RICHMOND HILL, ONT. – Mackenzie Health is going ahead with a full implementation of the Epic hospital information system, as part of its drive to achieve Level 7 in the HIMSS EMRAM scale within three years. In the process, Mackenzie Health, which is opening a second major site in 2019, will become the first hospital in Canada to implement the full suite of Epic systems.
Other Canadian hospitals have installed Epic, but only for ambulatory care. Mackenzie Health’s solution will encompass both ambulatory and acute care; it will also be able to connect with outside referring physicians through a portal.
The investment in Epic is part of the hospital’s drive to higher performance and patient care. “We’re at EMRAM Level 3 right now, but we aim to be at Level 6 in two years and Level 7 in three years,” said Richard Tam, executive vice-president and chief administrative officer at Mackenzie Health.
The HIMSS EMRAM scale measures the extent of electronic system usage in hospitals on a scale of zero to seven, with seven representing the most advanced implementations.
Hospitals at this stage are expected to be more efficient, with increased patient safety and better medical outcomes through requirements like computerized order entry, medication management and adverse-event checking, and standardized order sets.
Altaf Stationwala, president and CEO of Mackenzie Health, explained that the acquisition of new technology is not an end in itself, but a way of attaining the highest possible performance – in clinician communication, patient safety and cost effectiveness.
Technology must support better workflows, said Stationwala. “It’s not just about buying shiny boxes, it’s about making sure clinicians are using the technology, and that we optimize it to support better decision-making and patient-care.”
For this reason, Mackenzie Health recently launched its Innovation Lab, an actual unit of the hospital with 34 beds that serves as a testing ground for hardware and software. The goal is to pilot systems that can improve patient care – such as wireless patient alarms and bed falls alerts that are connected to a nurse’s phone – to ensure they are effective. The systems, and the associated clinician-friendly workflows, can then be rolled out across the hospital.
Mackenzie Health is working with partners such as Cisco, Hill-Rom, BlackBerry and ThoughtWire to produce these solutions. Stationwala pointed out that the hospital is not planning to profit from the rights to any new solutions that are produced in the Innovation Unit. Instead, the vendor partners are able to commercialize solutions and enhancements developed from projects in the Innovation Unit.
“We’re not demanding any IP [intellectual property] from the Innovation Unit,” said Stationwala. “We’re not in the business of selling IP, we’re in the business of improving patient care. IP and licensing would simply be a distraction to us.”
Through the Innovation Unit, the hospital is creating a “smart layer” of software and workflow solutions that improve productivity and patient safety. It’s being done by connecting various systems in ways that are easy to use by physicians, nurses and other clinicians.
When the new Mackenzie Health Vaughan hospital opens in 2019, several kilometres away, the same innovations will be used there. “We see the new hospital as an extension of this one,” said Diane Salois-Swallow, chief information officer. “We have A, B, C, and D wings here at Mackenzie Health Richmond Hill. Information should flow easily between us and the new site, as if it were E wing.”
To ensure this seamless interoperability between the two sites, Mackenzie Health recently issued an RFP for vendors who can build on what’s already in operation at the Richmond Hill site and implement it at the new Vaughan location.
“It’s not an easy task,” said Salois-Swallow. “Too many vendors want to start installing new and different systems, which don’t mesh in the same way with what we have produced. We need things to work in the same way at both locations.”
Mackenzie Health is also highlighting patient-centred care. For this reason, it recently launched a patient portal and MyChart, a personal health record that was pioneered at Sunnybrook Hospital, in Toronto. MyChart will enable patients to view portions of their electronic records, to make or change appointments, and to communicate through secure emails with their care-givers.
Systems like MyChart give patients more control over their care, helping them to become more involved in getting better or staying healthy.
Mackenzie Health’s MyChart system was launched with patients in the department of medicine; it will gradually be rolled out to other parts of the hospital.
Management has also been paying a good deal of attention to the new Mackenzie Vaughan site, a 350-bed “smart hospital” that will be the first hospital built in the region in 50 years.
Mackenzie Health recently named Philips as its ‘managed equipment services’ (MES) partner, an innovative deal that will see Philips supply leading-edge equipment (its own and from other vendors), procurement services, installation and maintenance, for the next 18 years. The total value of the arrangement has been pegged at $300 million.
Mackenzie Health is the first to work with its MES partner in the early RFP phase of the project – in this case, before its new Mackenzie Vaughan Hospital has been constructed. “We’re the first to engage [with the MES partner] before the construction phase of the project,” said Tam. “So our vendor can actually participate in the design of the facility.”
That means, said Tam, that Philips can advise the architects and builders about the future requirements of hospitals, to make it easier to maintain and replace equipment. For example, equipment vendors can advise architects to position MRI suites near outside walls, so that it is easier to move magnets in and out of the facility when upgrades are required.
Iain Burns, President and CEO of Philips Canada, said the MES with Mackenzie Health is itself an innovation, one that will help streamline the operation of the hospital.
That’s because Philips will look after the procurement and acquisition of technology for the next 18 years, relieving the hospital of this chore. It will issue RFPs, evaluate technologies, and work with management to make final decisions.
“Issuing RFPs is an expensive and time-consuming process for any hospital,” said Burns. “We are now going to handle that, and Mackenzie Health will be able to focus on patient care.”
If the hospital is evolving through its partnerships, said Burns, so is Philips. “We will be working more closely with other vendors.”
For its part, Philips has been forging ahead in leading-edge technologies like analytics, cloud and remote patient monitoring. “Mackenzie Health will have early access to our innovations around the world,” commented Burns.
And the hospital will become an international showcase for Philips. “We’ll be doing a lot of first-of-their-kind projects with Mackenzie Health.”
He credited Stationwala on this score. “Altaf is a visionary and a forward thinker. He and his team are really creating the hospital of the future.”