St. Joseph’s electronic patient records focus on improving quality of care

St. Joseph’s Health Centre, Toronto is excited about our progress to date as we enter the later stages of Phase 2 of our eCare project, which is one of our largest clinical undertakings in our hospital’s 90 year history. This project, known as eHealth to some, is the full transition from paper, patient health records to an electronic version. We anticipate the third and final phase of our $20 million eCare project to be completed in 2014.

Right now our focus is all about the build. Across the Health Centre we continue to make progress with the development of order sets and the streamlined process to get those order sets vetted and ready to go when the system is ready to run. We’re coming toward completion of that piece of work and it will then be taken to our analysts and other members of the Information Services team to be built into the system.

The next big thing on the horizon is the go live of clinician order management, which is set to begin towards the end of 2012. This stage of work will follow a “pop-bang” approach, with the first go live taking place in an isolated inpatient unit, followed closely by the second go live which stretches the project to all inpatient areas of the Health Centre. And finally bringing the third go live to the emergency department. In preparation for the first go live of Phase II, Stage 2, the order sets will be completed, followed by the use of the system in a testing environment to validate that everything is working.

Dovetailing with that work is the development of a training and education strategy for eCare. Tajbanu Thobani-Lakhani, eCare Education Coordinator, is charged with coming up with a strategy to prepare not only the physicians and clinicians, but also the entire hospital.

Mark Vimr, Executive Vice President, Clinical Programs, sees eCare as part of our overall strategy to Put Patients First in all aspects of care. “Once fully implemented, our eCare project has the potential to enhance several of the Health Centre’s priorities such as increasing safety, improving quality of care, and leading to better overall patient experience,” says Vimr, who is also Chief Nursing Executive. “All Health Centre clinicians and physicians will have access to the same electronic patient records and this will help ensure a smoother transition for patients as they navigate throughout our organization.”

Integral to the go live strategy and education strategy is ensuring that we have good champions and super users out while we go live, who are available to answer questions and support all members of our health care team. To increase our success and reduce bumps in the road as we implement eCare, we are involving staff in the design and usage of how we put electronic records into daily practice. One group providing the Health Centre with this input is our Physician Advisory Group.

“Our hospital is seeing an increase in the level of physician engagement, particularly in our emergency epartment (ED) when it comes to eCare,” says Dr. Paul Sullivan, Physician Lead, eCare at the Health Centre. “A lot of thanks for that can go to Drs Andrew Sue-A-Quan, Albert Lau and Steven Rhee because they truly understand the affect that eCare will have on the flow of their day. They have come on board and stepped into champion roles for the ED in preparation for this and are actively involving themselves in the development and communication of this project,” he adds.

To continue with the engagement of the physicians at the Health Centre, we are in the process of planning a “Day in the Life” walking road show that would visit various departmental meetings. This will allow for the division heads and members of each department to get the first glimpse of how the Health Centre integrates the computer into what we are doing now.

Ideally, eCare will lead to more coordinated care as a patient’s electronic record follows them throughout their health care journey within our hospital. This will reduce the number of times patients are asked the same questions and can reduce adverse events caused by human error and help increase patient safety. We anticipate electronic records will improve patient care and health outcomes throughout the hospital.

Andrew Brearton, Chief of eCare, said the goal of eCare is one patient, one chart. He says “In spite of the anticipated challenges we have encountered we are fully committed to the original goals which Put the Patient First. (And doing this) while ensuring that the engagement and adoption activities are fully aligned with the workflow transformation activities to optimally support staff and physicians in this very complex change management process.”