Reducing Cardiac Care Wait Time

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Lina Rinaldi is a highly experienced nurse and Director of Cardiac Services Health System at the Trillium Health Centre in Mississauga. Each week, she ensures more than 130 patients get timely access to advanced cardiac procedures at her facility.

Lina uses the Cardiac Care Network of Ontario (CCN) wait list registry to monitor patient access to advanced cardiac services, of which there are more than 80,000 procedures performed every year in Ontario.

In August 2004, Trillium was one of the first hospitals to begin connecting to CCN using the secure private Internet developed by Smart Systems for Health Agency (SSHA). These connections allow CCN and hospitals to securely share the essential information needed to manage cardiac wait lists. It also reduces costs and complexity since each hospital uses a common network for communications instead of multiple, independent ones.

Dr. Kevin Glasgow, CCN CEO, says: “I’m enthusiastic about CCN partnering with SSHA and others to reduce cardiac patient wait times in Ontario.”

CCN’s wait list management system has been recognized for its leadership in the Wall Street Journal and The Globe and Mail as well as the Romanow and Kirby reports on the future of healthcare in Canada and was called a national success story by the CBC in a segment on The National.

Rinaldi states, “The CCN wait list registry helps me, the clinicians and the regional cardiac care coordinators better predict the acuity of patients, so that they are treated fairly based on their clinical condition and symptoms, not simply on a first-come, first-served basis.”

“We can track how long patients have been waiting to ensure that they don’t wait longer than recommended timelines. The wait list registry also helps us schedule our resources and we can make quality improvements in our processes.”

CCN’s managed wait list is the largest database of its kind in North America, expected to grow to 110,000 procedures by 2008 as a result of an aging population, which will create increased demand for cardiac care.

Dr. Glasgow says: “Cardiac care workers across Ontario are helped tremendously by CCN’s wait list registry system and network infrastructure. There’s a growing demand for managing patient wait lists and cardiac patients in Ontario have benefited from CCN’s internationally recognized system.”

A centrally administered wait list has many benefits for patients, including reduced wait times, the assurance of knowing their cardiac wait times are centrally monitored, and they have access to cardiac care coordinators as an added resource for help.

Health system managers and cardiac care coordinators use CCN to better plan and adjust timetables. Patients benefit from better scheduling based on their needs.

CCN CEO Glasgow notes that, “gathering accurate, up-to-date and secure data from the 17 member hospitals is quite a challenge. We’ve been using a variety of file transfer mechanisms.”

“In August 2004 we started using the Managed Private Network run by SSHA to transfer data from two of our member centres to the Provincial Office. The network connection is secure, reliable and offers better performance than the other data transfer methods we use. SSHA understands the absolute need of up-time, especially in the case of acute cardiac care.”Privacy and security are other advantages of SSHA’s network. Highly sensitive health information, like the data in CCN’s patient wait list management system, needs special handling. SSHA understands the importance of privacy and security. That’s why CCN plans to work with all of our member cardiac centres to use SSHA’s network over the coming year.Once all 17 hospitals in the CCN network are connected through SSHA, quicker data flow with less downtime is expected.

CCN has recently been approved to move to a centralized, online web-based registry. It will provide real-time capabilities allowing cardiac care managers to better monitor waiting times for cardiac surgery, catheterization and angioplasty. The new system will also have the capability to monitor other cardiac procedures to help ensure even more patients receive appropriate and timely access to care. It is likely CCN and SSHA will work together on these future improvements as well.

For Rinaldi and other wait list users, and the cardiac patients they help, data transfers are seamless. Rinaldi says, “I just know that I can rely on the system having accurate data that is transferred securely.”

CCN’s move to SSHA’s network takes advantage of existing computer technologies that transfer health data. By allowing CCN and its members to be worry-free about data transfers, they can focus on providing better patient care. They have more time for analysis, refining urgency rating scales, and planning for future requirements.

Another result is CCN can focus on operating the Provincial Adult Cardiac Registry and advising the Ministry of Health and Long-Term Care and assisting with planning for advanced cardiac care in Ontario. For users like Rinaldi, they can focus on improving patient access to cardiac services.

An added service to patients is that the CCN website provides information on waiting times by cardiac procedure, by each of the member hospitals, and by urgency rating. To view this information, which is currently retrospective, please visit www.ccn.on.ca and look under Patient Access to Care.

When the new web-based system is ready, patients, physicians and healthcare providers such as the regional cardiac care coordinators will be able to find out wait times for all advanced cardiac procedures, by cardiac centre by urgency rating in real time. This will enable patients to see what their options are for discussing a shorter wait with their referring physician.