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Inside the October 2005 print
edition of Canadian Healthcare Technology:
Feature Report: Developments in telehealth
 Toronto General rolls out innovative tele-dialysis
service
After a year-and-a-half of system design and
development, physicians at the University Health Network (UHN) have
launched a tele-hemodialysis program that promises to change the way
kidney dialysis is delivered across Canada and abroad.
Calgary e-health incubator
Dr. Penny Jennett of the University of Calgary,
assisted by $1.2 million in government funding, is heading a new
centre that will help companies refine their electronic technologies
to meet the needs of the healthcare marketplace.
READ THE STORY
ONLINE
CardioPACS in Quebec
The Montreal Heart Institute is implementing a
Picture Archiving and Communication System that integrates images
from both radiology and cardiology departments. It’s one of the
first in Canada.
Canadian sites refine use of tele-monitoring
Mrs. Lillian “Ruth” Patterson is a telehomecare
fan. Now the “poster girl” for one of the country’s first
telehomecare initiatives to gain sustained government backing, the
elderly New Brunswicker has been appearing in the papers and on
television to say how much being monitored closely at home via
technology has improved the quality of her life.
READ THE STORY
ONLINE
Credit Valley Hospital implements automated
patient registration
Credit Valley Hospital’s automated patient
registration process – possibly the first of its kind in Canada –
has been piloted with great success. In only two
months of usage, 1,259 patients have used the self-register. In
time, the hospital envisages more than half of the patients who have
access to self-registration using it.
READ THE STORY
ONLINE
Nurse practitioners’ network
The NORTH Network, Ontario’s busiest telehealth
network, has created a system to link nurse practitioners and their
patients to physicians, for consultations and advice about acute
problems and conditions.
Interview: Dr. Geoff Fernie
Geoff Fernie, vice president of research at
Toronto Rehab, leads a unique project to create a new generation of
assistive technologies. $36 million will be invested to create
innovative facilities, including a four-season, all-weather
simulator lab.
PLUS news stories, analysis, and features and more.
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Toronto General rolls out innovative tele-dialysis
service
By Jerry Zeidenberg
TORONTO – After a year-and-a-half of system design and development,
physicians at the University Health Network (UHN) have launched a
tele-hemodialysis program that promises to change the way kidney
dialysis is delivered across Canada and abroad.
The UHN team worked with partners at the University of Toronto and
corporations including Bell Canada, through its Bell University Labs
program, as well as Research in Motion (RIM), of Waterloo, Ont.,Gambro
Canada Inc., and Misys Healthcare.
Together, they produced a completely automated monitoring system that
supports kidney patients using dialysis equipment in their homes while
they are asleep.
“The breakthrough is that it’s all automated, and no human intervention
is required,” commented Dr. Christopher Chan, a nephrologist at the
Toronto General Hospital, UHN, and principal investigator for the
Tele-home Technology for the Chronically Ill Patient project.
“There would have been no economic benefit if we simply replaced nurses
at the point of care with people at the monitoring centre,” he
explained, adding that the system also helps patients feel more
confident and comfortable with taking the initiative for their care at
home.
How does the system work? Essentially, patients spend half-an-hour, five
nights a week, hooking themselves up to their home-based dialysis
machines and equipment that monitors their vital signs.
Signals from the dialysis machines and physiological sensors are
wirelessly transmitted to a computer in the home, which is connected via
high-speed Internet to central servers and workstations.
If there are any problems with patient or equipment, the system will
quickly sense the trouble and automatically alert the appropriate
care-giver or technologist by e-mail, pager or BlackBerry.
Care-givers can then respond in the appropriate manner, depending on the
severity of the problem.
It’s all designed to give patients the confidence they need to conduct
dialysis on their own.
Home-based, nocturnal hemodialysis has been shown to be dramatically
more effective than conventional, clinic-based dialysis, where patients
must travel to a hospital or clinic three times a week.
In-home, nocturnal dialysis enables patients to dialyze at night for 40
hours per week, as opposed to just 12 hours weekly that’s standard
practice with conventional hemodialysis.
