The NAECR Project: Developing a National Aeromedical Electronic Clinical Record (NAECR) for Pre-Hospital and Retrieval Medicine (PHRM) in New Zealand (NZ).

Dr Alana Harper¹

¹Northern Rescue Helicopter Limited, Auckland, New Zealand, ²Auckland District Health Board, Auckland, New Zealand

Background:

In 2019 the NZ Ministry of Health (MoH) introduced a three-region rotary aeromedical model, requiring previously independent, competitive organisations to work collaboratively. It also represented a paradigm shift in clinical governance and patient care becoming a principal aeromedical focus.

Patient clinical records (PCR) are crucial to high quality, safe pre-hospital and retrieval medicine operations (PHRM). They are an essential component of patient care and exemplify the complexity and diversity of PHRM work. The national aeromedical electronic clinical record (NAECR) project involved all regions as major stakeholders in designing and developing the NACER.

Objectives:

Major NACER requirements were identified:

1. A user friendly, ergonomic interface which is clinician designed
2. Integrations in order to reduce data entry burden (which is a research proven contributor to clinician burnout)
3. Wirelessly entrain data from validated sources reducing data entry errors & increasing data quality – including physiological data from cardiac monitors and ventilators
4. Flexible & offline working on handheld devices
5. Easy access to standardised data for clinical governance, continuous quality improvement, national (and international) benchmarking, resource allocation and reporting requirements
6. Medicolegal & data privacy responsibilities
7. Procedural & patient contact logbooks

Method

Usability scoring was undertaken of the existing PCR, which demonstrated good usability, confirming a useful NACER template. Subsequent requirements gap analysis led to two workstream phases.

Results

Phase 1: Improving medicolegal & privacy requirements and building several important integrations, including the MoH NHI database and wireless transfer of physiological data from Zoll cardiac monitors.

Phase 2: Further integrations with SNOMED CT database, District Health Board and the existing road ambulance electronic PCR are planned.

Conclusion

This is the first clinical collaboration between three New Zealand rotary aeromedical regions, with major implications for PHRM clinical quality and safety in NZ.

Biography:

Dr Alana Harper is an emergency medicine specialist at Auckland City Hospital and a Pre-Hospital Retrieval Medicine Doctor with the Northern Rescue Helicopter (NRHL) for over a decade. She is also the NRHL clinical lead for safety and quality.  Her HEMS clinical work involves mostly helicopter and road primary missions and some inter-hospital retrieval.  Alana is passionate about ensuring excellence in clinical care for all patients, and in remembering that the patient is our “why” and is at the centre of everything we do.