are indicated. Once submitted, the new booked case appears as “pending” on the theatre list, which is displayed on several monitors in our operating rooms,” said Dr Duvenage.

Once the operation has been done, the surgeon is directed from the online operation report, back to the emergency theatre list, to edit the case to “completed in emergency theatre” or “completed on another list” or “cancelled”. All the data is stored on a database and is also displayed graphically on a dashboard in real-time. This makes audit of the emergency theatre use very easy and quick,” continued Dr Duvenage.

To ensure compliance and to enable easy documentary proof of compliance with the Surgical Site Infection (SSI) bundle of the DoH’s Best Care Always policy, Dr Duvenage adapted the hospital’s operation reports to include several SSI-specific parameters, such as intra-operative normothermia, shaving of patients, use of prophylactic antibiotics, etc. All of which are also displayed on live dashboards.

Dr Duvenage has also developed online management tools for the hospital to streamline the Head of the Clinical Unit’s (HCU) monthly data submission for the Provincial Annual Operational Plan (AOP). “In the past, a spreadsheet used to be e-mailed to everyone, who then entered specialty-specific parameters on the AOP.  All these spreadsheets were then sent back to an admin clerk, who copied and pasted to reconcile the data into one final spreadsheet – a process that often took several days,” said Dr Duvenage.

“Now all the HCUs can enter their AOP data into a web interface, which is instantly accessible to the CEO and admin staff.  So they now no longer need to e-mail a spreadsheet around,” continued Dr Duvenage, who is also working on a few other tools to monitor compliance with HR documentation.

Lastly, Dr Duvenage has created web-based call lists for all specialties in the hospital, which is essentially an online calendar that shows which specialist and medical officer are on call on any given day. “Leave is also indicated, which makes leave management more effective,” said Dr Duvenage.

The advantage of a web-based call list above a printed one is that it’s updated in real time as people swop calls, ensuring that the correct call list is displayed at all times. It’s also accessible to all our referring hospitals, which makes patient referrals much easier,” continued Dr Duvenage.

Dr Duvenage’s work has been recognised by other hospitals in the region, and as a result he been sought out to develop a basic online clinical documentation system for the Department of Surgery at Mitchells Plain Hospital, which is expected to roll out next year. He has also been approached by the Anaesthetic Provincial Governing Committee to assist in developing a web-based Anaesthesia adverse event reporting system, abbreviated as ASPIP.

“This will also use a QR code, which can be displayed on all anaesthesia machines. If certain adverse events occur, the anaesthetist can simply scan the code into a smartphone and enter data. This is then sent to a database as well as the project manager of ASPIP,” concluded Dr Duvenage.

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