BenefitsRealization:HRMisimprovingqualityofcare,patientexperience,andefficiency

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Valuestatement

TheadoptionofOntarioMD’sHealthReportManager(HRM)acrossthesouthwestOntario(SWO)regionisenablingclinicalandorganizational(includingadministrative)valueforphysiciansbyallowingthemtosecurelyreceiveelectronicpatientreportsfromparticipatinghospitalsandspecialtyclinicsacrossOntario.Pertinentpatientinformationreachesthephysicianinatimelymanner,thusenhancingcontinuityofcare.Theinformationisintegrateddirectlyintothephysician’scertifiedelectronicmedicalrecord(EMR)enablingmoreefficientuseofresourcesandgreaterfocusonenhancingpatientexperienceandqualityofcare.

Afocustowardsimprovedpatientexperience

TheMinistryofHealthandLong-TermCare’sPatientsFirst:ActionPlanforHealthCarehighlightsthegovernment’scommitmenttoputpatientsfirstbyimprovingtheirhealthcareexperience.1Efficient,timely,patient-centeredcarethatisalsosafe,effectiveandequitablearethekeyelementsofqualitycarelinkedtopatientexperience.2Thechallengeofsatisfyingthedifferentaspectsofqualitycarehighlightstheneedtoembraceinnovativemethodstoenhanceefficiencysomorefocuscanbeplacedonprovidingtimelyandappropriatecarethatmeetspatientneedsandultimatelyleavespatientswithapositivehealthcareexperience.

AdoptingHRMtoimproveefficiencyandresourceallocation

TheUrologyAssociatesisaspecialistofficeinKitchener,operatedbythreeurologists,whocurrentlyuseHRM.PriortoHRMadoption,theofficemanagerwasresponsibleforscanningfaxedreportsfromthehospitalsandensuringthattheyarereviewedanduploadedinthepatient’sEMR,asoutlinedinFigure1.HRMhasenhancedefficiencyattheUrologyAssociates,aspatientreportsaresentelectronicallydirectlytotheEMR,decreasingtheamountoftimespentscanning,triaging,anduploadingfaxedreports.Theofficemanagernowusesthisextratimetoenhancepatientexperience:• Shefocusesonreferralscomingintotheofficeandfollowsupwithpatientstokeeptheminformedaboutthenext

stepsoftheircare.• Shehasimplementedandmaintainsasecureemailsystemtoimprovepatientaccesstotheofficeforany

questionsorconcernsthattheymayhaveintheprocessofcare.Thiswasfoundespeciallybeneficialforpatientswhoareawaitingsurgeriesandrequirepre-surgeryinformationandpaperwork.Throughemail,theofficemanagerisabletoforwardtheinformationrequired,reducingtheneedforthesepatientstotraveltotheoffice,ensuringthatpre-surgeryprocessesarefollowedandpatientcareisnotcompromised.

EvaluatingbenefitsisanimportantcomponentoftheconnectingSouthWestOntario(cSWO)Programthathelpstosupportanddemonstratetherealizationofhealthsystembenefitsthroughtheadoptionofanelectronichealthrecord(EHR).Bypursuingthemeasurementoforganizationalvalue(improvementsintheefficiencyofcaredeliverysuchastime-savingsandredirectedresources)andclinicalvalue(patientsundergofewerunnecessarytests,patientshaveimprovedaccesstocare),ultimatelypatientsbenefitfromhigherquality,betterinformedclinicaldecision-making.

ThecSWOBenefitsRealizationprogramusesaresearch-basedapproachtoidentifyareasofclinicalbestpracticethatareaffectedbytheuseoftheEHR,andworkscollaborativelywithclinicianstounderstandthevalueoftheEHR.Thisformativeevaluationprocessinformschangemanagementandadoption,andenablesclinicianstousetheEHRmoreeffectively.Thisresearchdoesnotincludetheuseofanypersonalhealthinformation.

ThisdocumentisoneinaseriesofcasestudieswhichdescribetheclinicalvalueoftheEHRindifferentclinicalsettingsandcontexts,particularlywithrespecttoclinicalbestpractices.TheworkofthecSWOBenefitsRealizationprogramisongoing;dependingonthecircumstance,thesecasesoccasionallyraisequestionsforfurtherinvestigation,andcliniciansareinvitedtoparticipateinbenefitsevaluationtocontinuetodeveloptheseanswers.

TheinformationinthisdocumentisnottobereproducedwithoutwrittenpermissionfromthecSWOProgram.

Published:January2017Updated:December2017

HRMenhancespatientsafetyandwasdesignedtoincorporateOntario’seSafetyguidelines.Whenanurgentsituationarises,staffdonothavetosort,uploadortriagefaxestofindpatientinformation.TheinformationiseasilysearchableandavailableintheEMR.Thisismostcrucialforhighurgencyreportsindicatingabnormalitiessuchascancer,wheretimelyinterventionsmaybevitaltopositivepatientoutcomes.

Figure1–BeforeandafterHRMadoption,patientreportsprocessesandoutcomesforthespecialistclinic.

Testimonial"SinceourclinichasadoptedHRM,IknowIcanrelyontheautomationoftestresultsprocessing,whichhasgivenmemoretimeandenergytofocusondevelopingnewpracticesandtechnologiesthatwillboostourclinic’squalityofcare,efficiencyandrevenue,allofwhichbenefitourpatients,staff,andtheclinic’sreputationasaleaderofcareinourcommunity..."

StephanieCrowther,OfficeManageratUrologyAssociates,KitchenerQuestionsForquestions,comments,ortoparticipateincSWOProgram’sBenefitsRealizationprogram,pleasecontact:LirijeHyseni,BenefitsRealizationSpecialist,cSWOChangeManagementandAdoptionDeliveryPartner,eHealthCentreofExcellence:[email protected]. OntarioMinistryofHealthandLong-TermCare.(2015).Patientsfirst:Actionplanforhealthcare.Toronto:Queen’sPrinterforOntario.2. HealthQualityOntario.(2015).QualityMatters:RealizingExcellentCareforAll.Toronto:Queen’sPrinterforOntario.

BenefitsRealizedo IncreasedpatientsafetyasaresultofsearchabledigitalinformationintegratedintoEMRsratherthana

manualscannedandnon-searchableimagebeingmanuallyfiledintoapatient’srecord.o Moretimelyinformationtosupportclinicaldecisions.Careisnolongerdependentonreportsbeingscanned

andreviewed.Processestoaddressabnormalresultsareenablingimmediatecareforpatients.o Improvedresourceefficiencyenablingprocessimprovements.UrologyAssociatessavedscanninganaverage

of250pages/day(shredding,maintenancecost,andfax(printingink/toner).Timesavingsof4hrs/day(~70percentreduction)enablingmanagerstoinvesteffortininitiativesthatenhancepatientexperienceandqualityofcare.