Frequently Asked Questions
eRIC stands for electronic Record for Intensive Care. It is a purpose built solution developed by NSW clinicians to meet the unique patient safety requirements of Level 5 and 6 Intensive Care Units (ICUs) as well as selected Level 4 sites that are based upon an Intensive Care Service Model. The system integrates data every minute from existing bedside monitors, ventilators and specialised equipment in one configuration for Adult ICUs using evidence based best clinical practise.
The system utilises the integration of data from existing bedside medical devices. There will be one configuration with three specific screen layouts supporting the distinct requirements of Adult, Paediatric and Neonatal ICUs.
As a single solution for NSW, eRIC will help to foster standard practices state-wide and support efficiencies and savings due to better use of resources. It is the first state based build to be rolled out to 21 ICUs in NSW, and once completed will be one of the largest system-wide ICU clinical information system in the world.
ICUs are the most data-intensive part of any hospital. Compared to regular wards, in an ICU thousands of data points are recorded per patient daily, often across multiple organ systems. Integration between devices (monitor, ventilator and dialysis machines) and the CIS is essential to improve data collection accuracy and decrease staff workload to record these parameters, enabling a higher focus on data analysis and overall patient care. A ward-based electronic solution cannot provide the complex minutely patient analysis necessary to safely manage the critically ill.
Development of the eRIC system is the result of a complex consultative process that included well defined governance with broad representation from clinicians, including ICU specialists, ward based clinicians and allied health specialists, health administrators and technical specialists. The system underwent a robust procurement process with expert ministry, technical, commercial and clinical representatives from across the state. eRIC has been built on the latest version of MetaVision software and specifically configured for the NSW Health environment. MetaVision software is used in ICUs in Queensland, Western Australia, the ACT and a number of large international ICU installations including Alberta (Canada) and Sorost (Norway).
Staff members who regularly look after patients within the ICU will be granted full access to eRIC specific to their role within the ICU. Staff members who are only required to view data for a patient from the ICU will be granted read-only access. In addition, if there is a need to view other patient data in ICUs within other eRIC based hospitals or LHDs, any staff member that is required to view data for a patient in the ICU will be granted read-only access to eRIC.
Each ward can produce 16 reports as Excel spreadsheets to support day-to-day management and optimisation of the unit’s operations. The reports are developed in consultation with Reporting SMERG (comprising of ICU clinicians and researchers) and produced automatically on the first day of each month for the previous month (except for Summary report which is produced every six months).
The reports include the following:
- Exit Block From ICU
- Readmission Within 48 Hours of ICU Discharge
- Admission Due to Rapid Response Call
- After Hours Discharge
- Reason for Intubation
- Renal Replacement Therapy
- Admissions and Discharges
- Mechanical Ventilation Hours
- Mechanically Ventilated Patients
- ICU-Acquired CLABSI
- MRO on Admission
- MRO in ICU
- Free Text Medication Usage
- Known Allergy/ADR Prescription Override
While integration between systems is a very complicated process, in the federated environment of NSW, eRIC will have to integrate with a number of systems in each of the LHDs. The eRIC system will communicate with the patient administration systems (eg PAS and PIMS), active directory (AD), electronic Medical Record (eMR), laboratory information systems (LIS) and radiology information systems (RIS) in each LHD.
A discharge summary of the ICU stay, known as the electronic Handover of Care (eHOC) document will also be exported to the eMR for easy access. In the short term eRIC and eMeds will not be integrated. This is seen as an important safety component that will ensure medication reconciliation on entry to and exit from the ICU, preventing the inadvertent continuation of medications at transition of care. The information obtained from eRIC will be exported to key databases such as the Adult Patient Database (ADP, ANZICS), ANZPICR and EDWARD data warehouse.
eRIC is delivered through a centralised deployment model, providing structured, supported implementation on a site-by-site basis. Deployment is managed and owned by the eRIC Program team and includes;
eRIC is currently deployed at;
- Central Coast LHD
- Hunter New England LHD
- Mid North Coast LHD
- Northern NSW LHD
- Illawarra Shaolhaven LHD
- South East Sydney LHD
- Northern Sydney LHD
- Western Sydney LHD
The eRIC application is built using the state based model to deliver the solution. This approach requires common design and shared investment for design, build, testing and support. The state based build approach will promote safety and quality in ICUs as it ensures standard eRIC design and build across all ICU facilities. This ensures that clinicians experience a consistent eRIC design as they move between facilities. There has been extensive consultation regarding the contents of the state based build for eRIC with clinicians working inside and outside of intensive care. A recurring feature of clinical engagement was conformity and agreement in many decisions regarding the build of eRIC.
