Johan Hallenborg is the Director of IT at Kalmar County Council, which is pioneering county-wide digitisation. Like many other regions, Kalmar is struggling with an ageing population, more people with comorbidities and increasing pressure on the health service. If these challenges are to be met in the future, it will be necessary to find new solutions and make changes to working practices. “We are a making a major investment and carrying out a significant transformation, but this is necessary if we are to cope with growing demand and expectations,” says Johan Hallenborg.
An integrated care system
With the aim of creating a more efficient and better working environment for staff, and better interaction with patients, Kalmar County Council has developed an integrated health service system, where all the parts connect and where all the different systems are linked together in one single information flow. This central system consists of COSMIC for PCs and Nova Board and Nova for the tablets used by care staff. Since COSMIC is integrated with the specialist systems, the doctor seeing a patient can do everything using one single interface and one single login, such as sending off all requests and access test results directly in COSMIC.
“This has made a big difference. It used to be a requirement to log in to several systems and use several different interfaces. Now there is one familiar interface, since we have built integrated connections to our specialist systems. A few remain to be done, but they are under way,” explains Johan Hallenborg.
The introduction of mobile work practices
In 2017, COSMIC Nova, the mobile extension of COSMIC, was introduced in the Geriatrics Clinic at the Kalmar County Hospital. This is an example of how technology can completely transform existing working practices, something that Johan insists requires a focus on operational development, and time set aside for staff and management to work on the changes. The introduction of COSMIC Nova in the Geriatrics Clinic was very successful, leading to savings of over an hour per staff member per day. Johan believes that the success was due to the head of the clinic really understanding the potential benefits, and that staff were involved and were allowed to set time aside to work on the changes. Another important parameter, according to Johan, is to have a plan in place in advance for how to utilise the time savings once the change has been carried out. In the case of the Geriatrics Clinic it was decided to use the time saved each day and by each user for direct patient contact, to provide an even better care experience. This was the goal that staff were aiming at. But in another context, the goal might be different, for instance using the time saved for reducing or even eliminating the employment of agency staff.
Solutions that make it easier for staff will also improve quality for the patient
For Johan it is a question of applying an overall perspective. Having an integrated system does not just make a big difference for those working within the health service. It also makes a difference to their interactions with patients. The systems are connected, and health service staff have access to patient records when they are with the patients, and this is of benefit to both user and patient. When the doctor can make notes and access test results directly on his tablet, there is more time for the patient, no unnecessary waiting time and improved patient safety. The risk of errors in the patient record is reduced when data are entered in the record directly, at the bedside. The greater efficiency and time savings we achieve are not just necessary if we are to manage at all, they also mean improved utility, safety and quality for the patient.
What is happening next
The success of the process of changing working practices in the Geriatric Clinic has created interest in the rest of the organisation. The plan is to carry on introducing the system in further clinics during 2018, building on experience from the Geriatric Clinic. But each new department that is about to implement this change needs thorough planning for how to carry it out in that specific department with its specific processes and working practices. We must determine the goal and decide how to use time saved in that specific department, Johan says.
Johan and Kalmar County Council can see many future possibilities for improved quality and accessibility. Most immediately, apart from introducing mobile working practices with COSMIC Nova, this will involve introducing digital consultations, COSMIC E-Visit. Digital consultations will lead to greater efficiency, but at the same time be more useful for patients living far away. If you live at the far end of the isle of Öland, a trip to the County Hospital is long and time consuming. Digital consultations with the doctor would above all save time for the patient and improve the quality of the experience.
We are on an exciting journey, and there are many things that can be made to work more efficiently and better with the help of digitalisation, but what is most important, after all, is the personal interaction between patient and care giver, a meeting between human beings. Johan Hallenborg finishes by observing that the new technology can improve the likelihood that this meeting is as good as possible.
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