Automatic transfer of vitals at Jewish General

MONTREAL – CIUSSS West-Central Montreal is introducing a new tool developed as part of the Connected Health Record (CHR) – its healthcare innovation demonstration project – made possible thanks to the philanthropic support of the Jewish General Hospital Foundation.

The latest addition, named Observa, automatically transfers vital sign data from bedside monitors into a patient’s digital chart, helping improve documentation efficiency, reduce manual entry, and support safer care.

Currently being implemented and evaluated at the Jewish General Hospital, Observa is one of several advancements in development through the CHR, a multi-year innovation project born in 2019 to modernize how clinical information is captured, shared, and used across the continuum of care.

“From its inception, the CHR has sought to replace fragmented systems with a unified, patient-centred digital record accessible across all care settings,” said Dr. Justin Cross (pictured), director of digital health at CIUSSS West-Central Montreal.

He added, “Our focus has always been on software usability. We want clinicians to feel supported by their software systems, not challenged by them. Introducing Observa represents another step forward. Clinicians have helped shape the module’s design, leading to a more streamlined documentation experience and, ultimately, more time for patient care.”

“Our focus is always on the people we care for, and this technology empowers our clinicians to act more quickly, more confidently, and more collaboratively,” said Dr. Lawrence Rosenberg, president and CEO of CIUSSS West-Central Montreal. “We are grateful for the interest and support we have received from our provincial partners. This advancement brings us closer to our vision of a fully integrated and intelligent health record ecosystem.”

Developed in partnership with Harris Healthcare, this project has enabled clinical teams to design, develop, and test new tools that enhance care and strengthen clinical workflows across the CIUSSS.

By relieving nurses and other clinicians of certain administrative tasks, the new Observa module is enabling JGH nurses and other clinicians to spend more time with their patients.

In addition, by automating the transfer of data from vital signs monitors to the CHR, the module is eliminating human errors that can occur when data is manually entered into the health records.

Of key importance is that Observa was developed in close consultation with nurses, doctors and other clinicians. As a result of their insights, suggestions and requests, the CHR will be a practical, custom-built tool that responds to the needs of staff.

When fully implemented, the CHR will make a wide range of consistent and updated information about all CIUSSS healthcare users easily available to clinicians on a single digital platform that can be accessed at any network site.

This places the CHR in direct alignment with the CIUSSS’s broad approach to care, known as Care Everywhere. It states that staff must strive to achieve the right outcomes by delivering the right care at the right time in the location that’s most appropriate, safest and most convenient for healthcare users.

Since the CHR will eventually make a uniform set of data available to all CIUSSS clinicians, the health records will, in effect, follow users to any CIUSSS site where care is to be delivered.

When work on the CHR began in 2022, the project was described as the largest, most complex and most challenging that the CIUSSS had ever embarked on – a prediction that has since been realized.

Dr. Rosenberg told the audience at Observa’s launch at the JGH that what they were inaugurating is much more than a new module.

“It is a genuine innovation and a demonstration of what is possible when clinical vision, technology partnership and philanthropic commitment come together in one place,” he said.

“This is not a story about technology. It is a story about people: the patient who deserves the full attention of their caregiver, the nurse who deserves tools worthy of their expertise, and an institution ready to show the way.”

For now, Observa is being deployed only at the JGH, along with training for the nursing teams. Their members are primarily responsible for using the vital-signs monitors most often to record basic indicators such as blood pressure, respiratory rate and heart rate.

Members of the remaining care teams, including physicians and allied health professionals, are receiving training resources to ensure they know how to view the new vital-signs information in the CHR.

By early July, the module will be up and running in most hospital units, except for certain critical-care areas, such as the Intensive Care Unit, which is slated for a deployment in a later phase of the CHR project. At some point, a roll-out to other CIUSSS facilities will also take place.

“I’m very proud of our Digital Health team – and everyone on staff who worked with us – for enabling us to take this important step as we near the full deployment of the CHR,” said Dr. Cross.

“We’re building on the success and momentum that we’ve achieved so far, and we’re making good on what we said we would do: build the CHR into an indispensable tool to benefit the patients, clients and residents of the JGH and our CIUSSS.”

In addition to praising staff for their creativity and commitment to the project, Erin Cook, the CIUSSS’s associate CEO, notes that bringing Observa and the CHR to life would not have been possible without the support of the JGH Foundation and its donors.

“We’re deeply grateful to them for all of the financial backing that the CHR requires,” Ms. Cook says. “Our generous donors are making a clear and measurable difference to the quality of our care.”

Observa is the second CHR module to go into service, the first being the Patient Timeline, which was launched in the fall of 2023 and gained recognition as an award-winning, provincial pace-setter.

Although JGH staff were able to view a broad range of useful health information in the Patient Timeline, they could not enter new data into the CHR, explained Chantal Bastien, a former nurse who is among those training nurses to use the new module.

With the introduction of Observa, she said, information will be recorded by the JGH’s smart monitors and, for the first time, will be transferred directly into the CHR. Since this digital information is centrally stored, clinicians will no longer have to waste time hunting for it on multiple platforms.

Previously, Ms. Cook added, the manual transfer of data was not only a time-consuming activity, it increased the risk of incorrect data being accidentally entered into the records. As well, it deprived nurses of precious time they could have spent with patients.

According to Dr. Cross, a vital-signs module is not unique, in and of itself. In fact, a similar feature is commonly found in off-the-shelf software for generic electronic health records.

What makes Observa special, he explains, is the input from staff that has led to the customized design of this particular module and the entire CHR.

As well, Dr. Cross says, by using Observa, staff have a relatively simple and straightforward means of actively familiarizing themselves with the CHR.

“They will gain experience logging in, pulling up the patients’ charts and vital-signs, and working with the data,” he says. “As an organization, this enables us to practice in a controlled manner. It also gets everybody using the system and subjecting it to a sort of stress test.

Another significant aspect of Observa, said Ms. Cook, is that it displays the data in such a way that allows clinicians to spot and monitor trends, “including the impending deterioration of a patient’s health.

“So, for example, if the patient’s breathing or heart rate accelerates, and if this pattern is sustained over a certain period of time, it may be an indication that something isn’t right – an early alert to possible trouble ahead.”

Farther down the road, Dr. Cross anticipates layering an AI algorithm onto the vital-signs data “to warn us proactively as soon as something starts to trend in the wrong direction.

“It’s this sort of potential that makes the CHR such an important tool as we go forward.”