Andrew Dalley

The introduction of electronic medication charts and prescribing in aged care facilities: An evaluation

The objective was to test the feasibility of electronic medication charts in aged care facilities and the impact on general practitioner (GP) and staff work processes. The Illawarra Division of General Practice conducted a trial where GPs used a modified version of commercially available software to generate medication charts, in four residential aged care facilities. Semistructured, face‐to‐face interviews, log books and an issue register were used to evaluate the success of this trial.

A technological model to define access to electronic clinical records

This communication describes a functioning model that permits access to an electronic health record across a small number of providers resident in an Australian regional setting. Design criteria designated that provider access rights were to be assignable, revokable, transportable, and informable.

Feasibility of implementing routine nutritional screening for older adults in Australian general practices: a mixed-methods study

BackgroundNutrition screening in older adults is not routinely performed in Australian primary care settings. Low awareness of the extent of malnutrition in this patient group, lack of training and time constraints are major barriers that practice staff face. This study aimed to demonstrate the feasibility of including a validated nutrition screening tool and accompanying nutrition resource kit for use with older patients attending general practice. Secondary aims were to assess nutrition-related knowledge of staff and to identify the extent of malnutrition in this patient group.MethodsNine general practitioners, two general practice registrars and 11 practice nurses from three participating general practices in a rural, regional and metropolitan area within a local health district of New South Wales, Australia were recruited by convenience sampling.Individual in-depth interviews, open-ended questionnaires and an 11-item knowledge questionnaire were completed three months following in-practice group workshops on the Mini Nutritional Assessment Short Form (MNA-SF). Staff were encouraged to complete the MNA-SF within the Medicare-funded 75+ Health Assessment within this time period. Staff interviews were digitally recorded, transcribed verbatim and analysed thematically using qualitative analysis software QSR NVivo 10.ResultsFour key themes were determined regarding the feasibility of performing MNA –SF: ease of use; incorporation into existing practice; benefit to patients’ health; and patients’ perception of MNA-SF. Two key themes related to the nutrition resource kit: applicability and improvement. These findings were supported by open ended questionnaire responses. Knowledge scores of staff significantly improved from baseline (52% to 66%; P < 0.05). Of the 143 patients that had been screened, 4.2% (n = 6) were classified as malnourished, 26.6% (n = 38) `at risk’ of malnutrition and 69.2% (n = 99) as well-nourished.ConclusionIt is feasible to include the MNA-SF and a nutrition resource kit within routine general practice, but further refinement of patients’ electronic clinical records in general practice software would streamline this process.

The use of smart tokens to permit the secure, remote access of electronic health records

A model is described whereby Electronic Health Records (EHRs) stored on a remote central server can be accessed from doctors surgeries in regional Australia. The centrepiece of the model is a smart token on which reside unique identifiers, which facilitate secure, remote, transportable access by consulting physicians of patient clinical data, at the discretion of the patient.

Managing collaboration across boundaries in health information technology projects

One reason that it is so difficult to build electronic systems for collecting and sharing health information is that their design and implementation requires clear goals and a great deal of collaboration among people from diverse social and occupational worlds. This paper uses empirical examples from two Australian health informatics projects to illustrate the importance of boundary objects and boundary spanning activities in facilitating the high degree of collaboration required for the design and implementation of workable systems.