rachel vickery, physiopac ltd: moving care beyond the hospital walls (supporting notes)
DESCRIPTION
Rachel Vickery, Physiotherapist and Technical Director, Physiopac Ltd delivered this presentation at the 2nd Annual Hip Fracture Management Conference 2013. This conference is the only regional event to discuss practical innovations and improvement processes for the management of Hip Fractures in the hospital setting. Find out more at http://www.healthcareconferences.com.au/hipfracture2013TRANSCRIPT
Moving Care Beyond the Hospital Walls
Slide 1: Intro
Slide 2:
Think about how you can start to shift your care away from being limited to one-‐on-‐one care and the confines of physical buildings.
You have a wealth of information that your patients will benefit from – they are limited in receiving it if they only have a brief encounter with you.
Slide 3:
The next few slides refer to the current / traditional scenario when care is limited to physical buildings & 1 on 1 contact time.
We acknowledge that a high number of hip fracture patients have other co-‐morbidities and / or dementia.
The scenarios presented here are more appropriate for patients who are elderly, but otherwise independent or need minimal assistance with ADL’s
Slide 4:
There are studies that show that patients commonly plateau in their ability to achieve previous functional ability especially post discharge “home”.
Often related to lack of confidence and also well-‐meaning “babying” by caregivers / family members.
Slide 5:
Depression is also a common factor post hip fracture, which negatively effects healing and the immune system.
Poor co-‐ordination between stages of care is highly correlated with increased re-‐admissions, medical complication, duplication of services and medical errors.
Slide 6:
Individual programs – nutrition, rehab etc take a long time to put together if they have to be built from scratch each time.
People can only learn a couple of exercises at once, if they do not have a comprehensive, easy to follow version of the program that they can keep referring back to.
2 or 3 exercises is insufficient to address the consequence of a hip fracture, and more importantly to INCREASE a person’s functional health post fracture so that they are less likely to have another fall or fracture.
Slide 7:
Significant load on the main caregiver – time off work, their health, their quality of life etc.
Slide 8:
The next few slides are to demonstrate how the same scenario can be dramatically improved by overlaying current care onto myHealthpac – a web based software program for Health Professionals and their patients
myHealthpac is one of SHI Global’s software programs
Meets all requirements for patient privacy.security of data etc. Incredibly cost effective. Probably less than a patient’s hospital meals for one day!
Designed to “talk to” existing Patient Management Systems, Electronic Health Records and The National Health Database.
Built to allow seamless integration between all stages of care, regardless of the physical location of the health professionals involved. Enables all health professionals to work together on the patient’s care – but the patient only ever sees one plan. From the patient’s side there is no confusion or conflicting advice.
Slide 9:
Users can use as much or as little of the platform as they like.
For example an individual team e.g. the hip fracture team, might use the existing myHealthpac system, using mostly our exercise videos and put their own relevant information on the site, or an organisation or hospital might use the entire platform and rebrand it as their own for example Diabletes Australia Victoria for their “Life” wellness program of diet, exercise and information / learning modules for patients with type 2 diabetes.
Slide 10:
myHealthpac is patient centered. It enables multiple health providers to create patient specific, co-‐ordinated and streamlined information / exercise plans for patients. Health providers can be in different physical locations, but can all see what the other Health professionals are doing if they have been invited to take part in the patient’s care.
Patient’s only see one plan – they just have ONE webpage to log in to where they see EVERYTHING that they need relevant to their care. i.e nutrition, pharma, exercise, general information, appointment reminders etc.
Patient’s can invite a caregiver to be able to view their page, from wherever the care giver is based.
Slide 11
Patient logs in to their own web page. As long as a patient is computer savvy enough to check their email they can use this system!
Everything is printable for patients without internet access. Caregivers can log in to help patients.
Everything that the patient needs to access about their care can be access from this page – any general information put in place by the careteam, specific exercises, nutrition, Tasks, communications etc
Slide 12:
A Health team can put in place content at the time of the consult i.e. a physio can put some exercises on the patient’s plan when they see them.
Most efficient and powerful way to use myHealthpac is to create Carepacs for conditions that are seem regularly
Slide 13:
Carepacs are Generic timelines, built as templates, that dictates when specific exercises, information, or other relevant content is made visible to a patient
This is powerful when there is a lot of generic information that they patient will benefit from, but that is appropriate at different time points moving forward. i.e. a patient just discharged from hospital may not be ready for information about walking on crutches, or picking up objects off the floor, but would benefit from this advice in the future. Similarly, exercises can be set up as a Generic Template that follows the “norm” or “post op protocol” for a particular procedure, but is then fine tuned when it is used for a specific patient. Exercises can be pre-‐populated with appropriate sets, reps etc to speed up the process further down the track.
Carepacs might be a few days or a few months in length.
The Carepac is built as a one-‐off in advance, by potentially multiple health care providers of different disciplines and is then selected for use for a specific patient. EVERYTHING from the Generic carepac can be edited, added to, deleted from etc as relevant for the patient in question but it takes away a lot of the bulk repetition and time in creating patient programs and management plans.
Using an existing carepac it takes less than 2 minutes to enter a new patient on the system, select the appropriate carepac, and then get it underway for them.
Slide 14:
Any information can be added either as a word document, PDF or video.
ANYTHING that you want to get out to your patients and caregivers you can – you are only limited by your imagination.
For example in elective surgery we have teams that include videos from the anaesthetists, videos from the nursing staff explaining what will happen when they first return to the ward, why Obs are taken so frequently etc.
The aim is to educate and empower patients, and to reduce their anxiety.
The aim for Health care team and organisations is to increase efficiency of what they do, minimise costs, create safer environments and outcomes for patients and staff.
Slide 15
This video is added separately. Please watch Hip Fracture Carepac.mp4
•http://youtu.be/TRCXE8hNQiI
Slide 16:
This is just an example. It is appropriate and relevant for any condition.
Slide 17: self explanatory
Slide 18:
Opening care of patients broader than just one on one time and physical boundaries of a clinic / hospital has changed the out come that my patients get.
You may not be ready for something like myHealthpac but think about how you can get your information, advice and knowledge out to your patients perhaps doing some videos and putting them on youtube, or doing skype consults
Slide 19:
Please email me on [email protected] if you would like any help or advice as to whether this would be suitable for your team. We work proactively with teams and organisations because we know many Health professionals don’t have the time or interest in learning new software / IT systems. You don’t have to be tech savvy – just ready and willing to offer something better to your patients.
This is a brilliant tool for research also as every piece of data is captured in a unique sell. Again, please email me if you are interested in using myHealthpac as a tool for research.