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A Healthier You April 2013

Presented by Northern Health and Glacier Media

Technology in Health Care

Be screen smart Using northern B.C. grown technology to stay healthy

THE PRINCE GEORGE

CITIZEN THE

The use of technology in fitness

PRINCE GEORGE

CITIZEN THE CITIZEN Published By

PRINCE GEORGE


A Healthier You

Inside...

3

CEO welcome

4

Health care foundations: Looking forward in 2013

5

Information and technology services recruitment

6

The use of technology in fitness

12

Be social and get healthy

14

Health tip : Be screen smart

16

Using northern B.C. grown technology to stay healthy

18

Electronic health records improve health care

20

SimMan3G helps train medical professionals in the north

22

Staff profile: Bill Clifford, Chief Medical Information Officer

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Technology in health care

THE PRINCE GEORGE

CITIZEN THE

PRINCE GEORGE ON THE COVER: Dino E. a R.T.E. at UHNBC. Citizen photo by Brent Braaten

CITIZEN A Healthier You is published by THE CITIZEN and PRINCE GEORGE

A product of

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Message from our CEO

Cathy Ulrich, Northern Health president and chief executive officer

Welcome to A Healthier You A

Cathy has held her position of president and CEO since 2007. From 2002 to 2007, she was the organization’s vice president, clinical services and chief nursing officer. Before the formation of Northern Health, Ulrich worked in a variety of nursing and management positions in northern B.C., Manitoba, and Alberta. Most of her career has been in rural and northern communities, giving her a solid understanding of their unique health needs.

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s technology continues to evolve, its impact on the health care industry changes as well. The introduction of new technology has made the work that Northern Health performs better, but it also comes with its own challenges. It has been fascinating to see film-based technologies become almost obsolete, geography shrink due to new communication channels, and Northern Health lead the way in terms of innovation in technology for health care in the north. 
The sixth edition of A Healthier You covers everything technology in northern B.C. Our facilities use the latest technology to better support the work of our staff and physicians. The new Northern Health Learning and Development Centre that will open in 2014 on the campus of UHNBC will incorporate the latest technology to support learning for students, staff, and physicians. Technology is also making a difference in tasks from how medical imaging is done, to how we safely manage and administer medications and

to the use of electronic medical records. In this edition, we share stories about how electronic health records have made continuity of care better. 
Northern Health’s information technology department has expanded in knowledge, skill, and capacity to support these technological changes that impact all aspects of Northern Health’s services. The staff who work every day to keep our electronic systems and equipment functioning effectively are vital to our organization. In this edition, we also share stories about the recruitment efforts for staff with this skill

and expertise. 
As online possibilities grow, so does the need to have a targeted strategy to reach northerners through these channels. This edition of A Healthier You describes the Northern Health social media feeds and their purposes, and how other organizations are promoting a healthy lifestyle through smartphone applications.   
With technology, the possibilities are endless. I look forward to seeing Northern Health continue to discover, test, and put this technology to use in order to enhance the services we provide for northerners. n

Visit the Northern Health Matters Blog for more healthy living tips at blog.northernhealth.ca — A HEALTHIER YOU — 3


Health care foundations

Health care foundations:

Looking forward in 2013

Throughout northern B.C., health care foundations work with the communities and donors on a variety of fundraising programs and the money they raise helps improve health care for local residents. It’s often used to buy specialized equipment for hospitals and clinics, like the warmers for premature babies that the Dawson Creek and District Hospital Foundation bought in 2012 (see the April 2012 issue of A Healthier You).

Kitimat General Hospital Foundation As an introduction to the community, the Kitimat General Hospital Foundation held the first annual Christmas Coffee House at the Kitimat General Hospital in December. Entertainment was provided by local talent, the school choir and drama club as well as the seniors’ choir. Patients, staff and residents from multi-level care thoroughly enjoyed the entertainment, coffee, tea, hot chocolate and delicious baked goodies provided by the hospital kitchen staff. A Christmas ornament depicting Kitimat’s snowflake logo was a gift provided for donations of $25 or over, with $5000 being raised.

