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  • 1. HAWKS- a pre-consultation kiosk for patients with URTIPilot - Woodlands PolyclinicPhase 1 ( May 2012 )

2. Managing the load : lane traffic ? Over 650 walk-ins a day Almost 150 200 of them having URTI What if we separate them, send them to 2 or 3rooms ? They would be seen faster, and leavethe clinic faster. Better yet, what if I could pass on the informationI get from them ( while segregating them ) to theend user : the doctor ? More time saved ! 3. Screening and Registration Recipe Card# Work Sequence Standard1 Screen at ATT Kiosk Ask Pt:1. Sir / Mdm, do you have Cough, Cold, Flu, Fever, Sore Eyes or Diarrhea?2. If Pt has Flu, Fever, Sore eyes or Diarrhea scan IC for Q ticket & direct to Screening 1 Station2 Screening 1 Station (URTI Symptoms / Diarrhoea / Sore Eyes Patient ONLY)1. Check Temperature2. Write temperature on Q Ticket3. Handoff Pt to Screening Staff3 Screening 1 Declaration Ask Pt:1. Are you here for a Referral or Long Term Medication2. Any Cough, Running Nose or Sore Throat3. Any Fever4. Any Diarrhoea5. Any Sore Eyes6. Does he need a Medical Certificate (If no, refer to OTC)Direct Pt to Waiting Area & wait for Reg Counter 1 or 2 to call.4 Exchange 2XXX with 5XXX Exchange Queue Ticket1.Patient eligible for Blue Cluster to exchange 2XXX Queue number with a 5XXX2.Staple a 5xxx number together with the 2xxx number. Ask patient to hold on to aduplicate 5xxx Q number.3.Ask patient to drop off the stapled 2xxx and 5xxx on a tray at the dedicated counters4.Ask patient to wait for his 5xxx number to call to be registered. 4. Recipe Card (Cont.)#Work SequenceStandard5Registration Counter Ask Pt:1.Call 5xxx Pt on Q panel2.Collect Pt 5xxx Q ticket3.Pt Identifier4.Sir/Mdm Im going to ask you some questions to make your Dr visit smoother5.Do you have any other complaint that requires attention by the Dr?6.Are you here to request a hospital referral?Patients who answer YES to 5 or 6, assign to normal acute cluster Dr6Reg URTI PatientsAsk Pt:1. Have you had fever for more than 4 days?2. Have you had fever >38C during this illness?3. Do you have Diabetes, Stroke, Heart or Lung Disease or are you taking any medicine for cancer?4. Any history of Asthma?5. Document all information into PSA template7Reg Keying into Enotes Enotes1. Copy & Paste Standard Template into Pts Enotes Free Text2. Edit the information in the template according to the answers given by the patient3. Save the information keyed into Free Text8Reg - Closing1. Assign Patient to Blue Cluster Dr2. Print out Service Chit3. Give Patient Service Chit4. Direct Patient to L2 Blue Cluster 5. Project Overview A self-help kiosk for patients to Answer basic health questions relating to medical history andclinical symptoms related to URTI Measure vital signs Upon patient being called, transfer all answers directly intodoctors electronic notes Future Application Allow remote consult during pandemic outbreaks Allow patient education to take place and improve health literacylevel 6. Current Condition 7. Proposed Flow (Pilot Phase 1) Q-Ticket Staff registers Dr sees patient, Patient Patient scans / generatedPatient waitsDoes and assigns prescribes presents at keys in MRN(2XXX Counters 3-5 patient haspatients to medication andPre-Reg No. Series)N for URTI? Non-URTI enters consult notes KioskRegistration Cluster in Aurora YPatient issued 5XXX series Q-No and waits for Dedicated RegCounters 1-2Counters 1-2 calls 5XXX Q- No. to register/assign patient to EndRms 46-47 Blue Zone and directs patient to HAWKSKioskPatient goes toPharmacy forprescription/payment Patient beginsanswering HAWKSKiosk Questions EndChanges madeHAWKS KioskPatient is sent backin Pilot Phasedetermines if patientto Counters 1-2 to eligible for Blue be reassigned to N another cluster Zone?Note:Y1.Patient has to be registered for visitPatientsBlue Zone Doctor callsinfo to be fired to all downstream Patient proceeds tointerfaces. Temperature/Weightpatient and opens patients taken by HAWKSwait at Blue Zoneclinical notes with2.5xxx series number acts a sequencerKiosk and Data waiting area forHAWKS data andfor dedicated Registrationgathered from Kiosk Consultation. proceeds with consultation.3.Kiosk would be aided by a HA duringflows to Aurorainitial pilot phase. 8. Workflow simplified viewPatient Obtains No. from ATTPatient has tobe registered before data from kiosk can flow toOtherAuroraComplaintsWaits for RegistrationPSA asks for purpose of visitwith General Pool URTI ComplaintsDedicated PSA Sent toPasses Acute VSM CriteriaMaintains room Registration & assigned to AcuteHawksassignment and consults KioskAcute VSM DoctorVSM DoctorFails Acute VSM Criteria, sent back to PSA &reassign to Acute Cluster 9. HAWKS Kiosk QuestionnairesReiteration Question1) DO YOU HAVE COUGH, RUNNY NOSE, SORE THROAT WITH/WITHOUT FEVER ? ( Yes - Proceed. No - Exit from kiosk flow )Exit Questions1) DO YOU HAVE ANY COMPLAINTS OTHER THAN COUGH/RUNNY NOSE/SORE THROAT +/- FEVER ? ( No - Proceed. Yes - Exit from kiosk flow )2) DO YOU NEED A REFERRAL OR DO YOU NEED TO TOP-UP YOUR (CHRONIC) MEDICINES ? ( No - Proceed. Yes - Exit from kiosk flow )3) ARE YOU PRESENTLY TAKING ANY MEDICINES/INHALERS FOR ASTHMA ? ( No - Proceed. Yes - Exit from kiosk flow ) 10. HAWKS Kiosk QuestionnairesActual data gathering at the Kiosk(Data has to flow in sentence format to Subjective Section of the Doctors eNotes)1) DO YOU HAVE COUGH ? IF YES, FOR HOW MANY DAYS ?2) DO YOU HAVE RUNNY NOSE? IF YES, FOR HOW MANY DAYS ?3) DO YOU HAVE SORE THROAT ? IF YES, FOR HOW MANY DAYS ?4) DO YOU HAVE A FEVER ? IF YES, FOR HOW MANY DAYS ?5) DID YOU CHECK YOUR TEMP AT HOME ? WHAT WAS THEMAXIMUM TEMPERATURE DURING THIS ILLNESS? ____6) PRESENT TEMP ___ C 11. Appearance in e-notesFinal appearance by Phase 2 would be grouping of symptoms according to duration, with longest mentioned first; for eg : Runny nose and Cough for 4 daysSore throat for 2 daysFever for 1 day Another example:Runny nose and Sore throat for 3 daysNo cough. No fever. 12. Timeline Dsfsdfdfsdfs df sdf 13. Phase 2 and ongoing HAWKs Kiosk to be interfaced with ePOS toassign patients to appropriate consultationclusters/rooms without human intervention.(Future State)