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Patient Record
“The right information to the right people, at the right time.”
August 6th, 2013, Volume 1, Issue 10
GO-LIVE SPECIAL EDITION
Providence Care is preparing to implement a new system that will change how medical information is captured, recorded and shared across our organization. Our new electronic Patient Record (ePR) system will help us provide safe, high quality care and services to our patients, clients and residents. The ePR will mean real-time, point-of-care information is available to clinical staff.
This special edition highlights the functionalities for milestones 1 & 2 only. More functionalities will be added as we reach future milestones in early 2014.
Implementing the ePR is a “journey”
Every staff member with an ePR system login will be able to:
Implementation of a system of this complexity and size across our whole organization will be a journey – it will not happen all at once. For the past two years, our ePR team and many others at Providence Care have been involved in preparing for the shift to an electronic patient record. We will be “turning the system on” in stages through the fall of 2013.
The first milestone is September 25th, when we Go Live at St. Mary’s. The second milestone is Fall/ Winter 2013, when we Go Live at MHS and Providence Manor.
• Access a single, confidential, computer-based patient record • Access the ePatient Record from any computer, at any time, on any computer at Providence Care and simultaneously by multiple users • Continue to do all current work done in MEDITECH in the new system • Have access to timely and relevant information: o Patient chart review from Providence Care including: - Current and historical patient information - Some nursing documentation (i.e. vital signs, heights, weights and allergies) - Physical and discharge summaries - Laboratory and Radiology orders and results - Medication Administration Record and medication orders - Quick view of patient level information ( e.g. allergies, height/weight, registration/contact information) - KGH and HDH lab and radiology results, transcribed reports, and scanned documents posted to the record post discharge • Access web links and e-library services directly from the desktop
Providence Care____________________________________________________________________________________________________________________
ePR Implementation The Beginning February 2011
Working Groups Creation 2011 Current and Future States of the PaJMa Models June 2011 to April 2013 Design/Build/Test and Consultations with staff 2011 to July 2013 Wireless Project Implementation December 2012 Basic Computer Training January to February 2013 Devices Selection Sessions March 2013
ePR Demonstrations and WebEx February to July 2013 PaJMa Party Wrap Up April 2013
ePR Travelling Road Show May 2013 HealthTech Readiness Plan May to July 2013 Integrated Testing June 2013 Devices Roll-Out August-September 2013 MEDITECH Conversion September 2013
Champions Recruitm June to August 2013
Devices Walking T July 2013
We are here
Milestone 1
September 25th, 2013 SMOL implementation
Mil
Fall/ MHS
Road Map e Patient Record
Scope for “go-live” milestones 1 & 2 Inpatient programs SMOL
Complex Continuing Care Palliative Care Specialized Geriatrics Physical Medicine and Rehabilitation
MHS
Adult Treatment and Rehabilitation Geriatric Psychiatry Forensic Psychiatry
• Allied Workload: capture of Allied workload • HIM (Health Information Management): Patient Records services including chart tracking, chart process, release of information, transcription of dictated notes, electronic signature
• Laboratory: Electronic review of lab results, scheduled lab tests and ability to trend • Nursing: Basic nursing functionality including nursing inbox, patient schedule, electronic Medication Administration Record, documentation of heights, weights, allergies and vitals
• Orders and Results Management (ORM): Will streamline processes for Allied
Health, Food & Nutrition Services, including the receipt of orders/referrals electronically
• Patient Administration: Registration processes including patient tracking and bed control/management
ment and Training 3
ePal
• Pharmacy: Integrated medication management from order to administration • Pharmacy Inventory: Inventory management functions for medications • Physicians: Basic physician functionality including physician inbox, editing and
e-signing dictations, review of clinical information, computerized provider order entry (CPOE) including order sets and documentation of allergies, extent of treatment and medication reconciliation
• Radiology: Electronic review of radiology results, scheduled radiology events and
Tours
transcribed reportspatient tracking and bed control/management radiology events and transcribed reports
Outpatient & Community programs
All Staff Massive Training September to December 2013
SMOL
Acute Care Consult Service (SG) Day Hospital Geriatric Medical Clinics Geriatric Outreach Assessment Service Outpatient Rehabilitation services Regional Community Brain Injury Services (RCBIS) Rehabilitation Management Services (RMS)
