Advancing Care Across the Continuum

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@ehealth_2015 @ClinicalConnect Advancing Care Across the Continuum Dale Anderson, Sr. Manager, ehealth Hamilton Niagara Haldimand Brant ehealth Office Dr. Barbara Teal, BA, MD, CCFP, FCFP Family Physician / Medical Director, Community Care Access Centre June 2015

Conflict of Interest Disclosure Dale Anderson, BComm (Hons) & Dr. Barbara Teal, BA,MD,CCFP, FCFP Family Physician / Medical Director, Community Care Access Centre have no real or apparent conflicts of interest to report. ClinicalConnect is a trademark of the public hospital Hamilton Health Sciences.

A comprehensive, data rich regional EHR Federates data securely, in real time Encompasses continuum of care Rigorous Privacy & Auditing Portable and mobile An ehealth platform / Flexible to adapt to incoming Provincial standards Electronic report and result distribution

ClinicalConnect Today Integrates data from: 61 hospitals (up from 36 hospitals last year) By mid summer: 67 acute care hospitals 4 Community Care Access Centres Oncology Centres 2 Provincial Data Repositories (Lab & Imaging) Nursing Assessment Repository 17,000+ authorized ClinicalConnect users across SW Ont. Leveraging to support Hospital Report Manager (HRM) and to send hospital lab data to OLIS

ClinicalConnect (funded by ehealth Ontario) is the Regional Clinical Viewer for the connecting South West Ontario (cswo) Program Hamilton Health Sciences is the solution provider deploying ClinicalConnect across the four South West Local Health Integration Networks The cswo Program, also funded by ehealth Ontario, is foundational to ehealth Ontario s commitment to integrate electronic health information for all Ontarians ClinicalConnect recognized by ehealth Ontario as provincial strategic asset

3.6M population (about 1/3 of Ontario) 35,000 HSPs at 3,500 Organizations 69 Hospitals 4 CCACs (Homecare) 2,900 Primary Care Providers 18 Public Health Units 530 Community Health Providers

Patient Journey Consolidated

CCAC Connected

Standardized Nursing Assessments Integrated HOBIC (Health Outcomes for Better Information and Care) Nursing Assessments Measures standardized clinical outcomes HOBIC Transition Synoptic Report Scale Name Admission Discharge Activities of Daily Living 0.2 0.1 Bladder Continence 1.0 0.5 Pain 2.7 0.7 Fatigue 2.0 1.0 Dyspnea 2.7 0.5 Nausea 0.5 0.5 Falls 0.5 0.5 Pressure Ulcers 0.5 1.0 Therapeutic Self Care 0.2 0.2

Mobile Data When Needed NEW RESULTS indicators

A Catalyst for Change 72% of HSPs are less likely to order a duplicate test given easier access to current results 63% felt more confident in care decisions with information at their fingertips 78% agree mobile devices provide faster access to vital patient info, facilitating quicker consultations, diagnostic testing, interventions and transitions

A Catalyst for Change 87% of HSPs say they should have access to their patient s/client s health information no matter where they are.

Most of our respondents agreed that ClinicalConnect on mobile devices had a positive impact on their productivity and quality. Anywhere, anytime access to patient information on mobile devices was perceived as an important factor in faster communications, referrals and handoffs. [1] 1. Bell Raj Eapen, MD, MSc, Barbara Chapman, BSC(N), MSc, Mobile Access to ClinicalConnect: A User Feedback Survey on Usability, Productivity and Quality, JMIR mhealth and uhealth 2015:3(2): e35) (http://mhealth.jmir.org/2015/2/e35

Call to the Bullpen

A Family Physician s Perspective How Dr. Barb Teal has benefitted using ClinicalConnect ClinicalConnect provides real time info for my patients. With a single sign on, I can see everything I need to know from a hospital history point of view (X rays, diagnostic tests, past consults and specialist and lab data, as examples) When patients transition across the continuum of care ER to Heart Investigation Unit to Surgery or Cath Lab then to ICU or Step Down Unit, back home and to my office ClinicalConnect is invaluable to understand what happened at each transition

A Family Physician s Perspective How Dr. Barb Teal has benefitted using ClinicalConnect I use ClinicalConnect so I can rely less on my patients and their families recollection of upsetting medical events I know without having to rehash situations I don t have to wait for hospital reports by mail/fax I download them directly to my EMR I can keep tabs on my patients that are receiving homecare services

Transitions of Care Communication breakdown no more ClinicalConnect is the google of real time information for my patient and single sign on Safely following the patient through their journey Easier to access, reliable past health information

Transitions of Care Saves time in many ways including family questioning at difficult times Less fragmented patient care Downloading Hospital Reports and Labs into EMR Easy to see my patients that are in hospital Reducing re admissions (Homecare example) Patient and Provider positive experiences

BUT, we need more as a one stop shop More of my community EMR records as part of ClinicalConnect enotifications that patients are in hospital ER Documentation Secure Messaging Patient Portal / Interaction ereferral / econsult

Change Management Pathway (Leveraging Canada Health Infoway Framework) Governance & Leadership Stakeholder Engagement Communications Workflow Analysis Training & Education Monitoring & Evaluation

Observations for Effective Change Management ClinicalConnect: Facilitates sharing of patient data across continuum Has delivered clinical value quickly while provincial ehealth standards/technical architecture are finalized Iterative evolve / add value workflow / savings Employ change management framework Builds in flexibility to adapt to incoming standards Has become catalyst for change Perfect is the enemy of good Voltaire

Thank You Dale Anderson, BComm(Hons) Senior Manager, ehealth HNHB ehealth Office anderdal@hhsc.ca Dr. Barbara Teal, BA, MD, CCFP, FCFP Family Physician Medical Director, Community Care Access Centre dr.bteal@gmail.com info.clinicalconnect.ca /clinicalconnect1 @clinicalconnect clinicalconnect1