VCH/PHC March 2014

CST Lunch and Learn with Demo August 12, 2014 Dr. Kellé Payne, Executive Director and Transformation CST Lead, VCH Dr. Bruce Long, Chief Medical Information Officer, VCH/PHC

3 A joint initiative of VCH, PHSA, and PHC Objectives of Lunch and Learn Session TopicWhoTime 1.A better understanding of CST Project and timelines 2.Know how to get involved or find out more Kellé Payne10 min 3.Better visualize our new system through a demonstration of Cerner technology Bruce Long~30 min 4.An opportunity to ask questions Panel15 min 5.Close: 1 st of many interactions with the CST project team Senior Leaders 2 min

4 A joint initiative of VCH, PHSA, and PHC Evolving Together With Our Patients Front and Centre This is our path to smarter, seamless care through: 1.a patient-focused clinical transformation; and 2.smarter technology tailored by us. The large scale and scope mean it won’t be easy, but it will be worth it. Our Shared Vision Our patients experience the best care in Canada because our world-class health professionals are supported by the highest-quality clinical information.

5 A joint initiative of VCH, PHSA, and PHC Scope of Project Inpatient Areas Outpatient Services Ambulatory CareOncology (TBD) Enhanced Ambulatory Care (TBD) Residential Clinical standardization CPOE Closed loop medication management Electronic clinical documentation Clinical Decision Support Pharmacy, laboratory, and radiology systems integrated

6 A joint initiative of VCH, PHSA, and PHC Evidence Indicates That…. Clinical automation and standardization is now recognized as a significant means to reduce medical error and improve outcome Source: Canada Health Infoway

7 A joint initiative of VCH, PHSA, and PHC What is CPOE? Computerized Physician/Provider Order Entry −Yes, it means the physicians enter the orders, rather than write them Becomes: This:

8 A joint initiative of VCH, PHSA, and PHC Why Are We Doing This? Improve patient outcomes Reduce medication errors Improve ability to use current data to monitor performance/guide decisions Replace old and separate clinical information systems

9 A joint initiative of VCH, PHSA, and PHC Current Healthcare Model Being Challenged For every …… in Canada 1000 hospital admissions75 people suffer an adverse event 1000 patients discharged from hospital 90 suffer a serious problem from drugs received upon discharge 1000 laboratory & radiology testsUp to 150 are unnecessary duplicates 1000 women at risk of cervical cancer are not screened 1000 patient visits with a Specialist680 Specialists received no patient info 1000 post-heart attack patients do not receive recommended Beta-blocker therapy 168 traditional health records received 136 did not have the information required to make patient care decision Source: Canada Health Infoway

10 A joint initiative of VCH, PHSA, and PHC How Other Organizations Have Benefited University of Pittsburg Medical Center decreased serious medication errors by 92% and medication safety events decreased by 60% Ohio State University Health System reduced medication turn- around times by 64% Implementation of CPOE has been shown to reduce adverse drug events by 70% North York General reports 91% of their eCare patients have medical histories taken North York General reports mortality rates for preventable in-hospital deaths for pneumonia or CPOD decreased 45%

11 A joint initiative of VCH, PHSA, and PHC Overview Of Project April 2013January Fall Phase 1: Strategy & Verification Phase 2: Enterprise-wide Design, Build & Integrate Phase 3: Implementation across VCH, PHSA, and PHC Current PhaseCompleted PhaseFuture Phase

12 A joint initiative of VCH, PHSA, and PHC The diagram below represents the phased rollout of the new clinical practices and clinical information systems across VCH, PHSA and PHC. The order of the sites rolling out and associated timeframes are subject to change. Phase 3: Implementation 2015 – 2018

13 A joint initiative of VCH, PHSA, and PHC Ways To Get Involved Providers (Physicians, Nurse Practitioners, Midwives, Dentists, Pharmacologists) Inquire about the: Provider Decision Group Device Strategy Task Group Order Sets Design Teams All Staff Connect with design team members or colleagues participating in testing Participate in the last part of testing (May 2015) Become a CST Champion to provide peer support

14 A joint initiative of VCH, PHSA, and PHC How to Find Out More Talk to your manager Visit CSTproject.ca or a question to Watch for CST bulletins and newsletters Contact a member of the CST Clinical Leadership Team: Dr. Bruce Long, Chief Medical Information Officer, VCH/PHC - Dr. Alain Gagnon, Chief Medical Information Officer, PHSA - Dr. Kellé Payne, CST Executive Director/Transformation Lead, VCH - Donna Stanton, CST Executive Director/Transformation Lead, VCH - Vicky Crompton, CST Executive Director and Transformation Lead, PHSA - Grant McCullough, CST Corporate Director/Transformation Lead, PHC -

15 A joint initiative of VCH, PHSA, and PHC A Demo Followed By Question Time You’re about to see a demo of the Cerner technology to help you visualize what our system will look like Follow a patient through the Emergency Department to see how providers will interact with the system and the patient’s experience. Our clinical information system is in development (due Spring 2015) We want to hear from you in question time… What excites you about CST? What are your questions or concerns?

A Day in the Life: A Patient’s Journey through the ED Bruce Long

17 A joint initiative of VCH, PHSA, and PHC What you will see during today’s demo – as a Nurse and as a Physician How a patient “flows” through the system How the Tracking Board is instantly updated with real time information on your patient How orders are entered and medication administered through closed loop medication Decision support and access to legacy systems Customizable preferences “On demand” access to patient documentation, including past history, clinical and discharge summaries

18 A joint initiative of VCH, PHSA, and PHC Quick Registration

19 A joint initiative of VCH, PHSA, and PHC Benefits Patient information available “real time” through the Tracking Board An electronic patient chart available at your fingertips, no more searching for the chart, or manual updates on paper or a whiteboard Closed loop medication with bar coding – the right medication for the right patient at the right time Decision support (i.e., stroke screening indicators) Access to legacy systems (i.e., MUSE) Customizable preferences for care providers “On demand” patient documentation (i.e., ED Summary, Patient Summary and Clinical Summary) Easy access to patient history, including prior clinical and discharge summaries

Question Time and Group Discussion