2. AskCusp@uhn.on.ca The University Health Network PMH TGH TWH

3. Presentation Overview  eHealth Records & Your Organization  History, Why Is There A CUSP?  What is CUSP?  CUSP Goals  Who are the CUSPies?  CUSP Services  Outcomes and Benefits  How Can We Help?

4. AskCusp@uhn.on.ca Consider This…  In 2007 studies showed that only 23% of Canadian doctors used electronic records. In 2009 this number has only increased to 33%  Canada is one of the slowest countries to integrate electronic records…the Netherlands are at 98% and New Zealand is at 92%

5. AskCusp@uhn.on.ca Consider This…  98,000 patients die annually due to preventable errors that could be remedied by access to more complete patient information that electronic health records (EHRs) can provide  7.5% of all patients admitted to hospital experience an adverse effect that could have been prevented by the patient’s information being more readily available

6. AskCusp@uhn.on.ca Consider This…  According to the Ontario Nurses Association, as of a 2007 study the average age of a Registered Nurse is 45.9. This number has steadily risen over the years.

7. AskCusp@uhn.on.ca Consider This…  There are economic costs to not adopting EHRs, including eliminating a large number of unnecessary duplicate testing, elimination of film & associated storage costs etc.  Projections for savings from automation are between 6 – 7 billion dollars annually.

8. AskCusp@uhn.on.ca Consider This…  The Federal Budget 2009 earmarked $500 million for Canada Health Infoway to expand the use of electronic records  The Federal investment was matched by provincial-territorial funds  In 2009 eHealth Ontario released a strategy to move rapidly towards EHRs

9. What Does This Mean to Your Organization?  EHRs positively affect patient safety and outcomes  Economic impact to not transitioning to EHRs is high  There will need to be a significant investment in process change management and human factor engineering to address the implementation of EHRs with the MDs and aging RN population

10. AskCusp@uhn.on.ca Is There a Solution?  Healthcare staff resent being told by the government how to practice  The ultimate goal is to raise the quality of healthcare  Change management is fundamental to a successful implementation  CUSP can help

11. AskCusp@uhn.on.ca History  The University Health Network, 3 sites of acute care, teaching and research hospitals with over 10,000 employees developed a IM strategy for 2000-2005  The strategy presented significant change for staff and clinicians  Staff computer skill levels needed to be assessed and feedback gathered.

12. AskCusp@uhn.on.ca History  Price, Waterhouse, Cooper conducted Focus Groups and a Computer Training Needs Survey and identified that the lack of staff preparedness for technological development was an area of high risk.  The Computer User Support Program (CUSP) was born.

13. AskCusp@uhn.on.ca What is CUSP? CUSP is a program developed to:  provide onsite individualized training  increase staff computer competency  help integrate technology into day-to-day professional practice

14. AskCusp@uhn.on.ca CUSP Goals  increase computer competency so that staff are prepared for future EHR project implementations  assist staff and physicians to integrate the EHRs into their everyday practice  improve efficiencies of cost and time

15. AskCusp@uhn.on.ca Who are the CUSPies?  Each training support specialist is dedicated to a specific site  They are clinical technical training specialists  They have a variety of hospital unit backgrounds (RNs, Medical Imaging etc.)  All TSSs (training support specialists) are certified in teaching and training adults

16. CUSP Services  1:1 training  Demonstrations  Case Studies  Small Group Tutorials and In-Services  Project Go-Live Support  Support for New Resident/Fellow and Nursing Student intakes  Creation of eLearning Modules

17. AskCusp@uhn.on.ca CUSP Outcomes and Benefits  Improved Computer Competency  Technical Liason / Staff Advocacy  Increased Physician Buy-In  Improved Staff Satisfaction / Save Time

18. Improved Computer Competency

19. AskCusp@uhn.on.ca Staff Advocacy  CUSP speeds the resolution of technical and workflow issues  CUSP Re-focus work; liaise with other departments to help resolve issues  CUSP establishes trusted relationships and have become an integral part of the clinical community

20. AskCusp@uhn.on.ca Staff Advocacy “ CUSP has positively contributed to the clinical staff’s adoption and comfort with technology.” “…the percentage of respondents who ‘agreed’ that they had received adequate training on technology increased to 56% from 39%, 18 months ago.” “Front staff acknowledge the many positive supports that have been put into place such as CUSP…” “ Respondents during interviews indicated that training and support has improved. CUSP was cited as an excellent example of this improvement.” Cap, Gemini, Ernst Young Annual IS Strategy Audit Review, 2003

21. Increased Physician Buy-In Trainers Attend Resident Rounds Provide weekly group tutorials on a single topic Show short cuts for more efficient use of system Answer immediate questions Provide area specific New Resident Orientation sessions during each intake

22. Increased Physician Buy-In “The CUSP program has been a fantastic initiative for medicine residents at the UHN. The residents find the regular interactive sessions informative and a terrific resource. They feel that the CUSP program allows them to be more productive in their daily interaction with Vista and the UHN network. I feel the program is a step in the right direction.” Chief Medical Resident TWH: Dante Morra “C.U.S.P. has been very helpful to the residents and medical students in giving them the support they need to make their 'computer/vista' time as easy as possible. The more efficient trainees become, the more it increases their time for education, as well as for patient care. We've been delighted with the reliability, knowledge base, and diligence with which the CUSP group has provided this support to us.” Chief Medical Resident TGH: Ryan Foster

23. AskCusp@uhn.on.ca Improved Staff Satisfaction The hospital is listening to our needs for computer training and support. We need this help so that we can do our job effectively” Staff Nurse “You are doing a fantastic job working with all the nurses. You are responsive, understanding and very patient” Nurse Manager “I prefer one-on-one training to classroom training because I feel more comfortable to ask questions” RPN

24. AskCusp@uhn.on.ca The Bottom Line  The need for better management of health information is indisputable  The implementation and management of EHRs is and will continue to be critical  To successfully implement and sustain EHRs business redesign and change management is fundamental

25. AskCusp@uhn.on.ca How Can We Help?  CUSP has the clinical experience to help  CUSP has the technical experience to help  CUSP has the change management experience to help  CUSP can be your key to EHR implementation success

26. AskCusp@uhn.on.ca The University Health Network PMH TGH TWH