And by staying at home, patients give themselves more time for work and
family during the daytime and evenings.
Dr. Chan noted that recent studies – one such groundbreaking study was
published in the prestigious Kidney International journal in 2002, with
Dr. Chan as lead author – have shown immense medical benefits for
patients using home nocturnal dialysis. These benefits include normal
blood pressure, compared with the hypertension that afflicts 80 percent
to 85 percent of patients using conventional hemodialysis.
Home nocturnal dialysis patients experience better circulation and
improved sleep, and have liberalized diets. They’re able to eat
normally, including foods like spaghetti and cola drinks, which are high
in potassium and phosphate and must be avoided by conventional dialysis
patients.
Moreover, the 2002 study showed that night hemodialysis patients were
able to wean themselves off their anti-hypertensive medications, whereas
there was no change in the group of patients on conventional hospital
dialysis.
Still, only a sprinkling of dialysis patients across Canada and the
United States use this form of therapy, largely due to fears of being
unable to monitor the process themselves and to handle problems that
might arise.
“There’s a real fear of performing an inadequate dialysis,” said Dr.
Chan. “Patients are afraid that something may go wrong.”
That’s where the UHN’s project comes in. Because it can detect problems
as they arise, and send out alerts to care-givers, patients will feel
that they’re not isolated.
Moreover, there’s a good deal of training involved, so that patients and
family members are better able to take charge of their dialysis. “We’re
training them to become their own dialysis nurses,” said Dr. Chan.
In addition to the manifold medical benefits of home-based nocturnal
dialysis, the telehealth program makes it cost effective – largely
because it’s fully automated.
“Instead of one nurse for every two or three dialysis patients, which is
the current ratio in conventional dialysis centres, you only need one
nurse for twenty home dialysis patients,” commented Dr. Chan. He noted
that there are wider economic benefits, as well. Because of the rigours
of conventional dialysis, with trips to hospitals or clinics three times
a week, most hemodialysis patients don’t work. Instead, they’re on
various forms of disability and income supports.
By contrast, those conducting home nocturnal dialysis are virtually all
able to work. They’re earning incomes and paying taxes – and boosting
their self-esteem.
Much of the funding for the tele-dialysis project was supplied by Bell
Canada through Bell University Labs, a multi-pronged research effort the
company runs with the University of Toronto and several other
universities across Canada. The core of the system runs on servers and
workstations at the Centre for Global eHealth Innovation, in Toronto,
itself a joint-venture between the UHN and the University of Toronto.
As well as cash, Bell is contributing network services, troubleshooting
and managerial services to launch the system and keep it up and running
– in total, over $300,000 worth of cash, equipment and services. “We’re
providing the utility based infrastructure that allows everything to
operate seamlessly,” said Brent McGaw, industry marketing director,
healthcare, for Bell Canada.
For its part, Toronto General Hospital, UHN was among the first
hospitals in Canada to launch a home-based nocturnal dialysis program.
It currently has 68 patients using home-based systems. Through the use
of its new telehealth program, it plans to steadily increase these
numbers.
Dr. Chan is confident that hospitals and clinics across the country will
increasingly shift to this form of dialysis therapy. “In the next five
years, the delivery of dialysis will change radically,” he said,
predicting that eventually, most hemodialysis will be conducted in the
home.
New Western Canada project brings e-Health and
caregivers together
By Gillian Crowley
CALGARY – In Western Canada, when a company develops a piece of
technology with potential application in the healthcare sector, a myriad
of questions arise:
• Who should be approached within the health jurisdictions to discuss
e-health needs and what our company can offer?
• How can we be sure this device or software will work in a healthcare
setting?
• Should we approach another company to bundle our products to engage
the healthcare sector more effectively?
Now, a $1.2 million grant from two funding agencies – Alberta Innovation
and Science and Western Canada Diversification – is making it easier for
industry to find answers to those questions.
