In 2015, Plunket embarked upon a bold digitisation programme that saw nurses swapping pen and paper for a tablet and a cloud-based app.
Today, all of the organisation’s 800 nurses work entirely on the digital platform, known as the Electronic Plunket Health Record (ePHR).
With key data from older paper records now added into the system, it now holds 250,000 client records and is proving to be a valuable tool.
Chief executive Amanda Malu says that the data has huge potential to make real change.
“It’s a significant and powerful dataset we now have. We do need to be careful because we are guardians of this data, but it is a very rich data set and we
want to ensure the best possible use for Kiwi families.”
At present Plunket is able to share high-level anonymised data, says Malu.
“We can see pockets of concern where, for example, immunisation rates might be low. We can then team up with other health organisations and make that a priority for that area.”
Information collected and analysed through the system has led to a new breastfeeding strategy within Plunket.
“We’ve now got that solid data that at around the six-week-old mark, breastfeeding rates decline.”
That insight led to Plunketline nurses training to be lactation consultants, who can now video-conference mums needing more support with breastfeeding.
Over time, the ePHR data will begin to show the correlation between the support and interventions provided by nurses and the longer term health of the child, says Malu.
“And suddenly we’re having the important conversations – talking about health outcomes, not outputs.”
Access to information
On a day-to-day basis, the real benefit of the digital system is timely access to information.
“We are more joined up as an organisation than we have ever been.”
Malu gives the example of an Auckland mother with a premature baby who went to Wellington to be cared for by family. While in Wellington, she attended Plunket appointments.
On her return home, her Auckland-based Plunket nurse was able to see everything that had been done with mother and baby in Wellington.
“Not rocket science I know, but this meant we saved so much time. Under our old system, we may have missed the opportunity to meet with the mum when she was in Wellington, potentially losing her altogether, or missing important development issues that could have been picked up in an early visit.”
Trying to ensure all the relevant information was recorded between the two nurses would have seen staff faxing and emailing information to one another. “Not the greatest use of specialist nursing time.”
Malu says that for hard-to-reach families, a nurse will often arrive for an appointment to find other family members staying there too.
“This digital system allows nurses to pull up information for those children then and there and keep them connected.”
Auckland-based community Karitane nurse Sharleen Rapoto has worked for Plunket for 13 years. She says on the very first day of using the digital system, she noticed the benefits.
“I was no longer having to take bundles of notes with me. Carrying those around threw up lots of issues around privacy risks, but ePHR eliminated that.”
Rapoto says instant access to resources via the app is also a bonus. “I don’t have to carry around bundles of pamphlets now. I can instantly pull up a resource on safe sleeping or dental hygiene, or whatever the family needs, right then and there.”
She is looking forward to updates to make the programme even more accessible and intuitive.
“I really love it. It has so much potential for not only our staff, but for our families and the health of our tamariki.”
Malu says Plunket is keen to share its system and data with other health organisations.
“The worst thing we could do was keep it to ourselves. It’s a fantastic way to create change in the healthcare system.”
Plunket is currently talking to the College of Midwives on how to link its system with ePHR, and aims to pilot and assess a referral system that will cut down duplication.
“Our families have told us they want a seamless transition from midwife through to Plunket. This proposal will make the all-important first visit more about getting to know one another, and talking about the baby, and less about gathering data.”
There are also plans for parents to be able to add to their child’s record. “After all, the data belongs to the family.”
Well Child books to stay
However, Malu is quick to point out that the “well-loved” Well Child books will still be printed.
“I still have mine. We know how treasured they are. They won’t be going anywhere.”