Brant system is first in Canada to adopt cloud-based MEDITECH EHR

The Brant Community Healthcare System, serving the city of Brantford, Ontario, and surrounding communities, is the first healthcare organization in Canada to opt for a fully managed, cloud-based software as a service (SaaS) electronic health record (EHR).

A MEDITECH customer since 1998, Brant Community Healthcare has signed for MEDITECH as a Service (MaaS) Expanse EHR after two years of extensive consultations and research of available solutions.

The MaaS EHR will be hosted on Google Cloud and frees Brant from having to invest in hardware and IT staff to manage an on-premise system and ensures enhanced protection from ransomware attacks.

“A large teaching hospital has more money to invest in redundant data centres and has larger IT teams,” said Danielle Myers, Brant Community’s director of ICT, Health Information Management and chief privacy officer. “We have a very small IT team. With the MaaS option, we’ll have the redundancy that we would be unable to build ourselves, which is so important in this age of cybersecurity. We’ll even have access to our EHR in periods of downtime because we’ll have access through the data centre on a mobile device, which is great for the continuity of patient care.”

An on-premise solution would have forced Brant to grow its IT team and invest in a redundant data centre, which would easily cost $1 million, said Myers.

With MEDITECH and Google Cloud providing 24-hour security monitoring, backups and comprehensive application support, Brant will be able to focus on delivering patient care.

MEDITECH has deployed its cloud-hosted EHR at 80 hospitals across 36 states and territories in the U.S., but the deployment at Brant Community Healthcare will be a first for Canada.

“The main driver for a cloud-based SaaS solution has been hospitals wanting to get out of the hardware business,” said Nick Palmieri, MEDITECH’s regional sales director for Canada. “So many healthcare organizations are coming up to refreshes of their hardware because the average shelf life of a hardware implementation is five years.”

The desire to prioritize staff and financial resources for patient care and increase security will inform more EHR procurement decisions going forward, predicts Palmieri.

“Instead of relying on an individual hospital’s resources to ensure the system is hardened up all the time, you’re relying on the experts at MEDITECH and Google Cloud. This is all they do. The cloud offers a whole host of engineered protocols that are evolving with the methods of the threat actors to ensure the solution is secure.”

A 324-bed organization comprising Brantford General Hospital and the Willett Urgent Care Centre in nearby Paris, Brant Community Healthcare is currently using MEDITECH’s Client/Server EHR but relies on a paper-based system in the Emergency Department and for ambulatory care. “Also, doctors in in-patient units are handwriting progress notes, which are then scanned into the system,” said Myers.

The upgrade to MEDITECH’s cloud-based Expanse EHR allows Brant Community Healthcare to move to a fully electronic solution that will also give patients enhanced access to their records and ensure interoperability with other healthcare organizations, including long-term care, primary care and home care.

The need for a new EHR was prioritized as part of a strategic plan Brant Community Healthcare began working on five years ago. “What we heard loud and clear through extensive consultations with physicians and our partners in the community was around our hybrid system and the accessibility of data,” said Alena Lukich, who led the exercise as chief of strategy, quality and risk.

When Brant began the process of researching EHR options two years ago, it again consulted widely through a co-ordinating committee that included physicians, patients, family members, Ontario Health Team partners and primary care doctors in the community.

The managed service offered by MEDITECH includes application management and maintenance. “In the past, we would have application analysts on our own IT team do more of the programming and changes to the system,” said Myers. “With MEDITECH supplying a build team to tweak the system, our IT analysts can focus more on educating users and optimizing the use of the system.”

MEDITECH’s build services help to alleviate the human resource crunch affecting all healthcare organizations in the wake of COVID, said Palmieri.

“We’re building the system on behalf of the hospital, so they don’t have to use the resources they historically required to put fingers to keyboards. This would normally be an expense to the hospital. Instead, we include a build team that helps the client significantly. That represents a major capital and resource saving and is an important differentiator.

“Because MEDITECH prescribes so much of the implementation, we can complete the build in a timeframe of nine to 12 months, whereas in an on-premise environment, it would take 14 to 16 months,” said Palmieri.

While some changes to the system are necessary to account for the unique needs of a hospital, the MaaS Expanse EHR is designed to move away from customization and help promote a pan-Canadian standard.

Instead of an up-front lump-sum payment, Brant Community Healthcare will pay for its cloud-based EHR using MEDITECH’s all-inclusive subscription model, which includes its ongoing services as well as Google Cloud hosting.

“It’s all included in a single monthly fee that we think is incredibly palatable and represents good stewardship of Canadian tax dollars,” said Bob Molloy, MEDITECH’s director, Canadian market and product strategy.

MEDITECH’s decision to partner with Google Cloud was to more efficiently provide healthcare teams with the information they need to help their patients, said Palmieri. “Google provides us with greater flexibility and scalability and enables us to relieve a lot of the burden on our customers, who no longer need to worry about running out of space.”

Cloud solutions also improve load times, giving providers access to information faster, including across physical, geographically dispersed locations.

Physicians also look forward to taking advantage of the opportunity to access and update records remotely. An ED doc at home, for example, will be able to reach out to a colleague in the department for a quick consult and view a patient record on a smartphone. The system also supports predictive surveillance, leveraging evidence-based clinical decision support to notify care team members of potential issues, such as signs of sepsis.

“They’re also excited about physician order entry and electronic medication reconciliation,” said Myers. “Currently, they have to read through the paper record from the ED to see what medications a patient came in with. Then they have to look at what they were prescribed during their hospital stay and come up with a discharge list of medications.

“It’s very cumbersome and takes a lot of time. MEDITECH’s Expanse EHR will bring it all up on one screen, so it’s much faster and safer because any contraindications are automatically identified.”