Implementing Technology to Improve Public Health Services: Managing the Change. Monday, February 24, 2014

Transcription

1 Implementing Technology to Improve Public Health Services: Managing the Change Monday, February 24, 2014

2 Introduction MSc ehealth grad 2011 Internship at City of Hamilton Public Health Services Project Manager, Planning & Business Improvement Division Portfolio: Strategic technology projects Continuous Quality Improvement Software implementation Business process improvement Legislative compliance ETC

3 Outline What is Public Health? Public Health in Hamilton Project: Oscar EMR Managing the change Discussion, Questions, Comments

4 What is Public Health? The science and art of promoting health, preventing disease, prolonging life and improving quality of life through the organized efforts of society. 1) Prevention of disease 2) Health needs of the population as a whole - Public Health Agency of Canada

5 Public Health in Hamilton Bed bugs Restaurant inspections Prenatal care Sexual Health Injury Prevention Dental clinics Surveillance Program Evaluation Immunization Head lice Health Promotion Infectious Disease West Nile Virus Nutrition Mental Health ETC Funded 75% by MOHLTC, 25% by City of Hamilton

6 We re Moving in!

7 Public Health & Information Technology Ministry databases: Panorama, IRIS, iphis, ISCIS Home grown applications Web-based communications Surveillance Program evaluation

8 OSCAR EMR at Hamilton Public Health Services

9 1. Internal Environmental Scan Interviewed 26 program and service managers Defined current information management practices Discussed needs/gaps/impact on business

10 2. Defined Business Problem Environmental Scan uncovered several information management issues: Sustainability of the databases currently used to manage client information and support PHS practices. Duplicate documentation Difficulty navigating and extracting information from current applications to guide management decision-making Direct impact on client services when timely, accurate information is not available Reliability of current software Security of client information that is stored in unknown locations and duplicated in home-grown databases. Security of hard copy records in transit Data heavy, information and knowledge poor

11 3. Researched Options Talked to other Health Units Researched EMRs Built business case Management team decided on OSCAR Developed relationship with McMaster

12 4. Implemented Oscar Open Source Clinical Application and Resource Developed based on the collective work, ideas and support of numerous health care providers and developers across the nation, including McMaster University Includes: Electronic Medical Records, case management, personal health record and other integrated applications There s a whole Oscar Community Kingston Health Unit Regeneration Community Services Oscar EMR

13 Benefits of an EMR at Public Health Allow clinician to search for clients from various locations Build a comprehensive medical record for each client Reduce number of forms Improve business processes Comply with nursing documentation standards Provide client s history Allow us to gather statistics efficiently Provide ability to pull ad hoc reports

14 Why Oscar? Cost effective No vendor lock-in Opportunity to collaborate Ability to expand use across several programs and services and contribute to Hamilton PHS Client Electronic Health Record Sustainable solution Large user community Potential to collaborate across healthcare sectors Includes automated import of lab data Co-location with McMaster clinics

15 Steps to Implementation Prioritize program needs Gather requirements Install and configure software Develop custom forms Define new business processes Conduct Privacy Impact Assessment

16 Steps to Implementation (cont d) Train users Go Live! Mental Health & Street Outreach Annual Flu Clinics Sexual Health Others waiting Support users, maintain software Ministry and program reports to inform decision making and maintain accountability

17 Challenges Change can be uncomfortable Many people resist change People deal with change differently Wide range of skill set With new technology comes new processes

18 What is Change Management? The process, tools and techniques to manage the people side of change to achieve the required business results Awareness People Desire Knowledge Ability Reinforcemen t Process Technology * ADKAR : A model for change in business, government and our community by Jeff Hiatt

19 Project management Technical side of the project Current state Transition state Future state Change management People side of the project

20 Managing Change Awareness of the need for change Desire to participate and support the change Knowledge on how to change Ability to implement required skills and behaviours Reinforcement to sustain the change

21 Change Management in Practice Building Blocks Examples Build Awareness Create Desire Transfer Knowledge Provide Ability Present and demo software, communicate and build relationship with users Demo what system can do, benefits, what s in it for them Training sessions, materials, practice time User account, hardware, connectivity Reinforce the change Celebrate Go Live, provide on-going support

22 Strategies for Managing Change Make a plan & identify barriers Involve users from the start Big picture thinking Communicate and demonstrate benefits Make senior management support visible

23 Strategies for Managing Change (cont d) Manage expectations Provide lots of training and support Celebrate success Build capacity Remember, you ve had more time to digest Explain WHY

24 Discussion, Comments, Questions?