Towards Sustainable Health Care
Health care will experience unprecedented demand pressure over the next 30 years. Key causal factors include:
- Age related illness exacerbated by generational shifts in the population
- Rising burden of chronic disease driven by life style factors and environmental degradation
- More severe pandemics as antibiotic effectiveness reduces
In Australia the ageing of the population alone will see the proportion of complex, multi comorbid patients rise by 3-4 time by 2040 based on the Australian Bureau of Statistics projections. These factors in rising health care demand is common across all Western countries that experienced the post-war “baby boom”.
For Western health care systems to be financially sustainable more health care delivery must be delivered effectively in the lower cost primary and community settings, with hospital service reserved for the most serious and complex cases. Smart systems are urgently needed to facilitate continuing improvements in workforce productivity and the assignment of patients to the most cost-effective service delivery point, with care integration across all services.
Alcidion has been working with innovative health care providers and funders to implement systems to support hospital avoidance and community care. Capabilities include:
- Determination of candidate eligibility for transitional, community and home care from the Emergency Department or Inpatient Units
- Assessment of risk and complexity to assemble the right resources to implement hospital avoidance
- Construction of multi-comorbidity, multidiscipline care plans that are individualised to the patient
- Integration of care services between allied health providers, out of hospital care, outpatients, specialist clinics and hospitals
- Communication of care plans to GPs and members of the care team
- Monitoring service delivery in the community to prevent logistic errors
- Assessments with decision support for community service providers to detect worsening condition, and to activate action plans to reduce avoidable admissions
Support for New Models of Care
While there is wide agreement that hospital avoidance and community-based care is the path to a sustainable health care system, the ideas are still evolving on exactly how it will be implemented and funded as part of everyday health practice. Furthermore, there are changes ahead in the national infrastructure for e-Health in many countries.
With so much to learn it is important to build upon a solution that is flexible, uses open standards, and that can evolve with the changing models of care as lessons are learned. Alcidion has experience in delivering IT solutions for integrated care, and a track record in ensuring that the Miya Platform is able to assist care teams in the community to deliver efficiently a high quality of service to those with chronic conditions.
The following diagram is a high level map of processes involved in integrated care, with notes on how the Miya platform supports each step of delivering integrated care.
Miya for Integrated Care
Electronic Health Record
The Miya EHR is a modern, scalable and accessible platform for storing clinical data no matter from where it is generated. Alcidion has experience in integrating multiple data types into the Miya EHR from different vendors. The Miya EHR is a flexible data store that can be accessed from the Miya Clinical Dashboard, web pages, and mobile devices. It’s your data, you should be able to access it securely in any way that improves patient care.
In contrast to other clinical data stores on the market that simply aggregate data, the Miya EHR is designed for integration with decision support and its specific needs. Any structured data in the Miya EHR can drive decision support to monitor for unhandled risk, assess patient progress, automate tasks and alert clinical staff before preventable patient harm occurs.
Avoidance
By monitoring every patient’s EHR, the Miya’s Decision Support Engine can identify avoidance opportunities and notify the right care team members to evaluate candidates for hospital alternatives. This can be as simple as identifying patients presenting with particular conditions who have had previous care coordination, or more complex involving matching care packages to potential candidates.
Smart Forms
Alcidion’s Smart Forms technology drives Miya Checklists and Guidelines. These interactive forms support numerous question types and sophisticated branching logic. Use Smart Forms to implement national or local best practice guidance at the point of care, health assessments, and reminder checklists. The system is designed to be fast to use, has a full audit trail, generates clinical documentation and can automate tasks such as ordering. Checklists and guidelines can be implemented at triage, registration, diagnosis, discharge, or in response to clinical conditions.
View Screen
Gateway Services
Miya can prepare messages for delivery to GPs and community providers. The Miya Gateway gathers relevant data, formats information for the specific recipient and delivers messages to numerous GP messaging systems, or directly through encrypted email or SMS. Miya Gateway also supports capturing referrals from the community to hospitals or care centres. Referrals can include Smart Forms for risk scoring or eligibility assessment.
Care Plans
Miya Care Plans are a sophisticated system for managing complex patients. The Care Planning system generates patient-specific care plans, including multi-comorbidity patients that require merging harmonisation of care plans. Miya Care Plans monitor for clinical activity, assist in scheduling appointments, and monitoring for care plan compliance.
Notifications
Messages to allied health, referrals and any other member of the care or hospital team are sent via Miya and tracked for follow up. Reminders can be escalated to ensure patient flow is not compromised. Workflow steps can be configured for each type of notification, e.g. radiology order status, transport, cleaning.
Portal
Get risk rated information, notifications, tasks and results from web browsers and mobile devices inside and outside the hospital. Miya Portal uses the latest web technologies to create a highly visual and responsive experience for modern web browsers and mobile devices. (Coming soon)
Alerts & Decision Support
The Miya Decision Support Engine (DSE) monitors all data flowing through the system and can trigger alerts and notifications. We call this active monitoring. Miya plays an active role in supporting clinical staff. The Miya DSE can be configured to monitor and alert for clinical and organisational risks.
Patient Outcomes
Miya Patient Outcomes monitors outcome indicators, observations, lab results and assessment scores and displays them so clinic staff can quickly see how a patient is progressing. Units can set thresholds for alerts or notifications to parts of the clinical team to monitor key outcomes and automate workflows. For example, if a patient on a high risk medication that develops signs of renal impairment then this is displayed on the Clinical Dashboard, and can generate notification to the unit pharmacist to review medications.
