Specifications, option analysis and business case for the digitisation of Clinical Manuals

⁠⁠⁠The Rural and Remote Clinical Support Unit (RRCSU), a statewide funded service based in Cairns, produces two clinical reference manuals. One of these is the Primary Clinical Care Manual (PCCM), the other is the Chronic Conditions Manual (CCM). Both manuals include hundreds of evidence-based clinical protocols and medicines instructions that guide isolated clinicians in the provision of clinical care.

Both the PCCM & CCM are currently accessed via web-based PDFs, via a USB or an A5 printed hard copy book.

The RRCSU manages the workflow and produces both manuals from end to end including the initial drafting, approvals for protocols to the distribution of manuals, USBs and web-based hosting of PDFs.

The Royal Flying Doctor Service, Queensland Section (RFDS) and Queensland Health (QH) share ownership of the PCCM.

The manuals are used across a broad spectrum of settings. All are isolated, there may not be a medical practitioner immediately available, and key stakeholders include:
• Rural health services across Australia. Most users are spread across rural Queensland. Staff from the following areas are key users:

• Torres & Cape Hospital & Health Service (HHS)
• North West HHS
• South West HHS
• Central West HHS
• Department of Health (Victoria)

• The RFDS
• All branches of the Australian Defence Forces (ADF)
• Aboriginal and Torres Strait Islander controlled non-government organisations (NGOs) – including Apunipima Cape York Health & Gidgee Health
• The manuals are used for educational purposes by some Vocational Education & Training (VET) providers
• The Australian College of Rural & Remote Medicine (ACRRM) has an agreement to host PCCM content

The manuals contain detailed protocols to support the delivery of clinical care in the primary care setting and rely on published best practice research findings & guidelines as their basis.

The PCCM is legislatively based, having its origin in the Queensland Drugs and Poisons Regulation 1996, likewise the Defence Forces and Victorian Department of Health authorise use of the manuals to support the provision of clinical care. Clinicians who are currently authorised to administer and/or supply medicines under the PCCM in Queensland include:
• Registered Nurses
• Rural and Isolated Practice Endorsed Nurses
• Isolated Practice Sexual and Reproductive Health Authorised Nurses
• Immunisation Program Authorised Registered Nurses
• Isolated Practice Area Paramedics
• Midwives
• Authorised Indigenous Health Workers
• Aboriginal & Torres Strait Islander Health Practitioners.

An initial workshop has been held, with agreement being reached that a digital solution is now required to ensure that content is available across a variety of austere, rural, & isolated settings and in a variety of formats.

Content will need to be up-to-date, searchable, and accessible to clinicians in a variety of settings (including being available both online and offline), on planes, ambulances, hospitals, in the field, in clinics, in print and via an App on smart phones.

This work will:
• Identify and implement innovative approaches to broad-based and diverse stakeholder consultation with PCCM/CCM users from across Queensland Health, the RFDS (Queensland Branch), NGO providers, the Defence Forces and Victorian Health
• As-is journey mapping & future state mapping
• Develop and validate detailed stakeholder needs analysis, specifications and proposed architecture
• Outline the options to be considered in the succeeding phases, and make recommendations on:

• Options in terms of proposed architecture, workflow solutions, system & content structure
• Cyber Security
• Cost to implement and
• Potential suppliers

The proposed solution must be driven by raw format content, and must be device agnostic, with an ability for printed manuals to be provided.

Reporting outputs:
• Stakeholder consultation map & plan
• Proposed specification & architecture report
• Detailed functional and technical requirements, including process flow maps
• Option analysis – including identified costs and cost benefits
• Business case for final solution
• Implementation plan including indicative resourcing effort