Thursday, November 06, 2008

"R.E.A.C.H." Clinical Portal Making a Difference in Doctors' and Patients’ Lives

R.E.A.C.H. or "Rapid Electronic Access to Clinical Health Information"is an electronic health information portal that allows authorized users access to their patients’ clinical information through a secure web-browser, whether inside or outside of the hospital.

This means Lab and Diagnostic test results, images, transcriptions and progress reports written (at any one of the REACH partner Hospital's) can be viewed immediately by a Physician treating the patient. Currently the REACH portal includes The Credit Valley Hospital William Osler Health Centre, and Halton Health Care. Trillium Health Centre and Headwaters Health Care Centre will be joining the network soon and Hamilton Health Sciences and the Scarborough Hospital also use the same vendor solution. Sharing Patient's clinical information is important because patients move between facilities for across a region to access different types of diagnostic tests and/or procedures---that are not necessarily performed at all facilities. At the Credit Valley Hospital, one of the Physicians was asked what he thought of this new EHR initiative. Here’s what he said.

Dr. Tom McGowan’s Notes*: Wednesday October 15, 2008
Sitting in clinic today it struck me how quickly REACH has changed how I work. Today was a day when I saw new cancer patients with new problems. Of the four new patients I saw today, I needed to look into REACH to get information from other hospitals on two of them. It took seconds to look them up, and find the information I needed from the other hospitals. Before REACH, getting that information would have taken anywhere from 15 minutes to hours, and usually many phone calls.

Given that we’re the only Radiation program in the region, we always see patients who have had all, or large portions, of their care elsewhere. Most of the time the referring doctors make sure all the information is faxed over when the referral is made. Most of the time we can make the decisions we need to make with the information we have. But if there was a recent test, or clinic visit, then we should see that report before we make a final treatment recommendation.

There’s wasted time and effort when information comes in piecemeal. There are times when the results of the test aren’t available when the patient is first referred by their medical doctor (MD). Sometimes the referring MD will send it when it’s ready, and sometimes not. We can’t expect that to happen because it’s too much to ask a busy referring doctor to keep track of upcoming tests, and make sure they’re faxed to us, when ready.

Even if it is sent after the result is in, we’ve got to be sure the new information gets attached to the original. While this normally happens, I’ve had cases where I’ve had our staff call a referring hospital to get a test result faxed over. Sometimes they say they’ve already sent it but we don’t have it. So we get them to send it again, only to find it went to my office rather than my clinic.

When there appear to be duplicates of the same test, there’s more time wasted while I compare the results from the two documents. Only then can I be sure it’s not new information that will influence the patient’s care. It’s pretty obvious that this isn’t the most efficient way to manage anybody’s time. Now I have an advantage that I hadn’t really appreciated until I started to use the REACH portal. By looking at the records from other hospitals, we can sometimes see results of tests that are relevant, but that the patient didn’t realize could be useful, or had completely forgotten about. This type of thing doesn’t happen very often, but when it does, it matters.

So getting back to today; I had two patients that had information I needed from other hospitals. Thanks to REACH, I had it, easily after looking for a few seconds. I didn’t have to figure out what to ask for, where things might have been done, and deciding whether I really needed it in the first place. I was able to spend all my clinic time doing clinical work, seeing my patients, explaining things to them, and figuring out what they needed to do next. And that makes for a satisfying day.

*Dr. Tom McGowan is Physician Director, Radiation Oncology at The Carlo Fidani Peel Regional Cancer Centre located at The Credit Valley Hospital.

Original article published in "A Credit to your Health" AUTUMN 2008 / VOLUME 10 ISSUE 4.