The grant received in Spring 2005 supports a University of Calgary
e-Health Industry Project aimed at helping companies and healthcare
providers find the best technology solutions for the health and wellness
sectors.
Grant recipient, Dr. Penny Jennett, says, “We’re delighted to receive
this 30-month funding as seed money for this project.” Dr. Jennett is
founder of the Telehealth Unit in the Faculty of Medicine, University of
Calgary, and also founding member and past-president of the Canadian
Society of Telehealth (CST).
Dr. Jennett adds, “We have strong, existing connections with both the
healthcare decision-makers and the technology companies, putting us in
an excellent position to help small and medium-sized companies that are
looking to test and deploy products that fit health and wellness needs.”
Healthcare professionals are facing constant change. From healthcare
reform and regionalization to transformation of the way care is
accessed, delivered and managed, E-health solutions are being viewed as
part of the solution to many challenges in the health and wellness
sectors. One of the e-Health Industry Project’s main goals is finding a
way to bridge the gap between e-health businesses and the healthcare
sector’s current and future needs.
The e-Health Industry Project offers four specific opportunities for
industries working in the e-health field:
• networking and information brokering at national and international
levels;
• showcasing, displays, demonstrations and workshops to bring industry
and healthcare representatives together;
• prototype testing in simulated clinical settings, along with field
studies in real clinical and wellness settings; and
• office space where companies can maintain close contact with health
collaborators and healthcare practitioners.
Frank Wong, CEO of Edmonton-based Meta4hand (www.meta4hand.com),
says, “The e-Health Industry Project empowers a company such as ours to
speak directly to end users and healthcare decision-makers. It provides
us with strategic contacts in e-health and insights into their
technology needs, so that we may improve our product offerings for this
market.” Meta4hand is one of three industry representatives on the
project’s advisory committee.
The project will meet company requirements as varied as the companies
themselves. Some firms may need help finding business opportunities
provincially while others may be ready to grow into the global
marketplace.
Most companies are looking for linkages to key decision-makers in
healthcare and several are seeking business partnerships. Project
capabilities include linking industry with consultants who have
clinical, training and evaluation expertise that can help companies
assess the potential success of their product in a health setting.
Member companies may choose from different options to suit their
individual needs for services.
Healthcare providers are excited about the concept. Dr. Jennett says
they look forward to getting more concrete feedback on new technologies
that could enhance patient care, and potentially have an impact on care
processes and outcomes. Evaluation of these technologies could also help
optimize deployment of resources and enlighten policies.
Healthcare decision-makers must be sure that products work as expected
within a healthcare environment. Located within the Health Sciences
Centre on the Foothills Hospital site, the project has access to a
futuristic hospital ward and clinical office.
In these settings, healthcare professionals can examine evidence of
“proof of concept” within a protected and approved networked health
environment. Interested health practitioners can drop in to “play with”
leading edge technology on display in the Telematics Unit and take part
in interactive training opportunities.
Dr. Jennett says, “We look forward to promoting fresh new perspectives
on the way industry and health professionals can work together to pursue
innovative technology that meets the criteria of quality, safety and
efficiency in the health and wellness fields.”
Gillian Crowley is a project coordinator with the University of
Calgary e-Health Industry Project. See
www.fp.ucalgary.ca/telehealth
Quebec hospitals and GE Healthcare to bridge
radiology, cardiology
By Jerry Zeidenberg
When the Montreal Heart Institute implemented a PACS earlier this year,
its physicians and department managers went far beyond the usual
implementation of a Picture Archiving and Communication System.
Not only did they computerize the images in the radiology department and
make them accessible across the hospital – a formidable task in itself –
they also integrated images from the cardiology department.
By doing so, they became among the first healthcare centres in Canada to
bridge these two departments – which in terms of electronic systems,
seem to exist as two solitudes.
While cardiology and general imaging departments are typically the two
largest producers of diagnostic images in any hospital, because of their
different clinical needs – and sometimes because of differing ‘corporate
cultures’ – their computer systems have developed separately and have
traditionally been incompatible.
