Canterbury Digitises Covid-19 Workflows

Canterbury DHB has accelerated the roll-out of its Cortex care coordination platform and developed new Covid-19 digital workflows.

Key specialities involved in the Covid-19 response including ICU, infectious diseases, general medicine and respiratory, are now fully digitised for clinical notes and multi-disciplinary team communication using Cortex.

The platform was developed by Sense Medical in partnership with Canterbury DHB.

Clinicians use iPhones or iPads to access the app to create and read clinical notes, send tasks and communicate with their teams.

Sense Medical co-founder Alistair Rumball-Smith says his team has worked with clinicians to develop a number of Covid-19 specific workflows, including a Covid-19 screening form; a screening reminder in all Cortex admissions; a Covid-19 summary document for tracking clinical status; and workflows to support referrals to the Covid-19 consult team.

The screening form categorises patients according to the MOH case definitions for Covid-19 and links to the Covid-19 pages in Hospital Health Pathways, which provide the clinical guidelines for management.

It can be completed by any clinician at CDHB and is updated within hours of any case definition changes.

A reminder for clinicians to screen all patients for Covid-19 has been inserted into the Cortex admission forms at CDHB, which currently cover 14 different specialities.

Canterbury DHB paediatrician John Garrett, who helped build the screening form, says it not only ensures all of the relevant questions are asked of patients, but also calculates the answer for clinicians.

He adds that the link to Health Pathways is key as they are only useful if staff look at them when they are making decisions about patient care.

A Covid-19 clinical summary is pinned to the top of each patient’s Cortex timeline.

Garrett says it is important that information about every patient in relation to Covid-19, such as current status and isolation requirements, is available at any time to everyone involved in their care.

If a patient has, or is suspected of having the virus, they can be electronically referred to Canterbury’s Covid-19 Consult Team, which has its own templates in Cortex for documenting patient reviews.

Garrett says the team has recently built an electronic referral process to notify Canterbury Public Health of a positive Covid-19 result. This was previously done via fax.

He says the tool also means clinicians can review patient information from home, reducing the amount of time they need to be in hospitals.

Rumball-Smith says there is real-time reporting of the completion of all of the Covid-19 forms with all data accessible by Canterbury’s decision support team for analysis as required.

Garrett says the data has huge utility as the team can extract information on exactly what happened to each patient with a case, or suspected case, of Covid-19.

“We can change Cortex day-to-day so we can adapt it to a changing situation,” says Garrett.

“Some other digital clinical systems are very fixed, but the major part of doing this well is the ability to respond to direction from the Ministry of Health.”

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