Studies in health technology and informatics
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Stud Health Technol Inform · Jan 2018
Does Point-of-Care Testing Impact Length of Stay in Emergency Departments (EDs)?: A Before and After Study of 26 Rural and Remote EDs.
The implementation of Point-of-Care Testing (PoCT) services across rural and remote emergency departments (EDs) by NSW Health Pathology has the potential to significantly improve timely access to results for certain types of pathology laboratory tests and help to deliver timely patient care. The aim of this study was to examine the impact of the implementation of PoCT on the length of stay (LOS) of patients in rural and remote EDs. A total of 3808 patients with a circulatory system illness were treated and discharged at any one of 22 rural and remote EDs during the study period. ⋯ Although average ED LOS was 11 minutes shorter in the post-PoCT period, the impact of PoCT on ED LOS was not conclusive after considering other important clinical factors (p=0.07). This study is the one of the few to examine changes in LOS following the introduction of PoCT in EDs in Australia. The study also identified areas where more robust methods could be applied in the future as the quality of PoCT data improves to further assess the potential effects of this technology on practice and outcomes.
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While it is widely accepted that whole of hospital solutions are necessary to reduce the ever-increasing burden on the public health system, little research has focussed on understanding the relationship between ambulance arrival related flow metrics and emergency department (ED) crowding. Queensland Ambulance Service (QAS) shares patient load across multiple hospitals, and receiving facilities strive to meet a Patient Off Stretcher Time (POST) target of 30 minutes. ⋯ No relationship between POST and ED length of stay was found, perhaps due to competing ED National Emergency Access Targets (NEAT). Further modelling is recommended to formally test these observations.
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Stud Health Technol Inform · Jan 2018
Telehealth: A Game Changer - Closing the Gap in Remote Indigenous Health in Three Remote Homeland Communities in the Laynhapuy Homelands, East Arnhem, Northern Australia.
Benefits of telehealth have been demonstrated both internationally and through local assessments. Early diagnosis and treatment, reduced costs associated with patient travel, minimized time spent away from community and providing improved patient and staff satisfaction are key drivers for using telehealth. Uptake of telehealth in the NT has been limited, for a variety of reasons including inadequate broadband access. ⋯ Early identification and decision making of malignancies can facilitate earlier intervention with better prognosis for the patient. Through collaboration, this program has demonstrated the value of uncontended and unlimited internet access in implementing telehealth. The question was: Is high quality internet required to improve service delivery? The service recognises the value and now relies heavily on this service and is committed to improving connectivity and implementing telehealth in more of their communities.
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Stud Health Technol Inform · Jan 2018
Mapping of Health Care Providers for People with Rare Diseases - From Vision to Implementation.
se-atlas - the health service information platform for rare diseases - is part of the German National Action Plan for People with Rare Diseases. The website www.se-atlas.de provides an overview of health care providers and support groups focusing on rare diseases in Germany. Since the start of se-atlas in 2013, several strategies are being developed and evaluated. This paper gives an overview about the expectations and visions for se-atlas at the beginning of the project, the challenges and lessons learned within the project period and how se-atlas is implemented today.
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Stud Health Technol Inform · Jan 2018
Recommendations for Enhancing the Implementation and Utility of Shared Digital Health Records in Rural Australian Communities.
Internationally, shared digital health records are becoming an important addition to improving contemporary healthcare provision. In 2012, Australia launched its version of a shared digital health record, My Health Record, but enrolment is slow and there remain challenges in its practical implementation. ⋯ Based on the key research findings, recommendations are presented for improving national roll out of My Health Record. The findings highlight, to understand and engage vulnerable communities and support their adoption and use of shared digital health records, there is a need to move away from traditional models of healthcare delivery toward person-centred care delivered from a digital complex adaptive systems perspective.