St. Joseph’s Health Centre is taking the steps to enhance patient care through innovation, as plans move ahead as part of our eCare strategy for the implementation of a fully comprehensive electronic health record by November 2013.
Our eCare initiative has the capacity to be “truly transformational” for our organization and for patients, explains Mark Vimr, Executive Vice-President of Clinical Programs and Chief Nursing Executive.
“We’re at a very exciting time with eCare, given all the work we’ve done over the past three years, and the recent decision made by our Board to commit to a revised plan that sees us going live later this year,” Vimr says.
Electronic health records provide a safe way for health care providers to store and access patient health information – and the launch of these records through eCare will result in a secure paperless system here at St. Joseph’s. Our eCare initiative is part of a province-wide push from the Ministry of Health for electronic health records and reflects our goal of Putting Patients First by ensuring the safest care.
Over the past three years, there have been some significant developments in our eCare strategy.
“About a year ago, we fully upgraded the system in our Emergency Department and the current version of the Allscripts software we’re using for our electronic health record, so that we would be in a good position to build the next steps,” explains Vimr. “We called that Phase 1 of the electronic health record journey.”
That first phase helped build the infrastructure for eCare, allowing us to gear up for our November launch.
Where we are now is the second phase – a realignment of our original strategy, which involves a closer look at the logistics of using electronic health records. In order to achieve our goal that means implementation of CPOE (computerized provider order entry), physician documentation and full in-patient clinical and inter-professional documentation.
According to Stephen Banyai, Chief Information Officer at St. Joseph’s, the eCare strategy will be fully integrated. That means everything – including prescriptions, lab results and diagnostic imaging such as x-rays or MRIs – will be in one consolidated patient record available to all clinicians within our organization.
“After November, the patient experience here will change. At that time, when someone comes into the hospital, the information that is collected up-front will be available to all appropriate care providers at St. Joe’s, throughout their entire journey,” explains Banyai.
This will result in a streamlined process that will no longer include repeated questions about patient details, such as allergies and medications, as a patient moves through different hospital units.
“Electronic health records allow you to put in certain checks and balances automatically,” notes Vimr. “So that when certain medications are ordered that may counteract other medications, we can program red flags that will automatically pop up.”
The entire operation will become faster and more efficient, Vimr adds. “But first and foremost, the quality of care that we give is going to be much safer.”
Some patients here are already witnessing first-hand the power of electronic health records. Foreign Exam Management went live late last year, and now allows clinicians at St. Joseph’s to access patient scans from within the GTA West Diagnostic Imaging Repository (DI-r) – a shared regional bank of diagnostic imaging results.
“We now have the capability to store and view foreign studies that are relevant to exams being performed at St. Joe’s,” explains Cam Hyginus, Technical Lead with the GTA West DI-r team at St. Joseph’s.
For example, if a patient here at the Health Centre is scheduled for a scan – such as an MRI or x-ray – then clinicians are able to access any previous scans the patient has had at other hospitals within the GTA West DI-r. This allows clinicians to compare results and ensure they are provided with a full picture of the patient’s history to inform the appropriate treatment. It also has the added benefit of reducing radiation on patients, since repeated scans will be less frequent thanks to easier access to past results. This new capability of being able to share images and results among the various hospitals a patient is likely to visit is a direct result of the Health Centre being connected to the DI-r and ultimately translates into improved and safer care for that patient.
While diagnostic imaging is only a small fraction of the work we do here at St. Joseph’s, it does provide an example of the great potential for improved care thanks to electronic health records. Achieving something similar on a hospital-wide scale is, of course, a much larger task.
“In a project of this size, we have many major milestones,” says Banyai.
“We are in the process now of identifying which devices will be used by health care providers,” adds Vimr. The eCare team at St. Joseph’s is looking at all the options: Smartphones, tablets, computers on wheels and workstations. Phase 2 also involves determining how many devices are needed and where they would be more effective within the Health Centre.
“As well, we’re doing a lot of work establishing the pharmacy database,” Vimr says. “All the drugs we use at St. Joseph’s have to go in that database so that physicians can access the information.”
Staff members that provide direct patient care will begin training in August 2013 for the new electronic health record. A pilot unit will be selected for a trial run of the new system, in order to work out any remaining issues and obtain important feedback from our clinicians. Vimr says St. Joseph’s is also working to put protocols in place so that if our electronic system is ever unavailable or off-line, we would be able to revert back to a paper-based system.
With all of the system upgrades, training and preparation over the last three years, the Health Centre is confident that the launch of the electronic health record will be a seamless transition from a paper-based environment to electronic documentation.
“eCare is our number one priority right now,” he says. “I feel very confident that we have the expertise, leaders, physicians and staff engagement that we need to make this truly successful – and I look forward to seeing the outcome of all our hard work.”
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