The new system, a Canadian first, gives care providers access to patient information anytime, anyplace, improving care coordination, efficiency and effectiveness.
The Centre for Diabetes, Endocrinology and Metabolism of St. Joseph’s Health Care London has long been a leader in innovation and diabetes care, and now another ground-breaking milestone has been reached. The team has successfully combined clinical and research work with technology to implement an innovative electronic medical record (EMR), the first of its kind in Canada.
Web DR (Web-based Diabetes Records) is a fully functional diabetes-specific EMR. With no existing EMRs available to meet the needs of the outpatient diabetes clinic, the team, over the past two years, built this new system from the ground up under the leadership of Dr. Stewart Harris and Dr. Irene Hramiak, and project leads Dr. Tamara Spaic and Selam Mequanint.
Web DR is a diabetes-specific, web-based, researchable, electronic medical record and database, explains Dr. Spaic. It is simultaneously used by the primary and tertiary diabetes specialists, medical trainees, diabetes educators, allied health professionals and administrative staff at three locations: the Diabetes, Endocrinology and Metabolism Clinic at St. Joseph’s Hospital, Diabetes Education Centre also at St. Joseph’s Hospital, and the Primary Care Diabetes Support Program at St. Joseph’s Family Medical and Dental Centre. (All are part of St. Joseph’s Centre for Diabetes, Endocrinology and Metabolism.)
“Each patient has a unique Web DR medical record that can be used by all diabetes team members,” says Dr. Stewart Harris. “This allows coordination of care across disciplines and helps improve the efficiency and effectiveness of care delivery.“
Web DR was built by an external vendor and is now fully supported by Information Technology Services at St. Joseph’s, providing maintenance and sustainability. It has a bidirectional link with the hospital electronic medical record system (Cerner), providing multiple interfaces with Cerner to receive patient information and also send completed assessments and clinic notes back to Powerchart in Cerner. The clinic note, previously requiring transcription, is now created automatically using a unique combination of dropdown menus, checkboxes, and free text fields. This promotes ease of use and speed, while still preserving the narrative nature of the note.
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Web DR currently houses more than 15,000 patient records from the diabetes care programs at St. Joseph’s. At present, 14 physicians and more than 40 aligned health care professionals use Web DR for more than 90 per cent of patient visits.
“There has been a great interest in Web DR across the region,” says Dr. Hramiak. “The next expansion will include the Paediatric Diabetes Clinic at the Children’s Hospital, London Health Sciences Centre. Future plans are to continue to expand to other care providers in the region.”
Through the creation of Web DR, “we have learned that accepting new and letting go of old requires time, support and strong leadership,” adds Dr. Spaic. “But once Web DR was fully adopted in the clinical practice, it was difficult to imagine not being connected and having information at your fingertips – anytime, anyplace. Today, we can say we are at the forefront of diabetes patient care. It is wonderful to see so much involvement from everyone, and the support from the hospital has been great.”
Web DR Benefits
Improved documentation and efficiency:
- From paper-based to electronic-based practice
- From a desktop-based computer system to a web-based system that is enhanced to meet the needs of care providers anywhere, anytime, and improve care delivery
- From dictation to electronic documentation
- From manual faxing of consult notes to electronic distribution to referring physicians
Improved coordination of care:
- Interface with the Cerner system for demographic information and real time laboratory results
- One-patient, one-chart approach for optimization of care and enhanced patient safety
- A dynamic link between providers to enhance information sharing and delivery of best practice in care of diabetes patients.
Quality Improvement and research
- Facilitates access to researchable data for researchers, as well as medical students, research fellows and residents as part of their training.
- Allows care providers to measure workload, quantify their patient population demographic as well as a clinical profile for strategic planning and budgeting purposes.
- Allows for the creation of reports for practice audits and influencing changes in care process.