Map of Medicine development at MidCentral DHB

1 May 2012

Map of Medicine** is an electronic collection of evidence-based care “maps” connecting all the knowledge and services around a clinical condition.

MidCentral DHB has purchased the tool to help meet the Ministry of Health’s ‘Better, Sooner, More Convenient’ pathway targets, and the Map of Medicine is being adopted for developing 33 collaborative clinical care maps. The first three “maps” – covering atrial fibrillation, cellulitis and chronic kidney disease - are due to go live at MidCentral this month. (NB May)

The Map is a web-based tool presenting the latest information about clinical conditions and medical problems in an easy-to-use format. The computer screen interface is modelled on flow-charts, enabling the health care team to drill-down through screens to the level of information that’s required.

Map of Medicine will assist health professionals to quickly find the most appropriate clinical information at the point of care. What’s more, the Map of Medicine enables care map customisation, whereby local, regional, and national knowledge and expertise can be used to refine care map information – more commonly known as “localisation”.

The process of localisation is currently underway with a team of trained Map of Medicine editors and facilitators embarking on the localisation of the first three care maps – atrial fibrillation, cellulitis, and chronic kidney disease. For each of the three care maps, representative clinical experts (ideally, one each from primary and secondary care), an editor, and a facilitator meet to complete the first localised draft.

For the atrial fibrillation care map, a cardiologist and a general practitioner with a special interest in cardiovascular health are the clinical leads. Their roles are to provide clinical expertise, advice, and leadership and to collaboratively work with other health care professionals. It is the clinical leads that maintain ultimate responsibility for the clinical content of the finalised care map.

The editor is responsible for editing the care map on software supplied by Map of Medicine. The editor creates draft and final electronic versions of the care map in tandem with actual dictation and guidance from the clinical leads. The editors also have an important role in identifying any inconsistencies or inaccuracies in care map design and acts accordingly to mitigate any potential clinical risk. A facilitator is present to provide focus for the group and ensure proper process is followed.

Following the first draft care map, the initial team is expanded to six people. For the atrial fibrillation care map, additional clinical expertise has been harnessed with the inclusion of a nurse practitioner, general practitioner, haematologist and a community pharmacist. Their roles are to work up and agree on the second draft of the care map.

The second working draft will then be subject to stakeholder review and feedback, with a further working group meeting to finalise editorial changes. It is at that point the relevant care map is ready for clinical and organisational sign off.

The official launch of the care map takes place electronically and can be accessed by front line clinicians – both primary and secondary – with the click of a mouse.

Following our “go live” launch, we will closely monitor the relevant care map usage and clinical effectiveness to evaluate benefit from improved patient experiences, more streamlined care across the continuum, increased knowledge sharing and a reduction in avoidable hospital admissions.

Article contributed by Jan Dewar, Nurse Director Medicine & Map of Medicine Facilitator, and Dean Kinloch, Clinical Nurse Specialist (Acute Care) and Map of Medicine Editor, both of MidCentral DHB

The Map of Medicine** was initially developed within the National Health Service in the United Kingdom and an international firm has since bought up the innovation. MCDHB is understood to be the first New Zealand DHB to sign up to a software license for the web-based tool.