Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2023

Implementation of a Clinician-led Digital Health Workflow Review in Prehabilitation   (#325)

Amy Bowman 1 2 , Julia Staples 1 3 4 5 , Tom Poulton 1 2 6 , Kate Burbury 1 2 , James Hibbard 1 , Jessica Crowe 1 2 , Kath Feely 1 3 4 5
  1. Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
  2. University of Melbourne, Melbourne, Victoria, Australia
  3. The Royal Children’s Hospital, Melbourne, Victoria, Australia
  4. The Royal Melbourne Hospital, Melbourne, Victoria, Australia
  5. The Royal Women’s Hospital, Melbourne, Victoria, Australia
  6. University College London, London, United Kingdom

Introduction

Prehabilitation is a multidisciplinary model of care shown to decrease hospital length of stay and acuity of treatment required in the hospital, in addition to improving patient outcomes. Resource availability, structures to enable multidisciplinary collaboration and the digital infrastructures to support this have been proposed as barriers to the widespread implementation of prehabilitation. Clinician EMR (Electronic Medical Records) builder programs integrate clinicians into the process of digital health transformation within healthcare systems to develop and deliver workflow optimisation.

 

Aims

To implement and evaluate the impact of a clinician-led workflow review and digital optimisation project on system usability, data integrity and workflow efficiency within a multidisciplinary prehabilitation clinic at a tertiary cancer centre.

 

Methods

A clinician builder worked with digital health and prehabilitation specialists to scope, develop, build and deliver an optimised digital workflow for prehabilitation exercise professionals. A data dictionary was developed to standardise the collection of outcome measures. Clinicians (n=5) were asked to complete the system usability scale (SUS) pre and post-implementation. Routinely collected data about Occasions of Service (OOS) and outpatient encounter time were analysed pre and post-implementation.


Results

Clinician-reported SUS scores improved from poor usability (33) pre-intervention to excellent usability (84) post-intervention. Comparisons of service utility data in the 3 months post-intervention compared with the 12 months prior to implementation revealed an average reduction of 8.2 minutes per encounter (from an average of 55 to 47 minutes), as well as a 29% increase in the number of outpatient OOS per week. Core data entry compliance improved to >95% post-intervention from 5 to 55% pre-intervention.

Conclusions
Clinician builder-led implementation fosters a collaborative design approach leading to enhanced utility of EMR systems for improved efficiency, data accuracy, and system usability. Mapping and designing EMR change around core data and clinical workflows enhances data entry compliance.