Gold Coast Integrated Care Shared Care Record.

Introduction: Access to targeted, timely information is crucial for driving service improvement in healthcare1. Shared health information technology can have a major impact on provider effectiveness in coordinating and integrating care as well as enhancing patient outcomes. Healthcare information is currently created and managed in different locations using a variety of reporting tools and software, with different patient identifiers and coding systems according to diseases and conditions. When information is subject to rapid change, such as in health services systems are needed that expedite access for all health providers to the array of disparate clinical information. Without access patient information becomes quickly unmanageable especially when information is subject to change. This presentation reports on a unique initiative to integrate care using a Shared Care Record. The Gold Coast Hospital and Health Service (GCHHS), in partnership with the Primary Health Network (PHN), and Griffith University (GU) introduced a person-centred model of health care delivered primarily in the primary care sector, to provide the most cost effective solution for the holistic management of local patients with complex and comorbid conditions Collaboratively designed and mobilised over an 18 month period, the Gold Coast Integrated Care (GCIC) program commenced enrolling patients in March 2015 for a four year proof of concept phase. Practice Change: The Shared Care Record (SCR) links 'live' health systems data between hospital, GPs, ambulatory care, specialists and community services. Developed on an information technology infrastructure it was designed as a single system to minimise duplication and maximise care coordination. From the integrated care coordination centre the SCR , acts as a single point of management for the diverse information systems involved in coordinating care for patients with chronic, complex and comorbid conditions such as the elderly, and those with diabetes, COPD, and chronic kidney and heart disease. Shared Care data are created, collated, stored and presented in a longitudinal healthcare history of patient information from input by the patient's care team. With sophisticated data analytic capability the SCR guides the daily activities of clinicians in the Coordination Centre, feeding in to the array of disease registers to proactively manage population risks. This information, alongside patient assessment data is used as a basis to create and manage individualised care plans for ongoing management by a care team. Where other information systems don't exist, the SCR is accessible to healthcare professionals and patients via a web URL. Practice Change Highlights: The SCR is currently utilised daily by GPs, hospital and community service staff to manage for a patient population expected to reach over 10,000 during the proof of concept phase. Our analysis indicates early success in implementing the SCR, albeit with certain barriers and enablers that we are working to overcome. These include: General Practice buy-in when GPs are time poor. Including GPs in the development of the software has alleviated this pressure to some extent. Cost effectiveness continues to be carefully calculated beyond developing the archetypes to meet program needs and to accommodate user changes, particularly in aiming for simplicity and ease of use. [ABSTRACT FROM AUTHOR]