General

An Electronic Medical Record (EMR) is a system to document, manage and store relevant health information for our patients. The EMR will replace paper-based records in inpatient services across Northern Health. Our Northern Health EMR is different to My Health Record, which is the federal government’s online summary of a patient’s key health information. Our Electronic Medical Records system is our own enclosed system.

This is an opportunity to use technology to improve the patient and consumer experience and the quality of care we provide. Our Electronic Medical Records enable us to do this by ensuring information is accessible, up-to-date and secure. The implementation of the EMR will also bring Northern Health into line with other public hospitals in Victoria.

No. My Health Record is the federal government’s online summary of a patient’s key health information whereas our EMR is for Northern Health only.

Just like with paper records today, a patient can access their electronic medical records via a Freedom of Information (FOI) request. We are not implementing a patient portal at this stage.

No, our Electronic Medical Records system is our own enclosed system. Only Northern Health employees involved in a patient’s care will have access to that patient record. In some certain circumstances, there will be read-only access provided to external clinicians e.g. community based clinicians managing mental health consumers.

GPs will not have access to our EMR system; however, we will be able to send some information electronically from our EMR with GPs for certain information (e.g. referrals and discharge summaries).

Staff will be able to do more in the EMR than they can do today in CPF. The EMR will allow clinicians to electronically prescribe and administer medications, request pathology and radiology orders and view results. There will be decision support tools to help clinicians with decision making. CPF will continue to be a repository for scanned paper documentation and will hold historical information on the patient entered before Q2 2023.

A Digital Medical Record essentially holds paper forms in a digital format. Implementing a DMR is usually a stepping-stone to an Electronic Medical Record, which offers more functionality.

Historical results will be migrated into the patient EMR record. We are migrating, 2 years’ worth of pathology from the Laboratory Information System (LIS) and 5 years’ worth of radiology results from the Radiology Information System (RIS) to the EMR.

You can access our EMR Glossary here. If there is a term that you can’t find in the glossary, please contact Ginnie.Leung@nh.org.au.

We will access the EMR via our Favourites link at this stage, we are investigating if it is possible for us to access the EMR via a on the Intranet site

A Code Yellow will be called if the downtime event is deemed to significate. If a Code Yellow is called, then instructions to return back to paper will be given. For critical areas like ICU and ED, they may be instructed to go to paper straight away. We are working with the business to ensure there is a plan in place.

External paperwork will still need to be scanned into CPF, and clinicians will need to reference this in their EMR documentation.

About the EMR and how will Northern Health utilise the system

No, Northern Health will be paper light instead of paperless. Some documentation will need to remain on paper because it is for the best interest for our patients, for example Code Blue documentation. Post go live there will be ongoing opportunities to optimise the system and continually incorporate more paper-based workflows.

Information is held in the EMR ongoing and can be accessed and updated at any time. Some information is encounter specific, so per visit. Every admission of the patient will only display when that encounter is selected, while other information will flow across encounters. There will be a ‘results review’ page where you can look back at historical results for the patient.

Yes, Maternity in the Home will be included. Chemotherapy in the Home is still under discussion and we will keep you updated when we have more information. The EMR team are currently putting together a paper that will discuss the possible process for HITH, MITH and Chemo in the Home.

The community client episode for Dialysis will be an open encounter and will be managed in the EMR Dialysis nursing staff will be able to go into their community client episode, where the patient’s dialysis treatment order, drug chart, pathology orders and results will be available. The EMR will alert staff that they have selected the Community Client encounter giving them an opportunity to cancel or continue.

The management of the encounter for HITH to Dialysis, in iPM, will remain unchanged.

We are working towards managing blood products on the EMR, it is a complex process and very dependent on our current pathology system. We will provide further information once we have worked through the workflow for the ordering and administration of blood products.

Yes, referrals will be placed in the EMR instead of HealthPower and we will be able to indicate the level of priority – the Allied Health team are currently building this out in the EMR.

Yes, you can prescribe medication to patients using the system for both inpatient administration and Discharge Prescriptions. For Discharge prescriptions the EMR system will  provide aprintout of the prescription, which can then hand it to your patients, where they can collect the medication in the pharmacy.

Ordered This status includes the initial status of a new order.
Scheduled This status identifies orders that qualify to be scheduled to a future collection list.
Dispatched The status identifies orders that are ready for collection.
Collected This status identifies orders that are marketed as ‘Collected.
Complete This status indicates that all pending (required) results for the orderable item have been verified.
On Hold This status indicates that an order has been missed for collection or is a future order. Orders with a ‘Future Order Status’ will have an ‘On Hold’ department order status.

Message Centre, primarily a medical staff member’s landing page (the first page you land after logging in), can be used for results endorsement, reviewing co-signed medications e.g. nurse initiated medication or pathology orders, as a communication tool between clinicians, management of saved documents, and notification of patient admissions if required.

Initially not all forms will be in the EMR but over time, we will transition them across as part of the optimisation phase. The data we collect in our forms today, and the form’s function will be included in the EMR design however paper-based forms are not recreated in the EMR as ‘like for like’. This requires a change in mindset for most of us as the EMR is workflow based.

No, the EMR doesn’t track the patient. It just reflects where they are currently admitted and which clinical unit they are under, for example, if a patient is admitted to Ward 6 Bed 8 but they have gone to radiology, then the EMR will display Ward 6 Bed 8 in the banner bar and not Radiology.

