Clinical Systems

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Overview

The Clinical System project employs a common system design foundation for all implementations. This version of the Cerner Millennium software is referred to as the Victorian state build. The Victorian state build is the product of extensive health sector consultation and system tailoring to meet Victorian clinical practice and workflow requirements.

The Victorian state build is being produced as a series of design releases, which are listed below.

• Release 1: Clinical Workbench (CW) and ePrescribing (eP)
• Release 2: Order Entry (OE) and Medication Management (MM)
• Release 3: Clinical Documentation (CD)

Each release comprises a set of functionality that together represents the full HealthSMART Clinical System scope. Releases 1 and 2 are in scope for the current implementations.

Eastern Health and the Royal Victorian Eye and Ear Hospital are the Clinical System lead agencies. They are using a phased implementation approach aligned to the availability of the state-build releases.  Two subsequent groups of agencies will combine Release 1 and 2 into a single end-to-end project.

Functionality

The HealthSMART Clinical System (Cerner Millennium) will provide functionality that supports the delivery of patient care. The primary users of a Clinical System are medical and nursing staff, pharmacists, investigative service providers and allied health professionals.

Release 1: Clinical Workbench (CW) and ePrescribing (eP)

This includes functionality for results reporting (pathology and medical imaging results) with the ability for physicians to endorse results; problem list, allergies, alerts, discharge summary, electronic medication profile, electronic prescribing for outpatient and discharge medications and decision support.

Release 2: Order Entry (OE) and Medication Management (MM):

This includes functionality to electronically order pathology and medical imaging tests, automation of the paper medication administration chart which includes ordering of the medication, scheduling and documentation of medication administration, use of barcode technology to verify patient and medication; pharmacy clinical review and decision support. 

Release 3: Clinical Documentation (CD):

This includes automation of clinical documentation across one clinical specialty, e.g. cardiology.

 

Background

The Clinical System portfolio is one of a number of portfolios within Victoria’s whole-of-health information and communication technology HealthSMART initiative.

The Clinical Systems initiative will transform the current model of information management across the Victorian Public Health Sector (VPHS). The HealthSMART vision for a Clinical System is to improve patient care through the introduction of information systems that support clinical service delivery.

Through the Clinical Systems request for tender, the Millennium software supplied by Cerner Corporation was selected as the HealthSMART Clinical System solution. Millennium will support medical staff, nurses and other clinicians in their day-to-day care of patients by providing electronic access to medical records and the capability for prescribing, drug administration charting, investigation ordering and reviewing results and other clinical information.

The key aims of the project are to:

• Automate clinical care activities including prescribing, drug administration, investigation ordering and reviewing
• Support clinical care to make informed decisions by providing efficient and effective access to patient data
• Provide clinical information at the point of care and reduce the time spent by patients re-presenting to clinicians.

The expected outcomes of the Clinical Systems project are:

• Reduced medication errors
• Reduced redundant pathology tests by minimising transcription errors
• Reduced clinician administrative tasks, resulting in more time spent with patients
• Improvements in turnaround times for medication orders
• Increased use of less expensive drugs and tests
• Reduced delays in patient discharge from speedy availability of test results
• Reduction in additional bed-days associated with adverse events.