ehealth is a journey not a destination! 2013 ehealth Summit May 1-3, 2013

Transcription

1 ehealth is a journey not a destination! 2013 ehealth Summit May 1-3, 2013

2 About Bayshore Founded in 1966 Diversified health services company 100% Canadian owned & operated Operating in all Canadian provinces and territories 2

3 What is ehealth ehealth has also been defined as a collection of interconnected technologies used to support healthcare that are client-centred and can be consumer-driven (Oh et al., 2005) 3

4 Why did Bayshore need ehealth? Better care / outcomes Support efficient operations Support new business initiatives Support new business models & reporting standards 4

5 Bayshore s ehealth journey Phase I Initial experimentation w/ non-intelligent electronic forms (Word, Adobe, etc.) No workflow or indexing for fast reference Inexpensive to implement and deploy - costly and onerous to maintain 5

6 Bayshore s ehealth journey Phase II Moved experimentation to front-office solution Rudimentary electronic forms Basic workflow Integrated w/ scheduling & coordination Very slow, difficult and too costly to operate 2G 6

7 Bayshore s ehealth journey Phase III Dedicated mobile documentation system Advanced smart electronic forms and flowsheets Customized workflow 3 rd party integration w/ front-office scheduling & coordination software Very onerous and costly to operate 3G 7

8 Phase III Evaluation Purpose: To assess the effectiveness of our implementation process. To examine the impact of the implementation process on frontline nurse, clients, and on the organization. 8

9 Evaluation: Conceptual Framework Factors effecting sustainability Improved efficiencies Satisfaction with the device Moderating and mediating factors effecting implementation Organizational Factors Characteristics of Nurses Patient satisfaction Goal attainment Nurse recruitment and retention Health care quality Characteristics of Patients Environment Factors Powell-Cope, Nelson, & Patterson (2008) Characteristics of Technology 9

10 Phase III Evaluation: Outcome Executive Data (Qualitative) Mediating and Moderating Factors Characteristics of Technology: An increased focus on the characteristics of the technology is required. Improvements to handheld devices and software programs are required to support the needs of a decentralized home care team. Nursing Data (Quantitative & Qualitative) If left on current trajectory, technology platform would receive poor adoption across the organization Satisfaction and Sustainability Characteristics of the Technology: The current hardware and software does not meet the needs of frontline nurses and is having a negative impact on nursing productivity, the nurse-client relationship, and recruitment and retention. Increased attention to the characteristics of the nurse and characteristics of our clients, and the potential impact of handheld technology on the delivery of care is required. 10

11 Bayshore s ehealth journey Phase IV EPSILON Platform (Present Day) Integrated front-office solution w/ enhanced mobile documentation system Advanced smart electronic forms and flowsheets Clinical Pathways and customized clinical workflow by staff-type Time & Attendance, Expense Reporting Integration with customers (funders) &key data stakeholders (eg. ICES, CCAC) 11

12 What is Epsilon? w Flexible An integrated process and technology platform for branch and field operations, that enables: Affordable Interoperable Sustainable Scalable 1. Collection of clinical and operational data at the point of care 2. Delivery of clinical and operational decision support at the point of care 3. Administrative efficiencies and improved communication 12

13 Industry-leading components w Procura Blackberry VMWare Microsoft Lenovo Front office, Field & Mobile Application Suite UCP Mobile Hardware / Software Platform Virtualization & Cloud Platform BI platform & laptop OS Clinical Hardware Platform 13

14 Application Suite Components w Automated Provider Reporting Intake Inbox Staff Portal Self- Scheduling mhealth for Clinical Professionals Mobile for Para- Professionals 14

15 Intake Inbox Automated System-to- System Communication XML Messaging Integrated to customer / funder systems Direct data movement into Bayshore s systems Presently operating in Ontario integrated to CCAC CHRIS pxml schema Architected to connect to any other customer / funder across the country Service Offers Service Referrals Intake Inbox Service Changes Notifications 15

16 Intake Inbox enables Automated Provider Reports XML Messaging Integrated to customer / funder systems Direct data movement from point of care directly to customer / funder systems Validated through extensive testing and FULL deployment in Ontario s NSM CCAC (Planning / scheduling underway in Champlain) Architected to connect to other customers / funders across the country Customer Systems XML Messaging Bayshore Systems 16

17 Complete electronic exchange of data Customer / Funder Systems APR Intake Inbox Field visit information 17

18 Self-Scheduling Leveraging system intelligence and automation Offer & Availability Scheduling Genius Service Requirements (Clinical, HR) Allows for system to create schedules based on predetermined rules and conditions Significantly decreases manual scheduling activity Breaks down silos of knowledge and makes it easy to schedule 80% of the time Will allow for easier regionalization of scheduling activities, if required 18

19 Mobile Docs for Para-Professionals Native Blackberry / Android Mobile App 100% integrated to core scheduling system Seamless data flow from field branch back office Built for UCP, with our input and workflow in mind Stable and reliable Blackberry or Android hardware platforms available Handheld SmartPhone Care Plan Electronic Documentation Mobile Docs for Para- Professionals Time & Attendance Offer / Portal Access 19

20 mhealth for Clinical Professionals Administrative EMR Comprehensive clinical point-of-care system Expenses & Mileage Access Portal Time & Attend. Availability Portal Care Plan Clinical Reference Clinical Doc. APR Client ROS Schedule 100% integrated Field staff documentation and clinical support system Designed and built with OBPR and Multi-Disciplinary needs in mind Ability to create / edit own forms, clinical pathways, assessments and flow sheets Able to scale and customize to regional needs 20

21 Staff Portal Enhanced Functionality Newer technology platform, better performance Ability for staff to receive, review, accept / reject offers of visits / shifts Staff availability update Web interface to allow for access across platforms and mobile smart phones Schedule Availability Staff Portal Time & Attendance Offers 21

22 Challenges of mhealth Pace of Change Technology is important, but it changes every 6 months! Apps Store & Forward Platform? Integration 22

23 Security Pressure Challenges of mhealth - Data Complexity Pressure Disposal Maintenance Creation Security Location Access 23

24 Commitment to ehealth Improve access to home care data & information Why? Improve the quality of care Inform health care funding models 24

25 Questions 25