Hospitals embarking on eHealth transformation

Computerized physician order entry and region-wide standardization are in the works

Tamara Shewciw, Chief Information Officer, North East LHIN (left) and Brian Ktytor, Vice-president, Corporate Services, North West LHIN.

Hospitals in the North East and North West Local Health Integration Networks (LHINs) are embarking on an ambitious eHealth transformation process that promises to drive efficiencies, and standardize and improve patient care.

In the North East, all 24 hospitals have agreed to work together to upgrade to version 6.1 of the Meditech hospital information system. The One Person, One Record, One System initiative will include the integration of digital order sets and enable computerized physician order entry.

Order sets identify evidence-based procedures and care plans for specific presentations or conditions, including blood tests, diagnostics and medications to be prescribed.

A new business entity or a shared service organization is also being contemplated to broaden the Northeast Ontario Network (NEON) information technology consortium, which currently includes all but three of the hospitals in the LHIN.

NEON, explained North East LHIN chief information officer Tamara Shewciw, has done an outstanding job bringing hospitals together to share technology resources, but with the integration of order sets and the enabling of evidence-based care through the technology, a new shared service organization will also need input from doctors.

“This is an opportunity to really transform hospital-based care in the northeast,” said Shewciw.

Ultimately, the system will also link through to family health teams, home and community care, and organizations involved in transitions of care, including rehab services.

Currently, NEON hospitals are able to share patient records, but the records don’t look the same everywhere.

“Going forward, the layout of the screens will be the same, so it will be much easier for physicians to use,” said Shewciw.

Abbreviations, date formats and pain management descriptions will also be standardized across all hospitals.

The One Person, One Record, One System initiative “will improve patient outcomes, improve safety and reduce harm,” said Dr. Derek Garniss, co-chair of the regional standards clinical steering committee and a Sault Area Hospital emergency doctor. “I see it as a unique opportunity for us to transform how we’re delivering our care. It’s also a much more efficient system because it will provide us with all the information we need at our fingertips.”

Currently, Sault Area Hospital, West Parry Sound Health Centre and North Bay Regional Health Centre are not members of the NEON consortium, “so we can’t pull up information for a patient from Blind River, for example,” said Garniss. “We have to call the hospital, get the patient’s consent and have the information faxed to us.”

The first wave of Meditech 6.1 installs will commence later this year and include hospitals in Sault Ste. Marie, Parry Sound and North Bay. They are scheduled to go live by January 2019. An additional group of hospitals will go live in 2020 and the entire region should be up and running by 2012, said Shewciw.

The North West LHIN is on a similar path.

Thunder Bay Regional Health Centre made the switch to digital order sets in September and most of the other hospitals in the region are moving in the same direction, said North West LHIN vice-president of corporate services Brian Ktytor.

The region’s 14 hospitals are all on the same version of Meditech and are able to share patient records, “so it doesn’t matter where you go or where you come from,” said Ktytor. “There’s one record per patient.”

The North West LHIN roadmap also includes an upgrade to Meditech 6.1, a computerized physician order entry and standardization system.

“Partners and stakeholders have a draft business plan and are engaging to define the journey and build out the roadmap,” said Ktytor.

Further regional integration is also in the works through the Connecting Ontario Northern and Eastern Region initiative, which will provide a clinical viewer doctors and other health-care professionals will be able to use to view patient information across the two Northern Ontario LHINs, as well as the Champlain and South East LHINs.

“They will be able to see key information for a patient from hospital, home and community care and eventually from primary care,” said David Newman, North West LHIN director of information management and eHealth.

Connecting Ontario will also aggregate clinical data, including lab results and drugs.

“All of the hospitals in the North West LHIN have already contributed data to a clinical repository,” said Newman. “Now, we’re in the process of preparing our hospitals and starting to engage with primary care to start to consume the data.”

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