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Three Ontario hospitals announce plans to share patient record system

By Jerry Zeidenberg

Three Ontario hospitals recently announced they are joining hands to share an implementation of Meditech’s latest electronic medical records system, called the Meditech Web EHR.

Markham Stouffville Hospital, in Markham, Ont., will host the system, and a single, shareable electronic health record will be created for patients at Markham Stouffville, Southlake Regional Health Centre, in Newmarket, Ont., and the Stevenson Memorial Hospital, in Alliston, Ont.

The new project is being called SHINE – short for Shared Health Information Network Exchange.

It’s the first group of hospitals to take a cue from the Ontario government’s new eHealth 2.0 strategy, which encourages hospitals to create geographical clusters that can share computerized systems as a way of reducing costs.

“There are substantial savings,” said Tim Pemberton, chief technology officer at Southlake. He noted that Markham Stouffville, which has been a long-time Meditech customer, was footing 100 percent of the bill for its own electronic health records system. Now that it has partners, it will bear only part of the cost of the shared solution.

For its part, Southlake is the biggest of the three hospitals in the partnership and will shoulder the largest portion of the costs. Pemberton noted the exact shares are still being worked out.

While there are other groups of hospitals in Ontario that are sharing Meditech software, Pemberton believes this will be the first time the partners will create a single record for all patients.

The goal is to have SHINE up and running in early 2018. Meanwhile, work is being done to prepare for the implementation, such as creating a master patient index and the merging and purging records of patients. Many of the patients in the region visit two or more of the partner hospitals, so information from their records must be consolidated.

“There are about 2 million patient records,” said Pemberton. “It’s a lot of work.”

Southlake was in the position of needing a new electronic patient record system, as it currently uses a McKesson solution that will reach sunset in 2018 – McKesson has told hospitals it is leaving the electronic health records marketplace in Canada. Sharing the Meditech Web EHR with Markham Stouffville seemed like a logical thing to do, as so many of the region’s patients visit both hospitals.

Southlake is regional centre for cancer care and has expertise in cardiology and many other areas. As a result, it attracts referrals from Markham Stouffville, Stevenson Memorial and from physicians in a wide catchment area.

By having a single patient record available, clinicians will get a more complete view of the patients’ medication histories and lab results, as the information will be merged from all three hospitals.

And while Meditech is sometimes thought of as an old-fashioned system, Pemberton is quick to observe that the latest, web-enabled version is unlike anything the company has produced before. “This is not your father’s Meditech,” quipped Pemberton. “This system is a game-changer.”

He noted that clinicians from the hospitals were impressed by a demonstration of the web-enabled Meditech. Everything can be done on a tablet or smartphone, and the system automatically detects what kind of device the user has – desktop, tablet or phone.

Moreover, the system handles all of the hospital workflows, including Emergency Department, inpatient, surgical and discharge – all from portable platforms as well as from desktops.

“It’s all mobile,” said Pemberton. “The clinicians were blown away.”

Meditech’s associate VP of marketing, Christine Parent, said the company has realized that doctors and nurses today are not tethered to desks. “It’s a new generation and they’re mobile. They need information at the point-of-care.”

For that reason, the Meditech Web EHR is designed to be used wirelessly, on a variety of platforms. “It allows you to roam,” said Parent.

Southlake and Stevenson will be able to leverage the expertise of Markham Stouffville, which has already achieved Stage 6 in the HIMSS EMRAM framework.

“We will share our Meditech knowledge with them,” said Lewis Hooper, CIO of Markham Stouffville, adding that MSH will also make resources like data dictionaries and other tools available.

“But we will also benefit from having partners, too,” he said, noting that Southlake has a large number of order sets that could be used on the road to implementing a Computerized Physician Order Entry (CPOE) system, something that’s in the works at both organizations.

Hooper said that Markham Stouffville will also learn from the Stevenson Memorial, a smaller hospital where clinicians and staff have learned to accomplish a lot with fewer resources. One person will often do a lot of things, and they’ve learned to do them very efficiently, Hooper asserted.

Calling them “specializing non-specialists,” Hooper said there’s a good deal of knowledge about efficient and effective practices that can be learned from Stevenson Memorial.

On the technological side, Hooper asserted that a shared EMR will make things easier and faster for clinicians and patients. Not only will more information be available at the touch of a few buttons, but the processes for reaching the data will be the same across all facilities – meaning that clinicians going from one site to another will know how to obtain the information without re-training.

And with everyone working on Meditech, the organizations will be able to develop more expertise in the technology – which can be shared among partners.

For its part, Southlake intends to reach HIMSS Stage 6 by the year 2020. To that end, it has also been investing in more powerful infrastructure, including a 100 gigabit/second wired network, using Cisco technology, and 10 gigabit/second wireless.

“This is all to support the HIS,” said Pemberton.

The hospital is also using Microsoft’s Office 365, with Skype, through the cloud. And it has implemented virtual desktops and proximity card log-ins that allow clinicians to roam from one computer to another with automatic logins and logouts.

The partners plan to deploy the patient portal component that is part of Meditech Web EHR. “It’s part of our strategy to engage our patients,” said Pemberton. He noted the system offers features like appointment scheduling, prescription renewals and an interface for contacting physicians and other clinicians.

The hospitals are still in the planning stages, however, about which of the features to provide. “We’ll see what the patients want,” said Pemberton.

Meditech is a major supplier of electronic record systems in Canada. Parent said the company does business in seven of the 10 provinces, and in two of the three territories. It has a 50 percent market share in Ontario’s acute care hospitals, and 41 percent in Canada as a whole.

She noted there is a great deal of interest in the project launched by Markham Stouffville, Southlake Regional and Stevenson Memorial. “A lot of institutions are watching this,” she said. “They want to learn from it.”

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