A key component of the centralised model will be a need to maintain a current layout throughout the state.
eRIC is an enterprise solution available to all level 4, 5 and 6 public ICUs within NSW. This includes all intensive care (general, cardiothoracic and neuro) and high dependency beds managed by intensive care teams. Coronary care, operating theatres and private intensive care beds are not part of the eRIC deployment.
Ventilators, bedside monitors, and dialysis machines will all be integrated into eRIC. Audits have been undertaken across the State to identify current equipment in use. As new equipment is purchased by facilities the required interfaces can be developed to integrate the bedside device with eRIC. Transport monitors, transport ventilators, syringe drivers, infusion pumps and standalone devices are not currently in scope for integration with eRIC.
eRIC's first deployment was in Port Macquarie Base Hospital on mid-October 2016. The entire deployment of eRIC will continue into 2020.
Yes. As units expand throughout the State, eRIC will be available. Part of the cost of new ICU beds will include the requirements for the installation of eRIC. The requirements for a CIS have been incorporated into the Australian Health Facility guidelines. These guidelines outline the requirements for building new ICUs and match the specifications required for installing eRIC into new ICUs.
The eRIC Program will meet the cost of installing this equipment. If there are specifications in excess of the minimum recommended standards, ICUs or LHDs may elect to meet these at their own cost. Monies will be allocated to LHDs to meet the ongoing costs of eRIC.
eRIC is designed with high availability and disaster recovery to ensure there is appropriate redundancy for all system components. The infrastructure supporting eRIC will be hosted in the “All of Government Data Centres”. There are two data centres, for redundancy, located in Silverwater and Unanderra.
The system will rely on the Health Wide Area Network (HWAN) to deliver eRIC into hospitals. The HWAN provides hospitals with a redundant and high performance network that will ensure eRIC’s availability. The data will be backed up frequently to minimise data loss in the event of unplanned system problems.
When the system goes down due to planned or unplanned downtime, units will revert to emergency paper packs. Medication charts eNIMC (electronic National Inpatient Medication Chart) will be printed out in a format designed to align with the State Forms NIMC (National Inpatient Medication Chart) and access to patient files will still be available via the Emergency Data Access (EDA) terminal. Extensive backup and downtime plans have been developed for the system.
eRIC has a comprehensive program to support the system after deployment. Each unit will have a clinical information system (CIS) manager to support eRIC. There will also be a 24 hour telephone helpdesk managed by the Statewide Services Desk. As the system is deployed throughout NSW, the eRIC clinical application services (CAS) team will be set up to support the continued operation, maintenance and upgrade of eRIC.
Some of the data received by eRIC includes:
- Patient demographics (Medical Record Number , Area Unique Identifier, patient’s first and last name, date of birth, sex, religion and contact details such as address, phone number)
- Patient visit information relating to their hospital visit/s, ward, bed, admission date and time, Admitting Medical Officer, discharge date and time
- An electronic Handover of Care summary is generated as a pdf that can be printed
- Sixteen Operational reports
- Pathology results and reports will be pushed from the laboratory to eRIC
- Allergies and Adverse Drug Reactions
- Medical images e.g. X-rays and CT scans will be available via eRIC
- An electronic Handover of Care document (eHOC) will be added to the patient’s electronic Medical Record (eMR)
- The severity of illness scores and outcome data will be transferred to ANZICS
Yes, records will be archived soon after the patient leaves the ICU. This step is carried out by your CIS Manager.
Archived Cases can be accessed using the normal search feature.