1. BC Nursing Informatics
Project Presentation
BC Nursing Informatics
March 31, 2017

2. Agenda
What is eCommunityNEXT? (Initial vision, plans, structure and timelines)
Care planning workshops
Vendor Involvement: Agile method
Roadshows
Roll-out and Sustainment Model
What is the CCP (Demo)

3. Clinical and Systems Transformation System Enablers for Quality Care
Acute & Ambulatory
Community Care
Primary Care *
Improving patient outcomes and reducing unnecessary variation in care through CST across the continuum
Cerner
PARIS v6.0
IntraHealth
Profile
* VCH funded Primary Care Clinics
Link the electronic health record across all sectors
System Enablers for Quality Care

4. Three Integrated Work Streams
Operational reports
Clinical assessments and forms
Care planning processes
Standardize and streamline work processes within and across programs
Better decision making
Stable indicators and dashboards
Timely reports to CIHI and MoH
Community analytics and management reporting
Better look/feel and easier navigation
Development of Clinical Care Plan
Enhanced information sharing and improved functionality
PARIS v. 6 system
This is our problem broken into 3 streams of work
Within the standardization stream – Reduce the volume of operational reports. Possible with the new print feature in PARIS and more comprehensive data available in Decision Support
Reduce and streamline assessments and forms – starting with 1 major overhaul within each program. Facilitated establishing regional standardization of practice
Define a regional standardized clinical care planning process and design the system to support it. This is the transformational piece of work in the upgrade
Analytics and reporting- The development of data warehouse within decision support to provide more outcome indicators and dashboards to support operations. Focus on outcomes in addition to volume indicators as measures of service provided. Supports the VCH strategic priorities
The build of PARISv6 which includes the Civica development of the clinical care plan module

5. Why a new Care Plan Application?
Key clinical aspects of system design
Supports efficient retrieval of clinical information
Enables clinical care coordination and information flow across program boundaries
Ability to measure the effectiveness of care
Key technical aspects of system design
Integrated, inter-disciplinary and accessible within and across programs
Standardization of location and content in PARIS
Minimal to no duplication of documentation
This is the expectation from the steering committee and this is what we need to deliver.
It’s the framework for care planning that we need to keep in mind when designing the process and system.

6. Transformational Approach for Design of Clinical Care Plan
Visioning & Strategic Alignment
Interdisciplinary Clinical, IMITS, & Civica Engagement
Foundational Elements that support future delivery models
Layered approach and process
Visioning and Strategic alignment – seize the opportunity – PARIS review/ SET attention/ larger CST project/ E-Community Steering visioning ( challenge with senior leadership to prioritize). Moved prioritizing down to clinical 2nd line leadership. Visioning session did articulate specific components that they wanted to see as part of future delivery of care. Care coordinator role and most responsible provider. These have been incorporated in to the design even though these roles are not yet defined and implemented
Interdisciplinary/ cross program clinicians to identify priorities and ranking importance/ IMITS for their priorities from a technical perspective/ Civica engagement as they know their product better than we do and what their vision is of product development . We can also influence their product development
Foundational elements – Clinical care plan ( design workshops with clinical leads, Civica and IMITS/ Civica facilitated workshops) Future care delivery models will need to support communication of care plan across providers and systems, responsive, flexible
Education and support model – requires operational priority to develop and train the coaches and educators to adequately support change management.

7. Design
Identify cross-program, cross-COC Subject Matter Experts (50+) – not front line staff
4 care plan “ideal state” sessions to define care planning ( assessment, identification of needs /problems, interventions followed by re-assessment) and the required Components – Needs, Goals and Interventions
7 detailed design sessions facilitated by the vendor and with a sub group of 15 from the care planning sessions

8. Development Vendor led agile approach to development of the care plan
Total of 7- 3 week sprints ( 5 months overall)
Delivered product essentially bug free and functioned as designed
Some components of the care plan VCH retained control of ( pick lists)

9. Clinical Transformation: Engagement Plan
Subject Matter Experts (SMEs) in Clinical Design Workshops
Clinical Workflow Designs drive system design
Review & Validate design with Peers, Practice Committees, Physicians & impacted stakeholders
Review & Validate
Design with Managers & Directors
Validate & Recommend design with
Project Steering Committee
Socializing done prior to full development using Visio created screen shots in face to face encounters

10. Implementation Utilizing new education/support model
In waves over approx 6 months ( target June 30)with returning to teams after initial roll out
Feedback to teams/Managers on how they are meeting their targets

11. Education Support Model
Decision Support & Application System Support
Practice Leads, & Professional Practice
Regional Clinical Support
Decision Support Team
Local Clinical Support
On site Support
(Clinical Educators,
Clinical Leads, Team Lead)
IMITS Application Support Team & PARIS
Educators
Community System Users
Coaches- formal or informal
Transformation Leads, Clinical
Systems Support Educators (CSSEs)
Accepting the reality that local clinical support is critical to standardization of documentation and practice
The role of the coach is to mentor the user in using the system as defined by clinical practice, supported by clinical educators or practice leads. Moving away from the concept of super user as they are sometimes too creative!
Education sessions will be co lead with clinical educators and application trainers
The regional support is to continue to advocate and facilitate regional standardization and support the coaches and clinical educators/leads.
The application support is the technical support for the user as well as ensuring system configuration and design meet clinical requirements
HSSBC
Service
Desk

12. DEMO Demo basic CCP entry using CHN NGI’s
Include description of worksheets and filtering components.