Electronic Health Record – Friend or Foe Sheranga Jayasinghe and Brenda Leppington

This Session is sponsored by:

Working together…for healthy people in healthy communities.

The Electronic Health Record

Build it and they will come.

Or WILL they?

Brenda Leppington – Director Information Management

Sheranga Jayasinghe – Director Information Technology

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About Sunrise..

Sunrise Health Region stretches from the

breathtaking beauty of the Qu’Appelle Valley to

the northern boreal forest, and from the bountiful

parklands of the Manitoba border into the rich

Saskatchewan prairie farmlands. Sunrise serves

58,000 persons – two-thirds living in our

comfortable, warm, friendly cities, towns and

villages, and 1,600 living in our historic First

Nations.

Sunrise employs more than 2,600 professional

and support staff to ensure the delivery of quality

care throughout the region.

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The Vision

The vision presented to care providers was a single

patient record. One place where care providers could

access patient information across the spectrum of health

care for their patient.

The perceived benefits:

• Information readily available when required

•Decreased need to have patient repeat information to

multiple care providers.

• Reduction of duplication of diagnostic tests

• Appropriate usage of medications

•Improved communication between care providers through

use of tracking boards (PSAG).

• And that was just the beginning………….

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The Reality

• Paper records still exist and continue to

form an integral part of patient information.

•Multiple electronic records exist and

contain pockets of information.

•Requiring multiple log-ins

•Multiple user names

•Multiple passwords

•Passwords expiring at

different times.

•Not enough information in a single

location to make it valuable.

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The Challenge

• Was it faster to retrieve information electronically?

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The Power

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The “Unauthorized” Solutions • Shared usernames and passwords

• Non clinicians accessing information on behalf of care

providers

•Reduces effectiveness of seeing trends in diagnostic

tests that are not apparent in the paper record.

•Reduces effectiveness of ability to determine patients

seeking multiple prescriptions.

• Patient concerns regarding privacy

•Not utilizing electronic solutions and returning to paper

processes

•Usage statistics revealed low user adoption

•User surveys revealed a small percentage of care

providers were persevering.

•Printing issues

•Multiple log-ins to set default printer

•Privacy breaches

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1) Add additional content.

Make it “worth it”

Sunrise Clinical Manager

•Demographic and Visit History

•Laboratory Results

•Medical Imaging Results

•Transcribed Documents

•Link to Pharmacy Program (PIP)

•Emergency Department Manager

• Patient tracking/communication

•Will require continuous interaction

The Solutions

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2) Make it easier for Care Providers

Access to information from any

device, any where, any time.

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Follow Me Computing

1.Follow Me Desktops

2.Follow Me Profiles

3.Follow Me Applications

4.Follow Me Print Jobs

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Follow Me Computing

Sunrise became the first Health Region in the province and in Canada to implement a fully functional ‘Follow Me Computing’ solution with Smart Cards and Single Sign-On.

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Follow Me Computing

What is ‘Follow Me Desktop’? Your Desktop will follow you from one

computer to another.

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Follow Me Computing

Components of ‘Follow Me Desktop’? Single Sign - On Single Sign - On will store your passwords

in a secure encrypted database and automatically populate the credential fields for all the applications you have access to, when opened.

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Follow Me Computing Smart Card A card that has an

embedded chip in it.(Same as your credit card) This Chip will store your PIN and a secure certificate in encrypted form.

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Follow Me Computing

What is ‘Follow Me Profile’? A profile stores all your user specific settings

(Your email settings, short cuts, favorites etc). Currently when you switch from one computer to another or receive a new computer you need to recreate all these settings.

With ‘Follow Me Profiles’, regardless of what Device you connect to, all your profile settings will remain the same.

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Follow Me Computing

What is ‘Follow Me Application’? All Applications opened within your current session

(desktop) will also follow you with your desktop.

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Follow Me Computing

What is ‘Follow Me Printing’? A secure user authenticated solution.

When you print, it will no longer print to a printer. Instead it will remain in a queue and print only when you request for it.

You can walk to any printer (once fully implemented) in any of the Sunrise Health Region facilities, authenticate yourself using your smart card/PIN and print your print job.

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Follow Me Computing

What is ‘Follow Me Printing’? Authentication Device

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Follow Me Computing

Access to the “Follow Me Desktop”

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Follow Me Computing

What we have learned so far?

1. Unexpected technical issues. 2. Create more documentation for users 3. Separate the components when deploying the

technology so that it does not become overwhelming to the end user

4. Need to establish the baseline before we proceed further. ( Infrastructure, Network etc)

5. Better password management policy has to be developed

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The Experience •Technical issues

• Frustration of learning new technology at the same

time as new functionality.

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The Hope

•Six months post go-live with ED Manager, the

physicians indicated that the # 1 thing they liked

about the project, was Smart Cards and

single sign-on

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The Proof

• User Surveys have shown increased support

for electronic solutions.

• Volume of patient information being accessed

electronically, has tripled.

• 1,000 records a week are accessed

electronically.

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The Future

• Nurses and physicians have expressed a

desire to move forward with additional electronic

documentation and additional Tracking Boards

on our Medicine Units. The work is currently

underway.

• Computers at the bedside

• Better single sign-on solution

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The Cooperation

• We do not host our own applications.

• We are working in partnership with eHealth for

an improved single sign-on solution.

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A BIG Thank you to….

1. Registration Team 2. Emergency Room Physician and Nursing team 3. Information Management Team 4. eHealth Saskatchewan 5. Human Resources Team. 6. Lorelei Stusek and the Executive Leadership Team 7. Information Technology Team

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Demo

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The END