Maternity Clinical Information System (MCIS)

The challenge of moving from paper to fully electronic CIS

Jane BrosnahanDirector of Nursing & Midwifery

Our Place - Primary & Secondary Maternity Unit – 11 Beds

Background to MCIS

• Fully electronic• Supports maternity journey from confirmation

of pregnancy through to 6 weeks post partum– Conception to six weeks postnatal– DHB and community care– All clinical staff involved with care of mother and

baby

What does MCIS look like?Thanks to Tairawhiti DHB for sharing this slide

Pregnancy CareThanks to Tairawhiti DHB for sharing this slide

The Warm Up

Implementation of Trendcare 2013

• Midwives were fearful/ mistrusting of new technology and reliability of the data

• Variable IT literacy in the workforce• Slow to uptake system• Once implemented good users

Implementation MCIS October 2014

• Small DHB not used to being early adopter – best at being a fast follower adopter

• Never anticipated that SCDHB would be the first DHB to utilise the entire system – originally selected to commence in 2nd tranche

• Externally managed system so constantly evolving (currently on version 8 – version 9 coming soon)

Implementation MCIS October 2014• Much bigger change process than anticipated –

training , training , training communication, communication, communication

• Success required individual level practice changes – clinical notes , increased use of partograms

• Need to purchase new tools of the trade – laptops (cows), secure bags, mobile printers, i phones

Training and utilisation

• All midwives (Core, Continuity of Care, LMC)– Some resistant staff with extra training and

involvement in the implementation they are now some of the best users

– LMC Midwives (non-employees) some now prefer MCIS as there preferred method for recording clinical notes

Training and utilisation cont’d

• Senior Medical Officers– Obstetricians (ongoing training required to increase

utilisation)

– Paediatricians (more involvement in version 9 release)

– Anaesthetists (training planned)

– Locums

Equipment

And then came

Membership• SCDHB General Manager, Clinical

Governance • SCDHB Director of Nursing &

Midwifery • SCDHB Falls Lead • SCDHB Strategy, Planning and

Funding • Home Based Support Services • Aged Residential Care Provider

• Sport Canterbury • ACC• Timaru District Council• Community Physiotherapist• Primary Care Chief Medical

Officer (as required)• Co-opted representatives (as

required)

Learnings (post implementation and from Tairawhiti DHB)

• Undercooked project management• Better preparation• More involvement of end users• Probably should have implemented part

rather than entire system• Greater consideration of Health and Safety

issues related to equipment

Benefits to come

• Automated triple enrolment – National Immunisation Register– Tamariki Ora Well Child providers– Oral Health– General Practice

Benefits to come

• Hearing screening module (implications for Public Health Nursing, General Practice)

• LMC Midwives MMPO notes to be linked to MCIS

• National Maternity dataset through Health Information Standards Organisation process

• Link to Health Connect South for lab results etc.