Wednesday, January 09, 2008
This article reprinted with permission from Medseek's eHealth Success Stories
In 2005, the Ontario Ministry of Health and Long-Term Care required William Osler Health Centre to transfer one of its hospitals to the Mississauga-Halton Local Health Integration Network (LHIN). Osler Health needed to provide physicians with real-time access to clinical information so that the continuity of care would not be disrupted during the transfer period and beyond. The most cost-effective and least complex solution was to build and deploy a clinical portal, and Osler turned to MEDSEEK due to the company’s reputation for reliability and service. Osler’s trust in MEDSEEK was extended when it rolled out their Rapid Electronic Access to Clinical Health information (R.E.A.C.H.) eHealth Portal in 2006.
The REACH eHealth Portal (EHR Viewer) has been extremely well received by physicians, in large part because the health system made sure to enlist their assistance and support from the start.
"From a quality perspective, more clinicians are using it and it is allowing them to access all the information they need to make patient care decisions faster, which ultimately affect clinical outcomes for the better," - Elizabeth Nemeth, RN, BScN, MN, project manager of the REACH and MD-Net portals
“A CIO can develop the vision, but if he or she doesn’t have physician and clinician champions along the way that vision is all for naught,” said Judy Middleton, chief information officer at Osler. “It’s really important to involve key individuals and end-users. They will let you know whether you are heading in the right direction and whether the information you’re providing is useful and meaningful to them. At the end of the day that’s what’s important.”
Although the divestiture provided the immediate spark that led Osler to launch a portal, the health system, one of the largest in Ontario, had been considering using a portal as a strategic tool to improve patient care and foster closer ties with physicians, patients, consumers and employees.
"It was part of the overall vision of the organization to provide access anywhere anytime to patient information over the Web,” Middleton said. “The master plan was already there and the Ministry of Health provided the impetus for us to make it happen sooner rather than later.”
Portals Improve Data Flow and Clinical Outcomes
Since its debut, REACH has been so successful that it led Osler to expand access in October 2007 to all nurses and allied health personnel. “From a quality perspective, more clinicians are using it and it is allowing them to access all the information they need to make patient care decisions faster, which ultimately affect clinical outcomes for the better,” said Elizabeth Nemeth, RN, BScN, MN, project manager of the R.E.A.C.H. and MD-Net portals at William Osler.
Due to its strategic nature and clinical impact, R.E.A.C.H. was expanded to the Peel and Halton regions, and just this past fall William Osler Health Centre welcomed clinicians at Credit Valley Hospital to the REACH portal. The successful collaboration between six physical hospital sites means all of their clinical stakeholders have instant access to patient health information stored electronically at any of the hospitals---regardless of legacy vendor platform.
"It was part of the overall vision of the organization to provide access anywhere anytime to patient information over the Web," - Judy Middleton, chief information officer at William Osler
The R.E.A.C.H. eHealth portal network provided federated access to over 90,000 inpatient stays and 1,050,000 outpatient visits for the fiscal year ended March 31, 2007. Patient stays and visits from all hospitals are consolidated into one, intuitive Web portal.
The REACH initiative (EHR "Viewer" based on Canada Health Infoway's designation) allows authorized users secure access to longitudinal patients information via a secure web-browser, whether inside and outside of the native hospital environment. This means records are both transferable and comprehensive. As patients move between regional facilities for different diagnostic tests and procedures, data like lab and diagnostic test results, images, transcriptions and progress reports written at one hospital can be viewed immediately by a physician treating the patient, on a subsequent visit, at any of the associated REACH facilities.
William Osler Health also plans to extend regional stakeholders a patient portal in the near future. While the organization’s Web site currently only extends minimal patient self-services (e.g.online bill payment,) the planned patient portal will offer patient stakeholders a richer menu of services such as online access to laboratory and test results, online appointment scheduling, and much more. Creating this portal, however, is particularly challenging because William Osler serves one of the most ethnically diverse populations in Canada.
“We are proceeding carefully because we want to be culturally sensitive and make sure that we do this right,” Middleton stated. “With each portal, we try to create a similar look and feel so the portals don’t look very different from each other but still meet the unique needs of the various end-users.”
"William Osler’s positive experience with REACH has also attracted the attention of the Province of Ontario's Ministry of Health. The Ministry is weighing whether other local health integration networks (LHIN's) in the Province should use it as a model for electronically exchanging information within their individual organization", Middleton said.