Spirit of the North Healthcare Foundation Throughout its history, the Spirit of the North Healthcare Foundation has been honoured with the involvement of many people and businesses in the north. Of special men-

tion is the ‘father’ of medical practice in Prince George, Dr. Jack McKenzie. “Dr. Jack represented a profession that he clearly considered to be his vocation. His wisdom and sense of humour were not to be surpassed by his common sense approach,” reflects Diane Rogers, current member and past president of the Foundation Board. “He was a visionary, recognizing the future of new, emerging technologies such as telemedicine, as part of an essential role in effective diagnosis and treatment, especially in rural populations.” When Dr. Jack passed away in January, his family requested donations to celebrate his life be made to the Spirit of the North and directed to the Dr. Jack McKenzie endowment. This is a permanent fund and the interest it earns is distributed each year. In Dr. Jack’s own words: I am proud to say that, since 1997, donations to an endowment fund in my name have provided close to $50,000 in educational grants. In so doing, the Foundation and its donors recognize that the greatest resource of our healthcare system is our people. For more information about the Spirit of the North Healthcare Foundation, contact us at 250.565.2515 or spiritofthenorth@northernhealth.ca.

Dawson Creek and District Hospital Foundation While it is Northern Health’s mandate to recruit highly qualified personnel, it is the Dawson Creek and District Hospital Foundation’s goal to help provide northern B.C.’s doctors and nurses with the most state-of-the-art life-saving equipment possible. We are proud of the overwhelming support that we receive from the community that makes these purchases possible. Currently, we are preparing for the “Have a Heart Radiothon,” during which we hope to raise $52,000 to purchase an advanced Isolette with thermoregulation and ventilation. For more information on this project and other events please visit: Dawsoncreekfoundation.ca or call the foundation at (250) 784-7355. n

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Recruitment

By Jonathon Dyck, Northern Health communications officer

Information and technology services recruitment

T

he information and technology services (ITS) department of Northern Health boasts an ability to train and recruit employees locally. Currently, there are over 130 people working in ITS throughout the north, and chief information officer Jeff Hunter says a bulk of these people are from northern B.C. originally.

“The practice of hiring locally has evolved over time. It starts with post-secondary training opportunities in the north for technical training, and then being able to recruit those students to Northern Health helps us develop our work force,” said Hunter. “It is similar to the philosophy for other northern postsecondary programs such as the trades or nursing in that you need to grow your workforce from within the region. Having these training opportunities in the north allows us to do that,” said Bjorn Butow, director of clinical information systems. “Both Jeff and I grew up here, and so finding experienced local talent or new talent coming out of the northern colleges and UNBC is a priority.” The ITS department at Northern Health is the largest in northern B.C. according to Hunter, and offers employees an ability to work in a variety of capacities if they wish. “We like having people that can come in and not only undertake the task they’re assigned to, but also bring new ideas on how to provide the services we offer,” said Hunter. Northern Health ITS supports over 200 applications, 40 phone systems, a network of 5,000 computers, and 120 network sites, along with auxiliary services. Even though it is the largest in the north, it is still a small team that is high functioning. “In health care we cannot afford to have our services go down for a period of time. It is crucial they’re able to operate,” said Hunter. “Our staff and physicians are being increasingly dependent on the technology tools to enable their work and deliver high quality care. We are part of the

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team of professionals at Northern Health that impacts the lives and well-being of people in our communities.” Despite having a local focus on hiring, ITS will take the best candidate for the job no matter where they are from or what industry they currently work in. “We recently recruited an ITS manager from non-health care national retail chain in Toronto to Prince George to work with our regional pharmacy services team,” said Butow. “He has brought his private sector experience, fresh thinking and crossover knowledge in packaged goods supply chain and inventory management to the pharmacy area, where medication management is a big part.” ITS staff are mostly located in Prince George, however there is a significant amount of staff located in the region to provide support where needed. The ITS department is always on the lookout for talented individuals to implement and support computing devices, application systems, business intelligence reports, network infrastructure and server technologies. If you’re interested in learning more about opportunities in Northern Health’s ITS department, visit careers.northernhealth.ca. n

Visit the Northern Health Matters Blog for more healthy living tips at blog.northernhealth.ca — A HEALTHIER YOU — 5


