Article as appeared in Hospital News

At St. Joseph's Health Centre, Toronto, we are undertaking one of the largest initiatives in our history – to deliver and implement a fully comprehensive electronic health record for every patient by 2013.

Most people will know this as eHealth. But as we continue to work towards our project's goal, we are realizing the word "eHealth" doesn't fully capture all the changes that need to take place right at the patient's bedside and in the way we provide care for them as they move through our hospital.

St. Joseph's has renamed our project eCare because it puts more of a focus on what we are in the business of doing – caring for our patients and their families. eCare is an essential initiative that helps us Put Patients First by providing the safest care.

An electronic health record has been identified as one of the critical foundational elements of a modern, integrated, accessible and sustainable health care system. Our strategy has been strategically aligned with the Ministry of Health and the Toronto Central LHIN's mandate.

Key components of our electronic health record include computer-based management of patient orders and clinical documentation. Patient safety, quality and interprofessional practice are key areas of focus, and to be successful, we continue to engage clinicians in the system design, usage and related workflow changes to ensure it meets patient, clinician and organizational needs. It won't replace good clinical judgment, rather it will provide a single access point to view patient information and will act as a starting point for our clinicians to plan and deliver care.

"Not only will eCare help to make the delivery of care more efficient and effective, more importantly, it will ensure that seamless information regarding a patients' past medical history at St. Joseph's Health Centre is easily accessible," said Mark Vimr, Executive Vice President, Clinical and Professional Programs & Services, Chief Nursing Executive and Chief of Interprofessional Practice. "eCare is a significant project to the organization and one that will greatly assist our health care providers in making more appropriate treatment decisions, enhancing the safe care we provide to our patients," said Vimr.

Delivering on our eCare promise means that our patients will have all their relevant health information safely stored electronically in one place. Currently, the electronic health record provides some information about our patients' hospital visit. For example, clinicians are able to view test results including laboratory tests, ECGs, and Diagnostic Imaging. In the future, eCare will provide access to clinical assessments, daily progress notes, and medication administration records. eCare will give our health care teams access to important patient information in real time, right at our finger tips and right at the patients' bedside.

We are approaching the end of Phase 1 of our eCare strategy, which served as the foundational stage, allowing us to lay the groundwork we need to follow on this journey over the next several years. Through this stage we worked to create awareness and provide education to staff and physicians around eCare; worked to gain knowledge and expertise by meeting with other organizations to learn from their successes on eHealth implementations; and promoted a culture of change that will enable us to move towards our goals. As we role into the additional phases of this project, the evolution of multiple project teams will be key to rally our physicians and staff for their involvement in a way that they can make significant contributions to this project. While many of the changes to date have been on the 'technical side' of our strategy, a number of eCare projects were completed in this phase: moving to full electronic documentation for our Paediatricians in our Just for Kids Clinic, the launch of PYRAMIS, our cardiac data management system which makes ECGs, stress and holter tests visible in our electronic health record; and face sheet scanning in our Emergency Department. We are currently in the midst of implementing our Single Sign On initiative, which will allow end-users easier access to the electronic applications they require, by using only one password to log into multiple computer applications.

"Phase 1 of our eCare Strategy is placing us in a good position to help us achieve success for our future phases. Not only have we improved access to clinical information, we have also laid the foundation for how care will be provided in our future," said Heather Binkle, Clinical Informatics Lead for St. Joseph's. "We have looked in detail to understand how our frontline clinicians provide care and are using this information to ensure our future system will meet their needs - clinicians are fundamental in the development of our electronic health record."

To guide the Health Centre towards eCare success, two committees have been formed. The eCare Steering Committee is mandated to provide oversight for the execution of the eCare program of work and all related projects with respect to time, budget and scope. The Clinical Informatics Committee, the governing body and operational enabling group, ensures that the electronic health record and other eCare projects are functionally implemented at St. Joseph's. This group works to identify issues around workflow and assesses the impact of eCare projects across the organization. St. Joseph's has also identified Dr. Paul Sullivan as our physician lead for eCare, to help ensure that our physician group is actively engaged in the process.

Read more about our eCare strategy

eCare at St. Joe's
Feature article - Delivering on our eCare Promise
Feature article - eCare: undertaking one of the largest projects in the hospital's history

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Page last updated: April 30, 2010