March 30, 2009

Electronic Health Care

Enabling enhanced focus on patient-centered care

There was a time, not long ago, when our workforce hurried to the bank on a Friday afternoon, to cash that paper paycheque or withdraw enough money to get through the weekend! Recognizing customer needs, banks
were among the first to adjust their business landscape to ensure better service for clients. Today, electronic banking technology has substituted most paychecks and other paper transactions. Clients can transfer monies from one account to another from the ease of their home and get cash at a debit machine - saving time and working within their schedules.

But the change wasn't just for clients - it improved the function of staff positions as well. Tellers at banks who were overrun with paper stamping for bill payments to other institutions now focus on more important roles of banking and customer service.

Electronic applications in health care have taken a little longer to implement, but in some ways have similar benefits associated with electronic banking. Once put into practice - information technology (IT) will provide collaborative patient-centered care and improve communication between health care providers and patients. Like tellers now focusing on more financial services, health care providers can use these technologies to provide client focused service and improved staff roles.

"For nurses, the largest population of health care providers, the benefits of electronic health care could be the most significant," Jan Currie, Vice President and Chief Nursing Officer in the Winnipeg health region says.

IT has already improved the way health care staff learn and study; distance learning, TeleHealth and multimedia are a few examples. Integrating computers into nursing practice is more challenging, but today in some health environments nurses no longer have to jot down vital signs and remember routine charting information until they get back to the nursing station - they have portable computers that can be used at their patient's beside.

In the Winnipeg health region, several IT initiatives are in place or in development which will help provide patient-focused service or improved staff functions for health care.


The Canadian Health Outcomes for Better Information and Care project - begins the process of collecting and standardizing related patient outcome information in Health Care Records across Canada. Currently, health organizations across Canada do not share standardized clinical information. Ontario, Prince Edward Island and Saskatchewan were the first provinces to begin collecting patient outcome information in the C-HOBIC system. Manitoba now joins as the first Home Care program in Canada to participate.

Thirty to thirty-six staff from Home Care and Personal Care Homes in the Winnipeg health region will participate in the program collecting patient outcome information on functional status, therapeutic self-care, symptom management such as pain, nausea, and fatigue, and safety outcomes and patient satisfaction with nursing care.

"Information the nurses key-in while doing an assessment is compared from one time to the next," Linda Dando, Director of Long Term Access Centre / Home Care with Winnipeg Regional Health Authority says. "C-HOBIC builds reports on already existing data from an electronic assessment document system currently used within Home Care and the Personal Care Home Program."

Staff participating will receive additional reports related to the assessment data they have entered. These reports will indicate whether the client's health status has improved or deteriorated in relation to the last assessment.

"The reports will be used by nurses to assist in identifying trends in clients and resident outcomes," Dando says.

This benefits nurses and care coordinators in coordinating and planning the client's services and care plan. Information related to nursing care across sectors of the health system can be shared across provinces and contributions to health outcomes can be better measured and understood.

Critical Care database

Another database in the Winnipeg health region is the Critical Care database. This free-standing database collects a wide variety of information such as demographics, clinical diagnosis, and severity of illness and therapeutic information including how many patients are treated, what was required and any interventions that took place. The system was implemented in Winnipeg's Health Sciences Centre in 1988 and then adopted by the other Winnipeg region hospitals by 1999.

"It helps us plan staffing, plan curriculums and education for nursing and determine appropriate workloads based on reports it provides on trends in Critical Care," Betty Lou Rock, Nursing Director with the Critical Care Program says. "The clinical information on patients is also used for research in treatments and to review the quality of treatments for specific groups of patients."


Another initiative, the Emergency Department Information System (EDIS), was recently implemented in all Winnipeg health region hospitals to provide a global view of the emergency department. EDIS tracks patient
stay throughout their Emergency department visit, from triage desk to discharge. Colour coded monitors allow nurses and other health care staff to easily view the number of patients, how long patients are waiting, lab results and reassessment status. EDIS also includes easy tracking of patient histories in the emergency department to assist with patient treatment.


The Hospital Information System Project (HISP), a province-wide initiative designed to improve access to patient information through a central electronic information system, an Electronic Patient Record, became active in St. Boniface General Hospital in 2008. For nurses, the system
allows immediate access to orders and results, patient demographics, medication and test results, and improves access to information online such as suggested medications or drug alerts. It also decreases the need for paper, decreases errors and increases patient safety.

"The working landscape is undeniably changing all around us as IT systems become more available and more user-friendly," Currie says. In health care, both patients and staff will benefit as, ultimately, the new age of electronic health care will connect the collective knowledge of health care staff. This connection will improve patient flow, patient outcomes and patient safety.

- Kathryn McBurney


For more health and wellness news, pick up the Spring 2009 edition of Aspire, now available at selected WRHA offices and facilities.

Aspire is also available for download here:

Aspire - Spring 2009

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