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VIHI alerts GPs when patients enter hospital

Brendan CarrVICTORIA, B.C. – Island Health has started automatically notifying family doctors when their patients are admitted to or discharged from hospital, improving quality and continuity of care for patients.

Family physicians play a pivotal role in helping patients maintain the best level of health possible. However many general practitioners don’t see their patients in the hospital and may not find out right away about changes to their patients’ health that require hospitalization.

“eNotification will help keep family physicians in the loop as a vital member of a patient’s healthcare team,” said Dr. Brendan Carr (pictured), Island Health CEO. “Very often the hospital system is seen as separate from primary care in the community, but we know patient outcomes are better when care is integrated and coordinated across all parts of the health system.”

A successful Victoria pilot project, carried out in partnership with the Victoria and South Island Divisions of Family Practice and Excelleris Technologies, prompted Island Health to introduce electronic notification in all 13 hospitals across the health authority.

As part of the trial, 42 GPs received real-time notifications of admission, discharge and death, delivered directly to their electronic medical records system, or to an Excelleris Launchpad for physicians without electronic records. The Excelleris Launchpad allows physicians around the province to access a secure internet portal for patient medical records, such as lab results and diagnostic imaging results. The pilot took place between July 2 and September 30, 2014.

“It was very timely, as I was then able to speak to my patient’s nurse case manager. She immediately phoned the family to make sure that my very frail, elderly patient had enough home supports in place upon discharge,” said Dr. Lisa Veres, one of the pilot participants.

An independent evaluation of the eNotification pilot found that 96 percent of participating GPs felt it would be an asset to their practice and 83 percent agreed that it helped them provide better care for their patients. Family doctors indicated that when they received a notification, they were more likely to:

• Cancel a patient’s non-hospital appointment;

• Feel better prepared to answer a patient’s family or caregiver questions;

• Make an urgent appointment for a patient if necessary; and/or

• Check PowerChart, Island Health’s electronic patient chart in hospital.

“It’s been very helpful in recalling patients quickly for follow-up from hospital,” said Dr. Laura Phillips. “I’m notified as soon as they are discharged and can deal with any lingering issues proactively.”

Family physicians also can provide caregivers in hospital with valuable information about patients and their families that helps them provide the best possible care.

“In some cases, when family doctors were made aware that their patients were in the hospital, they connected with the hospital staff or doctor to give important information or participate in discharge planning, all of which leads to better care for patients,” said Valerie Stevens, Island Health director of strategic initiatives.

The notifications are generated automatically when an admission or discharge is entered in the Island Health electronic medical record system, which is supplied by Cerner, and are sent to the family physician identified by the patient on registration in hospital. For patients unable to provide their family doctor’s name upon arrival, for example in an acute emergency situation, registration staff will follow up to get the information from patients or their families through staff on the unit.

eNotification started Feb. 9, 2015 and will be fully phased in over the coming months. There are about 750 active general practitioners with community family practices on Vancouver Island.

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2 Comment responses

  1. Avatar
    February 23, 2015

    I find it incredible, as a former, first, family practicioner, then, general surgeon, that this ‘no brainer’ was not seen as a vital adjunct to the care of hospitalized patients, long before now. It is deplorable that the administrators of the Health Care system took so long to realize the value of integrated care communications as a means of providing not only better in-hospital care , but as a cost-saving measure, not only in reducing unnecessary, or prolonged hospital admissions, but also in improved outcomes after discharge.

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  2. Avatar
    February 25, 2015

    This is important, but it is also important that sub-specialists who are looking after many patients with serious chronic diseases also be notified when their patients enter hospital, as they usually aren’t, leading to unnecessary expensive testing, consultations, and sometimes inappropropriate treatment.

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