MHS
All mental health outpatient, outreach and community programs* *Does not include Behavioural Support Services/BSO
• Allied Workload: capture of Allied workload • Dictation and Transcription: Only in programs where this services is in place currently
lestone 2
• Client Administration: Registration processes, access to review client information
/ Winter 2013 S & Providence Manor
Future Milestones Early 2014
available electronically from Kingston General Hospital, Hotel Dieu Hospital and St. Mary’s
Providence Manor Long-Term Care Attendant Care Outreach Program Hildegarde and Endymion
• Resident Administration: Registration / “Business office” processes (Admissions, Transfers, Discharges)
e Patient RecordNews
Allied Health
Spiritual Health, Speech- Language Pathology, Physiotherapy, Psychology, Social Work, Detician, Recreational therapy, Occupational Therapy, Community Nursing
Inpatient, outpatient and Community The Allied Health Workload Measurement System application will collect workload data from direct entry with minimal effort and will provide data for case costing, Management Information Systems (MIS) workload and caseload statistics, and much more. Inpatient Referrals process will be simplified by allowing Allied Health staff to receive and review any referrals from any Providence Care computer.
Community
Community staff members will benefit from a new Allied Health Workload Measurement System application. In addition, all registration activities will be converted from occurring in MEDITECH to occurring in the ePR. Staff will have the ability to aces timely and relevant information from any Providence Care patient charts (e.g. current and historical patient information, Laboratory and Radiology results, etc.).
Health Information Management (HIM)
Inpatient Patient Records services from inpatient will be available electronically, including chart tracking, chart process, release of information, transcription of dictated notes and electronic signature.
Laboratory
Inpatient The majority of the samples will be requested electronically (CPOE) and added directly to an electronic staff work list. Laboratory work will be routed to appropriate work queues based on the procedure being performed. The sample results will be traceable from the order request to the sample collection to the electronic partial to complete result.
Nursing
Inpatient Nurses will be interacting with a computer consistently from the beginning to end of a shift. All nursing related physicians’ orders (CPOE) will be routed electronically to the nursing section of the ePR system. It will generate a daily work list per patient to guide and assist the nurses in their work. Nurses will be able to review new orders as well as find data with ease. All medication orders will be routed directly to the Medication Administration Record (eMAR), eliminating transcription from paper MAR to the system.
Patient/Client Administration
Inpatient, outpatient and Community Patient registration for inpatient and outpatient on site will be done electronically in real-time, as possible. Inpatient All admitting staff will be able to see and track patients within the unit (i.e. bed check-in, bed transfers within the unit, weekend pass, off- unit and appointments).
Pharmacy
Inpatient All medication orders will be done electronically with CPOE and routed directly to the eMAR. Pharmacists will have timely access to all orders for processing and review. They will have the ability to suggest changes to any order or request clarifications which will be documented electronically.
Physicians
Inpatient Basic physician functionality will be accessible electronically by physicians, including physician inbox, editing and e-signing dictations, review of clinical information and CPOE. All inpatient CPOE will be done electronically and routed directly to the appropriated Providence Care services (e.g. laboratory, medication, referrals...). This seamless order entry by providers will include Admission Order sets, automatic orders on admission, Physician’s documentations will include allergies, extent of treatment and medication reconciliation.
Providence Manor
Providence Manor staff with access to ePR will access admission, discharge and transfer information for residents. The system will also improve access to information about residents on medical leave.
Radiology
Inpatient All diagnostic images (i.e. X-ray, CT, MRI, and Nuclear Medicine) performed at Providence Care, KGH and HDH will be centralized to one place and accessible electronically, including scanned cardiology results.
Contact Us ePatient News is designed and produced by the Providence Care Communications Department in association with the Providence Care ePatient Record Project Team and Decision Support Department. If you would like to suggest a topic for us to cover or you have questions about the ePatient Record, please send us an email at ePR@providencecare.ca
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