Student Dissertation

Agency : Hospital Information System; Patient Administration System; Hospital Automation

Objective : • To determine the key drivers and motivation behind CDHB’s initiative to allow greater hospital automation by replacing its legacy Patient Administration System (PAS) • To evaluate the tangible benefits CDHB has already achieved (or will achieve) by replacing its legacy PAS by plotting the: -> Patient volumes in IPD vs OPD vs ED (Patient Demographic Study) -> Total turn-around time for a patient (admission all the way through to discharge) in OPD, IPD and ED visits during all the -> Variance in the total cost borne by the hospital before and after the adoption of Orion Health Enterprise HIS after the adoption of Orion Health Enterprise HIS

Background : An elaborate 30-60- 90-day upskilling approach was employed at Orion Health that involved: • Induction into the organization and extensive training in Orion Health Enterprise Hospital Information System (HIS) followed by • A 2-day visit/workshop to two hospitals in Canterbury District Health Board (CDHB) i.e. Burwood Hospital and Princess Margaret Hospital located in Christchurch, New Zealand. • Hospital visit/workshop involved a thorough tour of the hospital, detailed discussions with hospital staff and patients, evaluation of how efficiently and HIS was operational in the hospital and finally • Collection and analysis of data collected during the 2-day visit, drafting conclusions and recommendations

Methodology : Study Area: Conducted on 2 hospitals in Canterbury District Health Board (CDHB) – Burwood and Princess Margaret Hospital in Christchurch, New Zealand Type of Study: Retrospective Cohort Study Duration: Complete duration of the study was from 5th February 2018 until 6th April 2018 (incl. visits to Burwood and Princess Margaret Hospital on 9th and 10th April 2018 respectively) Type of Data: Primary data which is defined as data used in research originally obtained through the direct efforts of the researcher through interviews and direct observation. Sampling Technique: The Audited record of patient visits for the following three periods: • 2nd February 2015 until 27th November 2015 • 29th July 2016 until 28th July 2017 and • 7th July 2017 until 30th March 2018 with a specific focus on the following ? Patient volumes in IPD vs OPD vs ED (Patient Demographic Study) ? Total turn-around time for a patient (admission all the way through to discharge) in OPD, IPD and ED visits ? Variance in the total cost borne by the hospital for each of the periods above Tool for Data Collection: Orion Health Enterprise HIS software - provision of a laptop with all the required software’s installation and training for complete installation of the Orion Health Enterprise HIS. An investment of 2 weeks of the time during the internship to learn about the software was scheduled so that I am well-versed with the intended use of the software. UX Wireframe, mock-ups and Proto-typing – A methodology used within Orion Health where User Experience (UX) design team constructs a series of software screen mock-ups and collects user feedback to evaluate the suitability of the screen Microsoft suite namely MS Word, MS Excel, MS PowerPoint, MS Visio Flowcharts and workflow diagrams on MS Visio Atlassian JIRA (Configuration Management Tool) Google Docs and Spreadsheet Mac Numbers (Analogous to MS Excel in Apple MacBook) Data Source: Complete patient workflow explained (from admission all the way through to discharge) in both the hospitals. Introduction to all the hospital staff responsible for various stages of the patient journey through the hospital e.g. front desk clerk, nursing staff, clinician, pharmacist, radiologist, lab technician, IT help desk, etc. Explanation of their roles, work-procedures during emergency hours, manuals they use when the hospital is switched to a manual mode Exhibition of how Orion Health Enterprise was operational at various kiosks, on front desk reception, in radiology rooms, operation theatres, etc. Interaction with the patients to understand their experience on a regular day to the hospital

Findings : Following were noticed as key benefits of Orion Health HIS adoption by Burwood and Princess Margaret Hospital: Better patient schedule management Easy patient record accessibility Patient record safety Less human errors Better coordination between hospital departments Better resource utilization Better operational efficiency Valuable insights for senior hospital management HIS adoption is valuable for hospitals of all scales

Recommendations : Adoption of Orion Health Enterprise HIS was clearly a wise decision and led to Better patient experience and fewer grievances/complaints Considerably higher return on investment that allows CDHB to invest in other key healthcare areas Better monitoring of hospital performance and availability of hospital reports for hospital management staff Transition to a HIS with higher level of automation was successfully achieved by CDHB