Posts by :
Manitoba-eHealth is reshaping the way the province delivers healthcare. It’s a big job to deliver an EHR system that serves 1.2 million people spread across 650,000 km2 (roughly the size of Texas).
Manitoba-eHealth recognized the limitations of a paper-based system. The organization wanted an electronic system that was practical, easy to use and relevant. Because patient information is a powerful tool in the hands of clinicians.
Access to patient data helps inform care decisions
For example, Dr. Ricardo Lobato de Faria was the physician on duty at Seven Oaks Hospital (Winnipeg, Manitoba) the night a patient walked in complaining of chest pains. He quickly diagnosed an irregular heartbeat, also known as arrhythmia. Because Seven Oaks has eChart, an electronic health record (EHR) system from dbMotion, he could access more information about the patient.
“Using eChart altered the path of care,” said Dr. Lobato de Faria in a recent article. After reviewing the patient’s information, caregivers realized they could treat the patient’s arrhythmia by increasing his medication dosage. Without access to this data, caregivers may have applied standard emergency treatment (i.e., electric shock), and it would not have addressed the underlying problem.
Launching eChart in Manitoba
Manitoba-eHealth launched the project in December 2010 with 33 primary care and emergency departments. The goal was to create more time for patient care by reducing the time clinicians spent searching for information. It also wanted to improve access to patient information and collaboration between providers.
eChart provides clinicians with a consolidated view of key patient health information. The information feeds into eChart from existing electronic systems, including prescriptions from retail pharmacies, immunization histories, demographic information, lab results and diagnostic image reports.
Lessons learned during implementation
At a recent dbMotion client conference, Manitoba e-Health’s manager of eChart, Shelley Irvine Day, shared a couple of lessons learned:
1) Know your “customers”
Take the time to plan your strategy with site requirements in mind. For example, Manitoba-eHealth discovered that the system’s information was sometimes too urban-centric for more rural sites. Also be aware of each site’s IT projects, such as integrations with other systems, to help avoid potential conflicts during implementation.
2) Communicate early and often
Manitoba-eHealth started driving demand before the program started with e-mail blasts and web information. In response to feedback, it also simplified and condensed its training materials, minimizing the amount of time required for clinicians to complete training. Users responded well to a variety of support materials, including an extranet, ongoing site reports, support contacts and “go-live” celebrations.
Information is the best medicine
These efforts are paying off. Manitoba-eHealth is currently in its next phase of deployment, with a goal to reach more than 300 sites.
Accelerated deployment has dramatically increased user adoption in Manitoba. For example, user logins have increased from 20,000 to nearly 40,000 in just one quarter.
I look forward to more great results from Manitoba-eHealth as the EHR system continues to re-shape how the province delivers healthcare.
Unity Health System (Rochester, NY) is home to one 346-bed hospital, more than 70 ambulatory sites, one home health agency and three nursing homes. While it’s had electronic health records (EHRs) at its ambulatory sites since 2004 and in the hospital since 2006, Unity wanted to improve its connectivity. It set strategic priorities to enable better clinical integration, analytics and care coordination.
The answer was a Health Information Exchange (HIE) called u.Net Connect, powered by dbMotion. The goal is to provide access to relevant clinical information to improve patient care, patient engagement and overall efficiency. The system went live in October 2012.
John Glynn, senior vice president and CIO, and Phyllis Larder, RN, MSN, clinical informatics analyst, shared Unity’s experiences at a recent dbMotion client conference. These tips are helpful if you’re about to embark on an effort to drive clinical adoption of a new system:
1) Don’t make them learn another password. Unity learned quickly from users that single sign-on was a key ingredient to success. It also helped reinforce the message that u.Net Connect is a helpful tool, not another separate EHR to learn.
2) Get consensus before you build. About 80% of your success depends on how you design the system. Engage clinicians early, and make them part of the selection process and design discussions. Unity advises consulting a variety of users, including physicians, nurses and social workers.
3) Design with ease of use in mind. Try and find ways to make the data consistent between systems, for example with vocabulary mapping and logical flow of information. Also, make accessing the EHR easy from different locations.
4) Security is important. Define user roles and limit views based on job requirements.
5) Keep out-of-the-box options. Reduce complexity by working with the system as it is, and limit changes.
6) Test and review as you go. Unity tested data integrity with a five-step process, used validation testing with key end users, training demos and other methods.
7) Support your go-live with helpful resources. Users had plenty of places to turn for help in the early days after launch. Unity provided a command center for the first three days, a bridge line, support staff in assigned areas, communications via the organization’s intranet, posters, overhead announcements, e-mails and face-to-face meetings.
These tips helped make u.Net Connect a success. What advice would you add for a successful HIE implementation?