Plunket is preparing to take its first steps into the information age, and they are not baby ones. The charity is searching for an information system, to be called PlunketPlus, that will let it create electronic health records for more than a quarter of a million babies and children under five that can be securely shared with doctors, social services agencies and parents. Staff will enter information into the database using mobile devices and the system will incorporate decision support tools and automatic alerts, to help ensure required actions are taken. National clinical adviser Brenda Hynes says Plunket nurses do 700,000 health checks each year, recording them using pen and paper. A small amount of information is scanned into computer systems, but only after a delay of six to eight weeks, and that information is not then available to staff manning PlunketLine, which last year handled 84,000 calls from parents of sick children. Ms Hynes says the long-term vision is an information portal that will let parents log on to see their child's health records and add information about their child's development, but it doesn't expect all the "bells and whistles from day one". Plunket first considered the investment in the 90s, she says, but the technology it needed wasn't there. Today it will issue tender documents, including a 381-page document setting out PlunketPlus' operational requirements. Ms Hynes says Plunket is a complex organisation, "not just about weighing and cuddling children". The system will be designed to improve health outcomes, she says, increasing immunisation rates, providing healthcare summaries to GPs and faster referrals to organisations such as Child, Youth and Family, while making sure children don't "fall through the cracks". "At the moment, nurses ask parents if they are up-to-date with immunisation", but integration with the National Immunisation Register will help nurses focus on any issues. "Being able to do a referral immediately to Child, Youth and Family in a written form, to give them all the information they need, is important. "What we are looking at is sending GPs a summary of all our core contacts. There are a lot of people we refer to – Housing New Zealand and Work and Income to make sure people get benefits – and we need to make sure we are inter-operable across them all." There will be no change to Plunket's policy that it will not share information about children's health records without their caregivers' permission, unless it believes their safety is at risk. PlunketPlus will need to work nationwide and allow Plunket's 1000 staff and volunteers to enter information online and offline. Computer Society chief executive Paul Matthews says the initiative appears ambitious, but he is confident the local IT industry is up to the challenge. "What they are talking about is fantastic. There are some risks and challenges, predominantly around privacy and accessing information. The electronic management of health records has been one of the more difficult areas internationally and people have invested huge sums of money trying to get it right. "But one thing that has been holding back the health system – which this is a component of – has been lack of investment in technology. If they can implement this and get it right, it will bring about significant efficiency and productivity gains." Ms Hynes hopes Plunket will pick a supplier by the end of the year and trial PlunketPlus by next June. The system will be implemented in stages and she expects funding will come from communities, businesses and the Government. "We will find the funding. We are determined this is going ahead."
Plunket planning electronic health records
Project will create EHRs for 250,000 children