Technology in fitness

Ted Clarke | PG Citizen

T he use of

technology S in

fitness

pin classes on an exercise bike are intense workouts, especially when retired Prince George RCMP officer Mike Stevenson is barking out the orders. Stevenson, a veteran of four Cops for Cancer fundraising rides, brings drill-sergeant intensity to the noon-hour workouts at the YMCA of Northern B.C. in Prince George and as group leader he gains the same physical benefits as each of the panting, sweat-soaked participants in his class. While spin classes are challenging tests of individual fitness, technology has the potential to turn that activity into a team event, and Y regular Chris Sitter has seen online what the latest gadgetry offers. “It sends telemetry [from each exercise bike] back to the instructor so he can put that up on a board and make the right side of the class compete against the left side,” said Sitter. “That will tell the instructor who’s working harder, who’s traveling further. The class gets competitive and it works.” 21st century electronic circuitry has made great strides in the fitness industry. Stationary bikes now utilize opposing magnets to create smooth quiet resistance with the touch of a button, replacing the old-school spring-loaded cranks and belts. Cont’d on page 8

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Visit the Northern Health Matters Blog for more healthy living tips at blog.northernhealth.ca — A HEALTHIER YOU — 7


Technology in fitness Cont’d from page 6 Each bike provides feedback on cadence (revolutions per minute), power output, heart rate, distance traveled, and gear selected so riders don’t have to guess if they are cranking their legs hard enough to maintain their instructor’s desired pace. If Stevenson tells them to climb up the Hart Highway hill, that means flipping a lever into the gear range with the most resistance. “I can tell these guys what RPM to be at and what gear to be in -- with the old bikes we couldn’t tell what gear you were in, you just said ‘pedal hard,’” said Stevenson. “It’s just another thing in our arsenal we use to train, so you know where you’re at and can see your improvement.” Mavis Bethune prefers working out with an instructor, but on days she can’t get there, she knows from past workouts what’s required to get through one of Stevenson’s sessions and uses the digital display instrument on her bike to replicate it. “I can make up my own class just by looking at the RPMs and the gears and that helps me stay honest,” said Bethune. “If I was just doing it by guess, it probably wouldn’t be as challenging.” Cont’d on page 10

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Visit the Northern Health Matters Blog for more healthy living tips at blog.northernhealth.ca — A HEALTHIER YOU — 9


Technology in fitness Cont’d from page 8 Machines that start out as stair climbers for warm-up mode automatically switch to a running motion that’s easy on the joints. They adjust to the length of each user’s strides to make interval training more comfortable and more fun. Steppers and treadmills have touch screens attached to the handlebars so users can pick and choose what they watch to keep their minds occupied while their bodies burn off calories. “I enjoy that, being able to watch the news while you work out, it takes your mind off the pain you’re in,” quipped Stevenson. Advances in communications technology in elliptical trainers, bikes and treadmills allow users to plug in their phones and watch Internet movies while they work out. Quick-response (QR) codes on posters at free weight stations in the gym can be scanned into smartphones to provide links to videos that show the proper way to perform each exercise. If spin classes are not your thing, stationary bikes can take you from the gym to a simulated world tour. With a TV screen hooked up to Google Maps Street View, you could be on Champs-Élysées avenue in Paris wrapping up the Tour de France, or be cruising on cliffs of Slea Head in Ireland enjoying spectacular ocean views. “For me, it’s all about keeping up with the technology

because it keeps my participants motivated,” said Shannon Johnson, YMCA of Northern B.C.’s coordinator of fitness programs. “For us [as instructors] the use of technology allows us to engage and retain our members better and helps motivate them. You have to try to stay up on the trends.” A smartphone loaded with fitness-related apps can be transformed into pocket personal trainer. For runners, apps like RunKeeper use GPS technology to map out real-time progress on a prescribed route, show how close you are to running a four-minute mile and will track whether you’re on pace to meet goals. iTreadmill makes your phone a pedometer, keeping track of all the steps you take in a day, the distance traveled and your average speed. FitnessBuilder offers thousands of photos and videos to show how to do 200 gym workouts, workout timers for interval training, and fitness calculators that figure out your rate of metabolism, body mass index and target heart rates. Weight-conscious workout buffs have apps like Lose It on their phones which allows them to input everything they eat and how much they burn off through exercise so they know exactly what they’re allowed to eat to keep from gaining on the scales. “I track my calories on the phone and that lets me know if I’m eating too much or having too many glasses of red wine,” said Stevenson. n

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Visit the Northern Health Matters Blog for more healthy living tips at blog.northernhealth.ca — A HEALTHIER YOU — 11


Online resources

By Jessica Quinn, Northern Health regional manager, health promotion and community engagement

Jessica Quinn is regional manager, health promotion and community engagement for Northern Health, where she is actively involved in promoting the great work of Northern Health staff to encourage healthy and active lifestyles. She manages NH’s social media channels (Facebook, Twitter, Pinterest, etc) and works with staff to create vibrant and inspiring content. When she’s not working, Jessica stays active by exploring the beautiful outdoors around Prince George via kayak, hiking boots or snowshoes, and she has recently completed her master’s degree in professional communications from Royal Roads University, with a focus on the use of social media in health care.

