Homecare Medical’s new clinical decision support system live
Homecare Medical’s new clinical decision support system goes live
Homecare Medical (formerly HML) has ‘pushed the button’ on its new clinical decision support system, Odyssey Tele Assess.
‘We’ve spent the last 18 months searching the world for an intelligent, evidence-based clinical decision support system that meets patients’ needs safely and effectively,’ said Homecare Medical Clinical Director Dr Karl Cole. ‘Odyssey is leading the world in this industry. Globally more than 25 million teleconsults take place annually using Odyssey in seven countries and seven languages. We’re the first New Zealand organisation to implement this system.’
‘Odyssey is supported by one of the UK’s largest software companies and has a massive international clinical community contributing to its development. As a user we have access to best practice training, audit and other important quality systems. This truly allows us to provide New Zealanders with world class telemedicine and telehealth services.’
What makes Odyssey unique is that it mirrors a natural consultation underpinned by Bayesian logic. All relevant information is examined simultaneously via a framework rather than through a restrictive algorithmic pathway. Multiple symptoms can be analysed simultaneously to give a final overall outcome, ensuring patient focus and risk management within a short timeframe. The Bayesian approach ensures potentially life threatening or serious conditions are quickly identified and dealt with appropriately. For less serious conditions, patients can have self-care safely recommended to them, with advice communicated in a way they can easily understand. The ability to supply the user with clear, unambiguous recommendations relevant to age, gender and symptoms is a key element of this system. Patients can also use its online symptom checker which can be accessed via the web or on their smart phones.
Professor Jeremy Dale from Advanced Health & Care, the company that developed Odyssey, said experience and a partnership approach with users and organisations over almost 20 years has ensured continuous development of a decision support tool that meets the needs of patients, practitioners and organisations while retaining an exemplary safety record.
Odyssey is developed and maintained through systematically reviewing evidence using processes that carry accreditation from the UK’s National Institute of Health and Care Excellence (NICE). This ensures that recommendations are always up to date and based on all relevant information relating to the symptom presentation concerned interpreted in the context of evidence of high methodological quality.
The effectiveness of Odyssey’s approach to decision support has been demonstrated in independent research studies conducted in the UK, the Netherlands and Switzerland.
‘This is a remarkable step forward for telehealth care in New Zealand,’ said Dr Cole. ‘Not only is the software state of the art but as part of the Odyssey family we are now able to continually access, best practice clinical research, trainers, online learning, journals and clinical governance that exceeds the requirements of many leading professional bodies and leapfrogs us in terms of clinical telemedicine advice.
Odyssey supports patient-centred assessment, advice and care in a way that naturally strengthens clinicians’ usual consultation and decision-making processes. It is used in a wide range of settings to support telephone or face to face consultation. Odyssey caters for the full range of patients encountered in acute primary and urgent care, supplying the user with clear, unambiguous recommendations relevant to age, gender and symptoms being experienced by the patient.
Designed by an international renowned clinical academic team, Odyssey draws on leading edge research-based analysis of clinical decision-making, to support evidence-based consultation and communication practices (e.g. Cambridge Calgary model). In this way, it supports an efficient use of consultation time, achieves excellent triage outcomes, high user and patient satisfaction, and improved adherence to advice. It presents evidence in a format that is pragmatic and can be used effortlessly in everyday practice with relatively little training.
Odyssey encourages use of open and closed questions in simple language to allow the patient to tell their own story and supports the clinician to elicit their concerns and ideas. Questions and pre-defined responses are designed to elicit facets of the symptom that may discriminate towards common and/or clinically significant diagnosis. The responses carry weightings which contribute to a suggested outcome based on diagnoses that have a greater likelihood of being present. It encourages facilitative responses and prompts to clarify patient’s statements (such as opening additional question sets for consideration) and encourages summarising and giving advice in simple language.
Consideration of the differential diagnosis associated with any symptom or combination of symptoms is central to the entire process of developing Odyssey clinical content. This involves consideration of the relevance and risks associated with any advice that is related to the symptom, and the benefits that exist for the patient and the wider health care service as a result of any particular recommendation.
In clinical reasoning terms, the method used to develop Odyssey’s questions and answers is predominantly by ‘abduction’. Abduction in this situation can be defined as inferring the likelihood that the patient is experiencing ‘feature a’ (a potential diagnosis) from the consequence ‘feature b’ (an aspect of the patient’s symptoms). This is the standard way that clinicians assess patients’ needs, and takes account of all available information about the patient, their history and their context. This is known as a Bayesian approach to decision making. In contrast to algorithmic decision supports, this allows Odyssey to synthesise data from multiple symptoms and to automatically interpret their significance within the context of the patient’s medical history.
Homecare Medical (formerly HML) provides 24/7 afterhours GP services, including nurse phone triage, health advice, practice information and care coordination.
Homecare Medical, in conjunction with other health organisations, is working to develop and deliver world-leading, coordinated and connected telehealth services to all New Zealanders. These services align closely with the Ministry of Health’s policy of integrated community-based healthcare and coordinated primary care options for acute care.
Earlier this week, ProCare (Auckland) and Pegasus Health (Canterbury) announced they had joined forces to deliver a variety of telephone and virtual health services to more than 2.2 million New Zealanders.
ProCare represents Auckland’s largest network of qualified GPs and general practice teams. The organisation has nearly 200 member practices which care for more than 841,000 patients. This includes 89,427 Maori and 113,084 Pacific.
Pegasus Health is a charitable company that supports 109 practices and 75% (357,000) of the enrolled patients within Canterbury. The Pegasus community includes 337 member GPs, 471 practice nurses, and nearly 400 support staff, as well as other community providers.
Advanced Health & Care (Advanced) is a leading provider of IT management systems for urgent and unscheduled care, clinical call centres, community health, mental health, hospice, home and residential care services.
Advanced has a unique focus on providing innovative mobile IT applications for community based care, supporting tens of thousands of care workers and clinicians with integrated device, software and airtime solutions.
Working closely with partners in Australia and New Zealand to distribute our solutions to a large number of local providers, Advanced is transforming health and care via an innovative and well established range of solutions.