Yes, you will be able to interact with the patient journey board across all sites. You will either have to be on the Northern Health network or use FollowMe Desktop.

You will be able to conduct a UR search on EMR to locate the patient once we go live.

Clinicians delivering care to our patients out in the community will not use the EMR when we initially go-live, largely due to technical and equipment constraints. There may be some clinicians who will document in the EMR when they return back to their health service.  We are currently working through how this will work. All inpatient documentation can still be access by community staff. 

Alerts and Allergies will be documented in the EMR. All patients will have Allergies recorded, e.g. no known allergy.

Alerts and Allergies will be updated in CPF when they are recorded in the patient’s EMR chart. It will display minimal information (allergies name and category), so if the clinician needs to know additional information, they should return to the source of truth, which is the EMR.

Yes – any override will be registered in the system.

VVED staff will use a small portion of the EMR for patient documentation. We are at the final stage of validating the EMR workflow for VVED. More details to come.

Northern Health EMR is built according to our workflows, policy and procedures. Although the build can be very similar to other hospitals that use Cerner EMR as well, there will be slight differences, which is why attending training is critical.

Device and Equipment

Yes, the EMR team is currently working on the strategy and procurement plan for the equipment and devices that staff will need to use the EMR. The team is also making an assessment of what will work best in each clinical location to make sure the type and placement of equipment is safe for patients and staff.

If a current computer is due for replacement, this will be part of our ICT swap over program. All computers and equipment are being assessed and may be replaced for the EMR.

Yes, the clear resolution of images is part of our equipment and device assessment criteria. 

The EMR team will cater for both in the selection of scanning equipment.  

Yes, there will be a pool for additional equipment and devices in the case of breakdown and we are making sure our suppliers provide very quick repair.

Yes, we will have equipment and devices for medication administration at the point of care, including barcode scanners and workstations of wheels (WOWs) with medication drawers for dispensing medication at the bedside in inpatient areas.

No, they will not have handheld devices. However, they will document in the EMR using workstations on wheels at the bedside.

As part of the EMR rollout, we will be providing clinicians with equipment and devices to be able to document in the EMR. Clinicians will be able to use the EMR on their own devices if they are connected to the NH network.

Yes, clinicians will be able to use the EMR on their phones, tablets, and laptops if they are connected to the Northern Health network. However, although this is technically feasible, the display will be small on a phone and the optimal way to use the EMR is on a NH full-screen device. 

Staff will use their swipe cards to access the EMR. It will be a ‘tap on tap off’ process for most staff. Some staff may be required to use network logins to access the system.

System integration/ migration

PowerChart is the general inpatient and outpatient application that will allow the clinician to review the patient chart and complete inpatient/outpatient documentation, orders including pathology, radiology, medications and patient care orders.

FirstNet is the Cerner information management system designed for Emergency Departments to manage workflows from triage through to admission or discharge.

SurgiNet is a surgical application that sits within PowerChart allowing the ordering of surgical procedures, pre-op checklist, intra-operative documentation and operation reports.

At this stage, the full workflow associated with CHARM has not fully been explored. Currently, we believe there may be a hybrid workflow with IV chemotherapy remaining in CHARM and Oral Chemotherapy moving to the Cerner Medication Administration Record (MAR).

Yes, documentation from the EMR will be sent to My Health Record. At this stage, we are determining which documentation and when this is sent. We are also working on the integration with Safe Script.

Yes, extraction of data can be done. There will be some existing and custom reports that can draw pout data from the clinical system. Also, the Business Intelligence team can extract information from a data warehouse to create necessary reports for the organisation.

The EMR is a clinical tool and will be the source of truth for clinical information. iPM is our Patient Administration System (PAS). Functions that iPM will continue to perform include VAED (quarterly state government) reporting for inpatient episodes, ESIS (Elective Surgery) reporting, VINAH (some outpatients) reporting, clinical coding, billing as well as being the master of patient information. iPM and EMR will integrate meaning that patient registrations, patient movements and some theatre information recorded in iPM will be sent to the EMR and EMR will return some information to iPM.

Yes. In the EMR, we need to capture information about our patients in ‘near real time’. This is required so that we have accurate documentation about the patient at any point in time.

Yes. We are making sure that we are collecting the data we need for our reporting purposes. However, be mindful that you are not requesting the same report multiple times in a short time frame, as this could overload the server.

The EMR will become the single source of truth for clinical information however it will not replace all clinical systems. While CPF will remain as an archive source, the aim for implementing the EMR is to be paper light. During the transition, clinicians may be referring to historical information in CPF. Over time, more information will be in our EMR, therefore, reducing the need to refer to CPF. Clinicians will be able to click directly from within the EMR into CPF to make it quicker for our staff to view.

Yes, anyone who has access to the EMR will also have access to FirstNet, e.g. staff on the ward may need to review an ED patient’s status or read the Emergency Discharge Summary before the patient arrives. Clinicians need to be aware that if access to FirstNet is not within their scope of practice, then they should not access it.

CPF will continue to store alerts and allergies, and will continue to be a repository for scanned paper documentation and will hold historical information on the patient.

Functions that iPM will continue to perform include VAED (quarterly state government) reporting for inpatient episodes, ESIS (Elective Surgery) reporting, VINAH (some outpatients) reporting, clinical coding, billing as well as being the master of patient information. iPM and EMR will integrate meaning that patient registrations, patient movements and some theatre information recorded in iPM will be sent to the EMR and EMR will return some information to iPM.

EMR will be the source of truth for all clinical information going forward.