iCIMS expands oncology MDM solution to Peter MacCullum, St George Hospital

iCIMS expands in Victoria and NSW with its Oncology MDM solution

Following on from the successful implementation of Melbourne Health’s Clinical & Research Information Management System used by the shared Breast Cancer service of The Royal Melbourne and The Royal Women’s Hospitals, the solution will be extended to the breast cancer patients of the Peter MacCallum Cancer Centre.

The Innovative Clinical Information Management Systems (iCIMS) installation is designed to allow easy access from all institutions within the Parkville precinct. The system – known as RUTH II – enables the three hospitals to track the patient journey, manage the Multidisciplinary Meetings (MDMs) and transparently share patient information.

iCIMS Product Development Director Ali Besiso said iCIMS used its advanced technology to enable a concept it calls Immediate Adaptability to very quickly prototype a system tailored specifically to the needs, workflows and outcomes required by the three hospitals. One example of this was the additional need for the PMCC solution to integrate with VERDI’s Clinical Viewer.

A facet of Immediate Adaptability that sets iCIMS developed systems apart is the speed of user-driven system design changes. This speed, in turn, allows iCIMS to deploy a unique installation model; once the initial handover is completed, the client has three months to request system design changes without additional cost.  The result is a highly tailored, fit for purpose solution that has overwhelmingly high user buy-in from senior clinicians, nurses, data administration and ancillary services.

Mr Besiso explained that as an example of the immediacy of changes, with the original RUTH II system that was installed into Melbourne Health, there were 98 design changes requested by the clinical users as a result of them using the system in a live environment in the first three months. Of those changes, 93 were delivered with an average turnaround time of 3 days without any system downtime. The remaining 5 changes required deeper engineering changes and took longer.

Professor Bruce Mann –   Director of Breast Tumour Stream, Victorian Comprehensive Cancer Centre (VCCC) has seen the effects of iCIMS’ Immediate Adaptability within his team; the members of the multi-disciplinary team have been impressed that changes suggested during a live MDM have been implemented and operational the following week.

RUTH II is integrated with the hospitals’ Patient Administration Systems (PAS) including HL7 A40 merge messages updating patients’ medical record number to the new Precinct Unique Record Number (PURN) shared across all three hospitals (including the Peter MacCallum Cancer Centre where the joint weekly Multi-Disciplinary Team Meetings takes place).

The integration, coupled with iCIMS’ workflow engine, reduces cognitive load, lowers ‘click fatigue’ and increases accuracy by prefilling form entries from the PAS and from patient clinical details held within RUTH II. This functionality increases accuracy and reduces the time taken by staff to enter data and prepare for Multidisciplinary Team Meetings. Current estimates put a saving of around 30% of data entry time using RUTH II vs the previous system. Time that is now available to manage an increased number of patients without additional workforce.

As well as the core functionality, the system has additional modules that produce:

  • End of treatment summaries and outcomes
  • A survivorship component that generates Survivorship Care Plans.
  • Breast audit data exports

RUTH II has been designed to be fully expandable into other tumour streams and other sites within the Parkville precinct.

Further north, in NSW, St. George Hospital Breast Cancer has also gone live.  The back-office functions have been running since 22nd of September, and a full go-live of the MDM occurred on October 4th.  The successful go-live followed a lot of preparation work on Phase 1 of data migration, importing data from a pre-existing ACCESS database.  This was done to satisfy the project aim to preserve historical data and combine that with new data for research and audits.

St. George’s Breast Cancer installation expands on the existing iCIMS infrastructure at the hospital complex.  The infrastructure has been supporting the MDM processes for Australia’s largest Peritonectomy practice and went live in November 2016.

iCIMS Ticks the Boxes for a Good EMR/CIS

A colleague recently wrote on a professional group list a set of deficiencies of the contemporary EMR in this vein:

All current EMRs get a maximum of a D- degree. They miss:

  1. The adaptive adding of data elements in compositions (Detailed Clinical Models);
  2. Adaptive creation of integrated pathways to support better co-ordination between different disciplines such as medical and dental treatment, plus nursing care, psychology and social care;
  3. A data element / valueset binding to standardised terminology;
  4. Options for standardised electronic data communication for various purposes, such as continuity of care, quality, decision support, management data, epidemiology, clinical trials, etc.

iCIMS can be judged by this list and comes out in good shape. Our real-time adaptability covers items 1 and 2, our in-built coding covers item 3, and we satisfy 4 — there might be more intended here by the author than what we can read in the words — by our ability to use HL7 messaging, and also our in-built analytics functions and the API for reading the data stores.