As a result, the flow of images and reports between the two has usually
taken place at less than optimal speed.
However, this year the Montreal Heart Institute implemented a GE
Healthcare Picture Archiving and Communication System as the central
archiving system for all images. The solution makes use of GE
applications for radiology image interpretation, with ProSolve Concept (PSC)
acting as a third party vendor for all cardiology applications.
With tight connections between general imaging and cardiology
departments, the result is bestowing numerous benefits.
“It makes a world of difference,” said Dr. Guy Pelletier, chief of
cardiology for the Institute. As cardiologists, “we need to see X-rays
and CT scans in addition to the cardiac exam. And the radiologists need
to see the echo and cath lab images for a better understanding of the
patient image file. It’s very important, and now you can do it all from
your workstation.”
Dr. Pelletier noted that cardiologists, radiologists and surgeons will
be able to view historical images much faster than before. “Previously,
we stored echocardiographic exams on VHS tapes, which were kept in
cupboards and had to be retrieved,” he said.
Now, there is computerized access to these studies, making it much
easier to compare recent and archived exams.
That’s a big gain for physician productivity, and also for speed and
quality of patient care.
“We can retrieve and compare in minutes,” said Dr. Pelletier. “It makes
a world of difference.”
The system has become equally useful for radiologists. “We can obtain CT
exams immediately, instead of waiting 24 hours,” commented Dr. Patricia
Ugolini, chief radiologist.
She noted that the Montreal Heart Institute is a teaching hospital, and
that the PACS will have an impact on education, as well. While making
rounds, doctors and students will no longer have to trek from echo lab
to cath lab to radiology department, in order to view various images of
patients.
Instead, it can all be done from a single workstation.
“We can discuss images from different modalities all in one location,”
she said. “We can retrieve everything on the web.”
The major modalities used at the hospital include CT, MRI, ultrasound,
cath lab and echo labs. Yves Amyot, biomedical engineering manager for
the Institute, pointed out that previously, the imaging technologies
used at the hospital were all unconnected – even if they were digital,
they weren’t linked in a network.
“Most modalities didn’t talk to each other,” said Mr. Amyot. “Even when
the equipment came from the same vendor, the different modalities all
had to be interfaced.”
Part of the problem was that various digital modalities conform to
differing standards. Through the PACS project, and the integration
that’s involved, all of the equipment is being joined in a seamless
network.
Enormous efficiency gains will be derived from automating the whole
process through a computerized network – with the elimination of lost
films or tapes, the reduction of clerical and support staff needed to
retrieve and file exams, and the addition of workstations with
high-level tools for analyzing images.
The Montreal Heart Institute is investing $ 4.5 million in its entire
digital imaging project, which includes web capabilities throughout the
hospital, and secure access for physicians who are off-site – at home or
at their private offices.
The hospital is also installing a 64-slice CT scanner from GE; it should
be operational this month (October).
Mr. Amyot noted that the cardiology department produces the bulk of the
images in the hospital, about two-thirds of the total, due to the heavy
use of dynamic images in the cath labs.
Drs. Pelletier and Ugolini said the cardiology department tested four
different systems, but ultimately chose ProSolve, largely for its
reporting capabilities and specific analysis tools for cardiac exams.
“The reporting needs of cardiologists are different,” said Dr. Ugolini.
However, GE and the hospital are working together to integrate the
systems, making them accessible to all authorized physicians and
care-givers.
Additionally, a Radiology Information System from Artefact of Montreal,
(now owned by IBM), will be integrated with both the radiology and
cardiology systems, enabling physicians to develop comprehensive reports
about patients that include all images.
Dr. Ugolini noted that on this count, the RIS will have to be ‘refined’
for usage in the cardiology department.
This integration is all in the effort to create an electronic patient
record at the Montreal Heart Institute, which will also incorporate
dictated notes.
Dr. Pelletier said the image management and reporting systems will be
valuable for data mining and analysis. “ProSolve allows us to accumulate
data for research and clinical analysis in the future,” he said. He
explained that the software will enable physicians and administrators to
analyze the volume and growth of various procedures, which can be used
for outcomes analysis.
