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Client Story

An efficient and paperless environment: Managing emergency department patients during a pandemic

CGH is constantly harnessing the power of healthcare IT to deliver higher
levels of care and service. The Sunrise EMR platform was instituted in 1998.
Different sections of Sunrise are incorporated into one platform, and clinical
documents are easily accessible through the EMR system, without having
to log in to multiple different systems. One such area that has benefitted
is the Emergency Department. Since CGH shares the same electronic
platform across SingHealth hospitals, the platform also makes it convenient
for healthcare teams to access patients’ records from other SingHealth
institutions and provide seamless patient care.

Improved accessibility to patient records across multiple hospitals
Increased efficiency by reducing time taken to order investigations as well as treatments for patients
Reduced incidents of recalling patients to the ED for abnormal reports
Boosted communications between doctors and nurses regarding patients’ orders and treatments 

To mitigate the high A&E attendance, CGH has also built capability upgrades
into Sunrise Emergency Care, which made a huge impact to the Emergency
Department in different ways.

“The Status board, for example, gives us an overview of the patients in the
emergency department. Clinicians can easily view the different locations
and patient statuses by looking at the status board. It also serves as open
communication between doctors and nurses regarding patient orders
and treatments requirements,” said Dr Goh Min Liong, Chief Medical
Informatics Officer.

"Sunrise has set a high standard in healthcare system because it provides a common platform for us to view patient’s records across SingHealth’s institutions. Clinicians can view patients’ results, upcoming appointments, past consults from other departments or hospitals that were not readily available to the Emergency Department previously.”

Dr Goh Min Liong

Chief Medical Informatics Officer, CGH

The flexibility of the Sunrise platform has enabled CGH to incorporate different clinical pathways in the platform’s “provider” note. This serves as a guide to clinicians when admitting patients with certain diagnoses, facilitating a smooth transition and ensuring continuity of treatment. CGH also incorporated the “results acknowledgement” module into the EMR to assist in the identification of abnormal results and facilitate early clinical intervention. This has reduced the incidents of recalling patients to the ED for abnormal reports.

To increase efficiency, CGH customised “emergency department order
sets” based on patients’ symptoms to reduce the time taken in ordering
investigations and treatments. CGH can also trace previous visits made by
patients and view the documentation made by other clinicians. In addition, the different icons in the status board keeps clinicians informed of patients’ current statuses and the availability of investigations and treatments.

“The collaborative efforts that we received from Altera Digital Health over the years have been tremendous. The teamwork between Altera Digital Health, IT, doctors, nurses and other healthcare staffs have created a conducive platform for us to work.”

Lawrence Loke
Deputy Director, Synapxe

Electronic documentation in Sunrise has helped advocate a paperless and
efficient environment at CGH, and its benefits were especially apparent during the COVID-19 pandemic. During the pandemic, CGH created new “locations” on Sunrise’s status board to identify patients’ information and locations, such as those waiting for their COVID-19 swab test results in the hospital’s isolation facility, and those with fever in the Emergency Department.

A separate medication order set was also developed in Sunrise for acute
respiratory symptoms to expedite patient discharge. CGH implemented a
pre-consult questionnaire that was sent to patients via an SMS link that was
incorporated into the provider note. This helped clinicians determine patient’s COVID-19 related symptoms, as well as travel and contact history prior to their consultation session.

“We were able to implement timely customised enhancements on Sunrise
while tackling the pandemic. This was particularly useful to identify and isolate suspected cases of COVID-19 to reduce the spread of the virus,” added Dr Goh.

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