Be social AND

get healthy

I

t’s one thing to tell you that it’s important to live a healthy lifestyle; at Northern Health, we like to show you how by equipping you with the tools and ideas you might need to make healthy changes to your lifestyle. This is why in the summer of 2011, we started creating a social media strategy for Northern Health, and now we’ve been able to reach thousands of people across the most popular social media platforms, including Facebook, Twitter, YouTube, LinkedIn, Pinterest, and our Northern Health Matters blog. Being active on these sites gives us the chance to connect with you – we really do want to know what you think about our posts and we want to hear your stories about getting active, eating good food and everything else about living a healthy lifestyle. So connect with us on one (or all) of the sites below and let’s talk!

Northern Health Matters blog blog.northernhealth.ca

Our Northern Health Matters blog is the hub of our current social media strategy –the place where most of our content stems from. Northern Health staff are a passionate group of people and the blog is where they get to share it with all of our readers. All posts are written and contributed by staff who want to personally share ways of incorporating health into day-to-day life, whether it’s about canning food, taking Zumba classes, quitting smoking or packing a healthy lunch. Of course, there’s a lot more, so check it out – and we invite you to leave your feedback and comments on any post you read! Cont’d on page 13 R001413886

12 — A HEALTHIER YOU — Visit the Northern Health Matters Blog for more healthy living tips at blog.northernhealth.ca

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Online resources

Cont’d from page 12

Facebook

facebook.com/northernhealth

On our Facebook page, we share photos (including the favourite semi-regular “I <3 Northern BC” feature), videos and stories about NH people and the great things they’re doing to promote healthy lifestyles in our region. It’s also the place you can find featured NH job postings and a few really good contests during the year. Make sure you Like our page so you know how to enter the next one!

Twitter

twitter.com/northern_health

Have a question or comment? Send it to us via Twitter! We post real-time information on news, events and jobs, as well as physician postings, and of course links to all of our stories and videos. Follow us!

YouTube

youtube.com/northernhealthbc

Visit our YouTube channel to view our latest videos. You’ll find fun videos such as the recent March MANness competitions, moving stories of those touched by HIV/AIDS, testimonials from staff who love

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working at NH, messages from our CEO in her video blog and much more!

Pinterest

pinterest.com/northernhealth

Who doesn’t love a pretty picture? We pin all things related to northern B.C. and your health, including healthy recipes, inspirational tips to get moving and be happy, and gorgeous photos we find of our amazing region.

LinkedIn

linkedin.com/company/northern-health-authority

Do you have a career at Northern Health, or hope to get one? Connect with our LinkedIn profile to see who you know already works here and to view the latest job postings.

Whatever site you’re on (or maybe all of them!), we hope you’ll connect with us. Deciding to get healthy (or stay healthy) isn’t always easy, but we hope we can help in some way to keep you motivated or inspired! n

Visit the Northern Health Matters Blog for more healthy living tips at blog.northernhealth.ca — A HEALTHIER YOU — 13


Health tip By Dr. David Bowering, Northern Health interim chief medical health officer

Be screen smart

I Dr. David Bowering is Northern Health’s interim chief medical health officer. In November 2010, he released the report “Where are the Men? Chief Medical Health Officer’s report on the Wellbeing of Men and Boys in Northern BC” and has been heavily involved with the men’s health program since then. To stay active, Dr. Bowering walks or bikes to work, walks his dog daily, boycotts elevators, hikes or cross-country skis most weekends and plays with his grandchildren.

n our fast-paced world we are continually faced with more and more information coming to us on screens. Stop for a minute and think of how many screens you face in your daily life - televisions, tablets, laptops, full-size computers, smartphones, watches, navigation systems, clocks… the list goes on and I’ve lost count of how many times I look at a screen daily. There is a lot of good information we can learn from connecting through the technology of screens. People can connect across vast distances and share important information very, very quickly. Screens can bring the world to your doorstep, but they can also keep you from stepping out the door. Screens are designed to capture your attention and hold it; they are mesmerizing and are here to stay. Generally, our screen use has emerged from the entertainment concept of drawing in an audience and entertaining them to keep them captivated. Many investors in advertising and entertainment know that screens have power and a great deal of money is spent to draw you in and keep you attached, returning again and again for more of what caught your attention. There is a downside to the increase in screen use: People connect with each other less and move less. With the advent of smartphones and tablets, we have allowed more mobility with our screen use, but even this expand-