For its part, GE Healthcare is able to weave together the various parts
of the ‘best-of-breed’ solutions at the Montreal Heart Institute into a
single network. The integration project – which uses the Centricity PACS
as the overarching technology – is also allowing the Institute to keep a
good deal of legacy equipment, resulting in lower overall costs for the
hospital.
“The challenge of this implementation was to integrate multiple vendor
applications, with one single archive systems – GE Centricity PACS,”
said Pierre Volant, GE project manager. “It gives the users the ability
to access best-of-breed applications, using a consolidated back-end that
allows access to both cardiology and radiology images under the same
application.”
Canadian sites refine use of tele-monitoring to
improve home-based care
By Andy Shaw
Mrs. Lillian “Ruth” Patterson is a telehomecare fan.
Now the “poster girl” for one of the country’s first telehomecare
initiatives to gain sustained government backing, the elderly New
Brunswicker has been appearing in the papers and on television to say
how much being monitored closely at home via technology has improved the
quality of her life.
Being cared for under an extension of River Valley Health’s Extra Mural
Program (EMP), called the EMP@home program, Patterson was one of the
first 30 congestive heart failure, chronic obstructive pulmonary, and
hypertension patients in the Woodstock, New Brunswick area to be
monitored by the program. As a result of the project, they’ve since
learned to look after themselves better in their own homes.
“My anxiety has decreased and I don’t worry nearly as much about my
health, since I am being closely monitored on a daily basis,” Patterson
has been quoted as saying. “The system is easy to use and I do it
myself.”
While similar telehomecare efforts are going on elsewhere in the
country, EMP@home is no longer “yet another telehealthcare pilot”. It
has made the leap from a pilot to a budgeted-for demonstrator project
for the entire province.
EMP@home will carry on at least until 2006, when it will be re-assessed
with an eye to expanding it.
“The strategic aim is to replicate EMP@home in every healthcare district
of New Brunswick,” says Valerie Hagerman, the regional telehealth
director for River Valley Health and the co-chair of the EMP@home
implementation committee.
Elsewhere, there are other signs that telehomecare is maturing. In the
nation’s capital, for example, the Ottawa Heart Institute has
established an on-going telehomecare program. In the East York district
of Toronto, the largest telehomecare effort in the country aims to soon
include nearly 200 patients, is also on the move towards permanency.
All these initiatives are sustained by the convictions of their
admirable leaders and their project partners that effective telehomecare
is both feasible and fundable – partly because it just makes such great
economic, cost-saving sense to look after patients at home rather than
in acute care hospitals; partly because remote monitoring technology has
become both reliable and handy; partly because care-givers are in short
supply; and partly because of the increasing familiarity, enthusiasm,
and comfort both patients and providers say they are experiencing with
the technology.
In New Brunswick, the technology is being provided by Honeywell HomMed
Health Monitoring System, which is based across the continent in
Victoria, B.C. In each of the 30 EMP@home patient’s residences sits a
HomMed Sentry monitoring unit. And each day, a gentle voice from the
Sentry guides the patient through a simple three-minute procedure to
gather their vital signs.
Plugged-in peripherals, including a blood pressure cuff and a weigh
scale among a variety of health measuring devices, digitally transmit
their results to the Sentry’s memory. The monitor also asks patients
like Ruth Patterson up to 10 disease-related questions, whose answers
Sentry dutifully records.
Sentry then automatically sends both data and voice out over regular
telephone lines to a HomMed Central Station at the EMP@home office in
Woodstock. There, EMP@home nurses can quickly and easily interpret the
results on the screen of the Central Station, thanks to built-in
software that can track and trend user data, record and view
nursing/physician notes, log patient contacts, and generate printed or
faxed reports.
