Interior Health Information

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Interior Health Information TechnologyA
Strong Foundation leads to Higher Quality
CarePat RyanBCHiMPs HIMMS northwest - April
2003
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(No Transcript)
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Interior HealthDemographics

• 233,000 Square Kilometers. 25 of BC.
• Population 690,000. 16.5 of BC.
• 1.1 billion operating budget
• 28 Acute facilities
• 91 Residential facilities
• 40 Health Units
• Total 183 Locations
• 740 Private Contracts. 74 million.
• 17,000 Employees

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Physicians Use the Systems

• 1,200 Physicians
• 78 of Physicians actively using the systems in
  some areas. (I.e. 355 of 456)
• 1/3 of Physician access is from remote.

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IT Budget / of Gross

• IT Base operating budget 1.1 of Gross
• Board approved 2002/3 IT Strategic Plan.
• June 2002 New 1.9 of Gross.
• Business Systems Plan - 3.7m
• Clinical Systems Plan - 21m over 3 years.

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OBJECTIVE

• Lifelong Client Centric Electronic Health Record
  available to care providers and clients anywhere
  within Interior Health.
• Bridging the Distance between care providers and
  clients through technological innovation.

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Interior Healths EHR Journey

• If you build it, will they come?

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Home Community Care
Digital Images
Interior Health EHR
Clinical Assessment Documentation
Pharmacy Records Diagnostic Results
Physician Records Reports
Lifetime Record of Visits
Individual Goals Plans
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Concept - FULL EHR
BC/Alta Health Authorities
Provincial Systems - PROMIS - PHIS -
Pharmanet - etc.
Acute Care
Community Care
Residential Care
Remote Physician Access
Client
Public Health
Mental Health
External Agencies - Labs - Private Healthcare
Providers - Non Profit Societies
Physician Practice Systems
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Current State in some areas of Interior Health
Remote Physician Access
Acute Care Admissions, Lab, Pharmacy, Radiology,
Transcription, Order Entry, Partial Clinical
Documentation
EHR
Residential Care Admissions
Community Care Client Registrations, Referrals,
Partial Clinical Documentation
Client
Mental Health Client Registration, Clinical
Documentation
Public Health Client Registration, Clinical
Documentation
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Order Entry

• Meditech Order Entry Installed at
• Kelowna General Hospital March 1989
• Vernon Jubilee Hospital October 1997
• Royal Inland Hospital November 1997
• South Okanagan General Hospital January 1999
• Kootenay Lake Hospital December 1999
• East Kootenay Regional Hospital June 2000
• Penticton Regional Hospital June 2002
• Creston District Hospital November 2002

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Realized Benefits

• Increased Quality / Safety
• Increased turn around time for results
• Reduced errors (e.g. adverse reactions, lost
  orders, duplicate orders)
• Consistent/standardized collection of key patient
  data (e.g. allergies, height/weight, patient
  alerts)
• Increased communication among care team
• Automates referral/communication process with
  Community Care Programs

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Realized Benefits

• Increased efficiency
• Elimination of manual requisitions for inpatient
  orders
• Automated order status tracking
• Reduction in duplicate data capture
• Automated decision support statistics

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Implementation Strategies

• Big Bang Implementation the Most Common
  Approach
• All patient orders
• All nursing units in a facility go-live
  simultaneously
• Invest in Training 6-8 hrs of training for
  nursing
• Senior Management Sponsorship

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Implementation Strategies

• Involve all the key stakeholders in the
  implementation
• RNs
• Unit Clerks
• Diagnostic/Ancillary Departments
• IT
• Development of Super Users on each Unit
• Computer training incorporated into the staff
  orientation process.

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Implementation Struggles

• Buy-in from Nursing. Immediate benefits accrue
  to diagnostic/ancillary departments. Nursing
  benefits are achieved over a longer time period.
• Perceived increased time to process orders
• Computer competency
• Change management

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Physician Usage of EHR (Patient Care Inquiry)

• 1,200 Physicians
• 78 of Physicians actively using the systems in
  some areas. (I.e. 355 of 456)
• 1/3 of Physician access is from remote.

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Physician Usage of Patient Care Inquiry

• Implementation Strategies
• Implement after Admissions, Lab, Radiology,
  Transcription, and Pharmacy are on-line
• Provide 11 hands-on training sessions for
  Physicians
• Provide MOA training and access from office
• Provide Physicians Remote Access from their
  office and home (organized and paid for by
  Interior Health).
• Reduce telephone service from diagnostic
  departments.

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Are We Ready to Build the Roof?

• Physicians and clinical staff have incorporated
  Information Technology into Their Daily Clinical
  Practice.
• The EHR foundation is in place.

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Next Steps

• Computerized Physician Order Entry
• Awareness and Education
• Exploration of software and hardware options
• Identification and Selection of Pilot Projects
• Bedside Medication Verification and Online
  Medication Administration Record
• Bar-coding and wireless technology

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Interior Healths EHR Journey

• If you build it, will they come?
• Yes, I believe they will come

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Interior Health Information
TechnologyThank You A Strong Foundation
leads to Higher Quality Care Pat RyanBCHiMPs
HIMMS northwest - April 2003