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ing technology creates issues we need to be aware of. If you are not already standing while you are reading this article, I invite you to stand up both while you finish reading about the issues and when you take the time to check out a few links for more information. Don’t use screens in your car to stay connected, be safe and pay attention to driving. If you need to use a screen, for example on your smartphone, stop and pull over to the side of the road. Lives will be saved. Resources: On the road | Preventable (preventable.ca)or Texting & Driving - It Can Wait | AT&T (itcanwait.com) Set limits on how much screen time your family engages in each day. The Canadian Sedentary Behaviour Guidelines (csep.ca) recommend limiting recreational screen time for children to less than two hours per day. Set limits on how much screen time you engage in each day. Research shows that sitting for more than six hours daily makes you sedentary. Check it out at JustStand. org: Combat Sitting Disease and Join the Wellness Uprising! (juststand.org/) There is more to life than screens and some communities have begun to take action to raise awareness about screen use. Home » Screen Smart (screensmart.ca/) Use technology to make life better, but don’t let technology become your whole life. n

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Visit the Northern Health Matters Blog for more healthy living tips at blog.northernhealth.ca — A HEALTHIER YOU — 15


Technology

By Tourism Northern BC

Using northern B.C. grown technology to

stay healthy

Photo courtesy of AlbertNormandin

Photo courtesy of Northern BC Tourism

K

eeping active year round in our northern climate can be a challenge, especially if you happen to be new to your community. There are many apps out there to count calories and track activities, but there is only one that can help you learn what to do in your community. “The Northern BC app helps travelers find the information they need, but also assists residents to find activities, parks and inspiration for their downtime,” says Northern British Columba Tourism CEO, Anthony Everett. There are over 900 suggestions of “What to Do” in northern B.C. communities in the free app, many of which are outdoor or adventure activities. Whether it’s golf, fishing, skiing or biking, the details - including locations, trails, guides or gear suppliers - are in the app. Recreation facilities like swimming pools, gyms, paintball and bowling alleys are listed in the “Entertainment” section. Looking for a hiking spot? The Parks and Recreation section has 384 listings that comprise provincial, regional and city parks. Drill down into the additional information on a park for a location map and park website. Where available, trail access details are supplied. The Northern BC app utilizes smartphones’ GPS (or location services) function to suggest activities that are close by. The Social Media section of the app showcases photos and experiences from around the northern B.C. region and can be used as a source of inspiration for planning outings. “With people becoming more technologically savvy and increasingly reliant on mobile devices, the app provides instant access to information, which helps people get out and experience more of northern B.C.,” said project manger, Clint Fraser. “We want people to be able to easily discover what’s available out there, and to find information specific to their needs.” Northern British Columbia Tourism developed the Northern BC app in partnership with five of the region’s destination marketing organizations. Tourism Dawson Creek, Tourism Prince George, Tourism Smithers, Kermodei Tourism (Terrace) and Tourism Prince Rupert all provided funding and input to the app, which was launched in October 2011. The Northern BC app is available for iPhone, iPad and Android smartphones and can be downloaded free from the App Store and Google Play. BlackBerry users can access the app’s sister mobile site at: m.nbctourism.com. n

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Visit the Northern Health Matters Blog for more healthy living tips at blog.northernhealth.ca — A HEALTHIER YOU — 17


Electronic health records

By Jonathon Dyck, Northern Health communications officer

Electronic health records improve health care With the introduction of electronic health records, information sharing has become significantly easier between medical professionals in Northern BC. No longer is information stored only in the facility it was received, with staff and physicians at that facility able to access it when required, but information can be input and retrieved from a variety of locations throughout Northern Health. “A patient could have traveled anywhere in the north from their home community, and now physicians and medical professionals have the ability to find out information about this patient they wouldn’t have known in the past thanks to electronic health records,” said Jeff Hunter, Northern Health’s chief information officer. “It improves care for the patients and allows the medical staff and physicians to understand the patient’s history before administering care.” Electronic records give clinicians access to patients’ medical status, visit history, and related radiology, laboratory and pharmacy information across the region. A specialist in Prince George can view the medical record of a patient from Smithers or Dawson Creek and provide a consult on their treatment without having to meet the patient in person. This saves the patient time and money from having to travel outside of the region.