“Our Sentry and now our new Genesis systems originally stem from
telemetry developed for intensive care units in hospitals by a company
called SpaceLabs,” explains Jennifer Brown, marketing director for
Honeywell HomMed in Victoria. “It had the same elements of a monitor and
a remote central station. But when the grandfather of developer, Buzz
Petticord, fell seriously ill, Buzz saw that the same system could be
applied to home care. I flew to Wisconsin to see what he developed and
came away convinced. It just made so much economic sense, given our
aging population and nursing shortages.”
While Brown set up the enterprise in Canada, Honeywell has since taken
over the business and leads its development. That gave Brown a solid
financial base for launching a mission.
“I went across the country and did a lot of educational work with
healthcare agencies and providers,” says Brown. “And the case I was
making everywhere I went was that telehealth and telehomecare are not to
be confused.”
Telehealth – bringing physicians and patients together for examinations
or consultations via video conferencing is good, admits Brown, but
telehomecare – the remote monitoring, aiding, and educating of the
infirm, the elderly, the demented or even the dying – is, in her words,
“a different ball of wax.”
Evidently Brown was convincing. At the time of writing, Honeywell HomMed
had penetrated the Canadian market with 130 Sentry and Genesis home
monitors, all speaking gently and guiding patients not only in New
Brunswick, but also in Quebec, Ontario, Manitoba, and Alberta.
HomMed accelerated that early market lead, reports Brown, by putting a
year of effort into meeting Health Canada’s 13485 ISO standard for
medical devices. And by adding the Genesis monitor to its line-up.
“The Sentry is what you might describe as our Toyota Corolla model,”
says Brown. “It is very reliable, simple to use, yet it is capable of a
high level of complex care. It can handle a range of high risk,
multiply-afflicted patients.
“The Genesis is more our Cadillac. It is very sophisticated and can be
focused on specific chronic diseases.”
Such as those the Ottawa Heart Institute treats.
The Heart Institute’s recently established e-Health unit has deployed 30
of its 40 Genesis units so far to cardiac patients recently discharged.
“Even though they have had successful bypass surgery, some of our
patients still need acute monitoring,” says Christine Struthers, a
clinical nurse who heads up the Institute’s new E-health unit.
“And with the Genesis unit we can monitor not just weight and vital
signs, but also, there are two circles on the unit that when patients
put their thumbs on them we can take electrocardiograms from them.” says
Struthers. “So we can watch them for arrhythmia, arterial fibrulation,
and heart failure. We also have a peripheral from which we get INR
(blood coagulation) readings.” At a pre-arranged time of day the ECG and
other results come winging down the phone lines to a Heart Institute
database that three assisting technicians and Struthers monitor on their
HomMed central station. If readings are out of whack, there’s an
automatic alert, and Struthers can immediately be on the phone – in some
cases on a HomMed-provided videophone – to the patient for corrective
action.
That plug-and-play facility has Kathryn Crone thinking of other uses.
Crone is the executive director of CareConnect, a co-operative
telehealth network that links all hospitals, including the Ontario Heart
Institute, in Eastern and South-eastern Ontario. It is CareConnect’s job
to assist its partner hospitals both with the choice and funding of its
telehealth systems. CareConnect advice, and a $160,000 contribution
arranged with the Ontario Ministry of Health and Long-Term Care, set the
Heart Institute and Struthers up with the HomMed system.
“In September, we’ll be helping to start up a similar program for
diabetic paediatric compliance at CHEO (Children’s Hospital of Eastern
Ontario),”says Crone, who expects the young patients will have a
favourable reaction to home monitoring.
And soon, home monitoring could be as close as the living room
television.
March Healthcare, based in Kanata, Ont., plans to make that relatively
unsophisticated but ubiquitous piece of technology the main telehomecare
patient interface in what is no doubt the most technically sophisticated
telehomecare system yet conceived. Due for launch this fall, March’s
Telehealth Applications will leverage all the rich interactive
advantages of high speed broadband.
“We found in our pilot study in Halifax that even people in their 80s
and 90s were comfortable using their own TV as the interface with the
nurse. We didn’t have to introduce them to any new technology,” says
Christine Cimaglia, March Health’s chief operating officer.