“Going digital in the health care industry is all about providing tools for our staff and physicians that will help them make better real-time decisions in a faster and more efficient manner,” said Bjorn Butow, Northern Health’s director of clinical information systems. “Beyond hospital-based care, we are also working to support higher quality communitybased care by implementing technology tools that will better integrate information and health services between physician clinics, long-term care facilities, public health centres and specialty programs.” According to Hunter, an additional strength of introducing electronic records is being able to turn the electronic health records into usable data. This includes being able to map trends, create graphs, and other support tools that will enable physicians and medical staff to better understand individual patients’ situations. “You can scan images and upload them to a computer electronically, but that doesn’t tell you much,” said Hunter. “Creating meaningful population health data is huge for the health care industry and creates new opportunities.” Northern B.C. does face some technological hurdles as some communities still do not have reliable access to telecommunications technology. “Some of the remote communities that need the technology the most unfortunately do not have access to it,” said Hunter. “However we are working closely with partner organizations to ensure appropriate infrastructure is in place or is on their radar to be installed in an effort to better serve these communities.” It isn’t just about the ease of access to information, but also the amount of paper and impacts on the environment. Mounds of paper, proper disposal techniques, and hours of filing are saved, thanks to electronic health records. Recognizing the changes that have been made, the health care industry still has a way to go compared to other industries, such as banking, which is almost all digital. Hunter and Butow believe changes over the coming years will move health care records more in that direction. n

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Visit the Northern Health Matters Blog for more healthy living tips at blog.northernhealth.ca — A HEALTHIER YOU — 19


SimMan3G

By Anne Scott, Northern Health communications officer

SimMan3G helps train medical professionals in the north

SimMan3G sounds like a video game, but he’s actually a life-size simulated human who blinks, breathes, bleeds, and has heart attacks on demand.

He’s known as a simulator, and he and his high-tech family -- including a baby, a child, and a female simulator who actually gives birth -- are revolutionizing healthcare training in northern B.C. “The simulators let us train our staff without risk to patients,” said Tammy Hoefer, Northern Health’s regional manager, Innovation and Development Commons. Using the simulators, staff can safely practice dealing with burns, labour and delivery, resuscitation and advanced life support, heart attacks, and much, much more. “You definitely want to practice on a simulator, rather than a real baby,” said Jane Ritchey, clinical nurse educator for perinatal services at the University Hospital of Northern BC in Prince George. “I’m incorporating them more and more into our training program and drills.” The simulators are currently available in Prince George, Quesnel, Terrace, and Fort St. John, with mobile remote capability for rural sites a possibility for the future. The program started in 2011, and is operated through a partnership between Northern Health, UNBC’s School of Nursing and the UBC Northern Medical Program. “Staff really like the realism,” Ritchey said. “Participants feel more involved in the scenarios and may actually stroke the face or hold the hand of the simulator in an effort to comfort them.” “Simulation safely fills the gap between theoretical knowledge and clinical practice,” said Dr. Pal Dhadly, head of the Department of Anesthesia at UHNBC, who also teaches simulation in the Northern Medical Program. “Students really love being able to do things that are hands-on, while not impacting patient safety. It’s an opportunity to push them to their limits in terms of skill development.” Cont’d on page 21 20 — A HEALTHIER YOU — Visit the Northern Health Matters Blog for more healthy living tips at blog.northernhealth.ca

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SimMan3G

Cont’d from page 20 Using sophisticated interactive electronics, the simulators can show symptoms of a heart attack, stroke, or other emergency: there are changes in pulse, breathing, temperature, blood pressure and more. Realistic makeup can even be applied to their “skin” to simulate bedsores, gunshot wounds, bruises, or burns, and their breathing can reflect smoke inhalation. “With some of the mill explosions, we had actually practiced airway management scenarios with burns the week before,” said Mike Lundin, coordinator, Northern Clinical Simulation Centres. “Although these horrific tragedies were obviously something that nobody could really prepare for, the simulation experience is a great forum for preparing health care providers for these rare extreme patient cases.” Practicing hands-on clinical skills is important, but another key benefit of simulators is promoting interprofessional team-building. “Nurses go to nursing school, doctors go to medical school, and then they’re put together in an environment where they’re expected to function as a team,” said Hoefer. “Practising with a simulator helps them with role clarity and communication. If there’s breakdown in any of those things, there’s a potential risk for the patient.” Jane Ritchey agrees. “Simulation helps you practice as a team before you’re in a critical situation,” she said, “and this definitely benefits our patients.” Just as important as the scenario itself is the debriefing

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that follows (the entire session is recorded). “It gives learners the opportunity to see actions and communications from the outside,” said Mike Lundin, Coordinator, Northern Clinical Simulation Centres. “Our recommendation is a safe learning environment in which we focus on the process itself, not the people doing it. It’s like having 20/20 – you don’t have that in the real world.” Simulators also help standardize training. “Once you finalize a course, you can repeat that over and over, so you have consistency,” said Lundin. “This means that we can provide consistent simulation training across the north.” n

Visit the Northern Health Matters Blog for more healthy living tips at blog.northernhealth.ca — A HEALTHIER YOU — 21


Bill Clifford

Staff profile

Chief medical information officer

Describe your family life.

I have a wife of 18 years and two stepsons who are now involved in their careers outside of Prince George.

Where did you grow up?

I was born in Trail but grew up from age of 3 in Prince George and attended school from grades 1-12 here.

Where do you currently live?

I live in the bowl on the Nechako River. We like to live close to work and city so that walking and cycling are an option.  My daily commute wouldn’t even be considered a commute in the lower mainland!

What brought you to your community?

I left Prince George after high school to attend university in Vancouver. This was a typical scenario in the 70s. Many returned back here but I took a circuitous route through post-graduate education in forestry in New Brunswick followed by medical training in Newfoundland.

What’s the most rewarding part about living where you do?

Friends and community are primarily what keeps us in the north. Prince George is big enough to offer cultural and shopping opportunities while not being so big that community spirit is negatively affected.  Proximity to cross-country skiing, hiking and canoe/kayak opportunities is also important.

What made you want to enter your field?

the two are very related. Forestry gave me lots of experience with computer science as well as human relations. The latter engendered a curiosity about the human condition in general and a desire to help make things better for individuals and communities. Making things better for communities is all about population health and population health is in large measure the product of effective primary care. All this led to being a family physician and the information technology experience helped me to develop useful tools to be a better provider.

What is the most rewarding part of your job?

Feeling like I’m making a difference in health care locally and farther afield. The information and knowledge that is generated/ presented by information technology extends far beyond the individual patient encounter. Those encounters are extremely important but I like to believe that my work leverages my experience with direct patient care.

What is the most challenging part of your job?

Constantly keeping up with ways to make documentation, clinical decision support and population health naturally and seamlessly fall out of an efficient workflow. The patient is at the centre of our activity and providers need to be as unencumbered as possible about stuff that is peripheral to the provider/patient relationship.

What is your favourite part of northern B.C.?

Geographically, it’s the mountains, lakes and rivers. Socially, it is the northern people and the spirit that goes with being in the north.

I’m frequently asked about the apparently big re-route in my career from forestry to medicine. Professionally and personally, 22 — A HEALTHIER YOU — Visit the Northern Health Matters Blog for more healthy living tips at blog.northernhealth.ca

Cont’d on page 24 April ‘ 13


April ‘ 13

Visit the Northern Health Matters Blog for more healthy living tips at blog.northernhealth.ca — A HEALTHIER YOU — 23


Staff profile

Cont’d from page 22

How has technology impacted your work in the medical field?

It seems like writing in a paper chart is a distant memory. A few years ago I had to write a prescription on paper and I actually struggled with getting it right and legible. The old paper charts were divided up into sections to accommodate things like progress notes, lab results and X-ray reports. Many physicians kept a form inside the front cover to list problems, medications, allergies etc. Eventually, this form often became illegible from cross outs

and additions to the margins in the only space left. The material in the sections became difficult to access. The modern EMR has a specific place to put most things and these individual items can be grouped, summarized and presented in context-sensitive ways to greatly increase the availability of information. Also, it can provide “clinical decision support” by adding prompts or warnings such as drug/drug interactions.

How have you utilized technology in your work?

As CMIO, there seems to be no limit to the requirements for technology in most aspects of modern health care. Almost all X-rays are digital these days and the majority of test results going to physician offices are delivered electronically. Text books are becoming a thing of the past as guidelines and literature is available online. Even policy and procedure manuals are digital and can be presented in ways that make them far more accessible than the old binders that often gathered dust.