The Halifax experience, the country’s largest independently assessed (by
the University of Calgary) telehomecare trial, led to a number of
product changes and additions, including the index finger printer. “It’s
important for people suffering from dementia, for example. They don’t
need to remember a PIN number,” says Cimaglia.
On the Canadian scale, however, no telehomecare initiative is currently
bigger than the one that’s been under way in the Toronto suburb of East
York for the past two years. It was developed and is now led by Lynda
Atack and Diane Duff. Both are registered nurses who earned their PhDs
and now teach at the college and university level.
The three-year, $2.3 million East York Telehomecare (EYTHC) project is
not only providing telehomecare using a broadband-based monitoring
system from American Telecare, of Eden Prairie, Minn., it also has
significant E-learning and research components.
“Telehomecare is still relatively new, so there are very few formal
training programs for healthcare providers working in this area,” says
Richard Johnson, president of Centennial College, one of the EYTHC
project’s founding partners – and where project co-leader Lynda Atack
teaches nursing science.
“We’ve used funding from the Ontario Innovation Trust to help create
online courses, and video learning opportunities for our care
providers,” says Atack. “And we’ve been able to establish a telehomecare
research centre at Centennial as well.”
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Credit Valley Hospital implements automated
patient registration
By Sara McNeil
Credit Valley Hospital’s automated patient
registration process – possibly the first of its kind in Canada – has
been piloted with great success.
In only two months of usage, 1,259 patients have used the self-register.
In time, the hospital envisages more than half of the patients who have
access to self-registration using it.
Patients in the new regional cancer center can self-register at a kiosk
in the patient care area. This expedites the registration process for
patients who frequently visit.
Recently, the hospital opened its fifth kiosk. Credit Valley will
eventually install the devices in the outpatient and ambulatory care
clinics, where the hospital sees the greatest volume of patients in a
short period of time.
The kiosk project arose because Credit Valley realized it needed more
efficient and adaptive patient registration processes for its Hospital
Information System (HIS) from Meditech. Like other facilities, the
hospital was resource constrained, and was interested in labour-saving
procedures.
With more than 40 registration areas, six of which are offsite, and 163
registration users, the process was difficult to monitor.
Without an efficient patient registration process, the hospital risked
inaccurate patient information and adverse impacts to revenue. To reduce
or eliminate risk to patients, it was time to move to the forefront of
automation in healthcare.
Overall, approximately 5,400 visitors and patients pass through The
Credit Valley Hospital in Mississauga, Ont., each day. Each year, about
20,000 acute care in-patients are admitted to the hospital, and more
than 66,000 patients are seen in the emergency department.
How do the kiosks work? Without a keyboard, a patient can scan his/her
health card at a kiosk. The hospital system deploys a real-time
network-to-network connection with the Ministry of Health and Long-Term
Care to ensure the patient’s identity and to validate the card.
If they are in sync, the system automatically signs the patient into the
Meditech admissions and scheduling modules and delivers paperwork to the
registration desk.
If the card is not valid, the system displays a message instructing the
patient to see a registration clerk for further assistance. The entire
transaction takes 30 seconds.
Avril Cardoso, manager, application services in the Information Systems
department, discovered that by using Boston WorkStation (BWS), from
Boston Software Systems, the facility could administer business rules
through the effective application of technology.
“Registration is the beginning of the healthcare process, so it is
critical to ensure patient information is correct,” said Cardoso. “This
provides more reliable patient information, which is important in
maintaining the continuity of care.”
BWS is workflow automation and integration technology that provides an
environment for on-demand process innovation and development. BWS will
enable Credit Valley to quickly respond to changing business
requirements by automating common tasks, creating complex processes or
integrating new applications.
When it comes to potential uses of the new system, Credit Valley has
just scratched the surface. The hospital plans to add intelligence to
the kiosks in the form of educational materials. Patients will be able
to access information about diseases and treatments with a few mouse
clicks.
Sara McNeil is President, Boston Software Systems.
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