Where do you see technology in health care going? Personal health records will likely become much more widely used. For some, might even become the primary record just like the meager paper charts that patients in Kenya would bring to me when I worked there. EMRs and other health care software will become much more interoperable thereby making care coordination much more seamless and effective. The next wave of paradigm shift will likely be in personal genomics. We will absolutely need technology to make that information understandable and usable. 

Who has been the most influential person in your life? When I was younger, I was much influenced by the writings of Mahatma Gandhi which likely had something to do with my choice of medicine as a career. I’ve been lucky to have excellent mentors in all of my work including my graduate studies thesis advisor, my family practice residency program preceptor and various influential medical colleagues over the years. Of course my wife is very influential and is definitely the most influential for the next chapter(s) in my life. n 24 — A HEALTHIER YOU — Visit the Northern Health Matters Blog for more healthy living tips at blog.northernhealth.ca

April ‘ 13


Medical imaging

By Ted Clark | PG Citizen

Medical imaging

benefits

from technological improvements

April ‘ 13

In an area as vast as northern B.C., where population densities are low, delivering health care is a monumental challenge. But thanks to advances in diagnostic equipment technology, widespread digital transmission of test results and reliable electronic communications links, the huge distances that separate rural patients from large-scale medical centres are no longer barriers to good health. “Technology is the big equalizer for remote and geographically-sparse communities,” said Ken Winnig, Northern Health’s director of diagnostic services. “Technology is delivering care through point-of-care devices. Often we can put the test in your community, where traditionally we’d have to go to a big lab to get it done well.” Northern Health’s system of processing imaging results and lab tests grew by leaps and bounds in 2006 when it introduced the Pictures Archiving and Communications Systems (PACS) technology. The digitized system stores X-rays, CT scans, MRI scans, and ultrasound tests so that are available to medical staff, nurses and physicians anywhere they have access to a computer. X-rays are no longer developed using film technology and the process has been sped up considerably. Cont’d on page 26

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Medical imaging

Cont’d from page 25 “Students today are not even getting trained in film processing,” said Winnig. “Technology on the imaging side means quicker and better access. If you need a radiologist or a specialist to review your image outside of your community, we can send it.” In 2012, Northern Health brought computer radiography technology to its smaller sites like Stewart and Dease Lake, which allows doctors to send out patient test results and share their findings with their colleagues at other facilities. Digital analysis technology enables medical staff to rapidly process the D-dimer test for a coagulation protein, which indicates the presence of a blood clot. If the test comes up negative, chances are high the patient has no thrombosis and won’t need medical treatment. Similar technology is used to process the fetal fibronectin enzyme test, which accurately predicts the likelihood of a premature birth.   Almost every one of the nearly 300,000 imaging tests Northern Health conducts every year are digitally processed. Even small communities in the Northern Health region have cardiac readers that measure troponin levels, which can be an indication of several different heart disorders. “I’d say we’re 98 per cent digital right now,” said Winnig. “The only thing that’s not digital is our mammography screening.” Northern Health operates mammography screening clinics in Kitimat, Prince Rupert, Terrace, Smithers, Quesnel

and Dawson Creek. The Prince George clinic is operated by Phoenix Medical Imaging at the privately-owned Phoenix Medical Centre. To outfit one clinic with a full-field digital mammography machine would cost about $850,000. Another challenge is finding trained staff to operate diagnostic equipment and conduct the estimated six million lab tests Northern Health performs each year. The College of New Caledonia has taken on that task by developing its health science programs in medical lab technology (a 2 1/2year program limited to 24 students per year) and radiology technology (two years, maximum of 16 students), producing dozens of graduates who are virtually guaranteed jobs. One critical need going unfulfilled is homegrown development of ultrasound technologists. BCIT in Vancouver is the only school in the province that offers that program and it graduates only 30 students each year. As a consequence of that staff shortage, the wait list continues to grow for ultrasound tests to measure blood flow and determine blockages, aneurysms, and heart conditions. “We have a number of vacancies for ultrasound techs and that’s where we’re really feeling it right now,” said Winnig. “If I had a wish list, I wish that the college here would be able to launch an ultrasound tech program. The CNC programs have been a lifesaver. Rather than having to scour the globe looking for technologists, we can recruit locally.” n

26 — A HEALTHIER YOU — Visit the Northern Health Matters Blog for more healthy living tips at blog.northernhealth.ca

April ‘ 13


April ‘ 13

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A Healthier You April 213  

Northern BC’s health information magazine

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