It’s close to midnight, and a patient presents to the Emergency Department at Lions Gate Hospital. She is pale and sweating profusely. Her blood pressure is low.

She tells staff she received chemotherapy treatment at the hospital’s Chemotherapy and Medical Outpatient Clinic the day before, but has no idea what medications she received. With her chemotherapy chart locked in the now-closed clinic, emergency staff has to ask security to let them in to get a copy.

It takes time – something the patient doesn’t have. What if staff had an integrated electronic chart that gave them instant access to her medication history?

With oncology and extended ambulatory now in scope for the Clinical & Systems Transformation (CST) project, this will become a reality at sites across VCH, PHSA and PHC.

“The new clinical information system will result in improved care, as records become easier and safer to share,” says Kellé Payne, CST executive director and transformation lead for VCH. “Patients will benefit from staff’s increased awareness of care received at other sites.”

Oncology

Technology will be implemented to support screening, referral, treatment and care transition, and to create and support standard leading practice. HIMSS Level 5 functionality – which includes electronic nursing and allied health documentation, computerized provider order entry (CPOE) and closed loop medication management – will also be achieved.

This work includes cancer screening and care delivery for adults and children, including the BC Cancer Agency’s Regional Cancer Centres, the Bone Marrow Transplant Program at VCH, the Pediatric Oncology Program at BC Children’s Hospital, and Community Oncology Networks (CONs) within VCH and PHC. More investigation is needed to clarify scope for services delivered in satellite clinics and Community Oncology Networks (CONs) outside of VCH and PHC.

Dr. Frances Wong, radiation oncologist and acting vice president of Medical Affairs with the BC Cancer Agency, is delighted to know these advances are on the way. It’s a decision she has been waiting for.

“This will replace our aged electronic health record system (CAIS) and means that we will truly be a part of the Clinical & Systems Transformation. Seamless connectivity with other health record systems will eliminate redundant investigations for patients,” she says.

“Also, the ability of physicians to utilize computerized provider order entry and computerized prescriptions will enhance the level of safe and quality care.”

Extended ambulatory

There is already ambulatory work underway at CST, including registration, scheduling and result viewing. Extended ambulatory refers to the additional scope required to achieve HIMSS Level 5 functionality across ambulatory clinics. It includes clinical documentation, computerized provider order entry, provider documentation and computerized prescriptions.

When will the work start?

The next step is to develop a detailed plan. The design and build work is expected to begin after the completion of the current Design, Build and Integrate phase, due in summer 2015.

We will know more about timelines once the planning work is complete. However, we know that, due to the amount of work and time involved, this will not be delivered by the time the first three phased rollout groups ‘go live.’ These groups are:

Phased Rollout Group 1 (September 2015)
• St Mary’s Hospital

Phased Rollout Group 2 (October 2015)
• BC Women’s Hospital
• BC Children’s Hospital
• Sunny Hill Health Centre
• BC Mental Health & Substance Use Services
• Forensic Psychiatric Services

Phased Rollout Group 3 (January 2016)
• Lions Gate Hospital
• Evergreen Extended Care
• Bella Coola General Hospital
• R.W. Large Memorial Hospital (Bella Bella)

Background information

• CST is a joint initiative of VCH, PHSA and PHC, and one of the largest and most complex healthcare projects in Canada. It spans across several areas of the continuum of care including: acute care inpatient and outpatient units, ambulatory care and residential care. As well as creating consistent, leading practices, and a shared clinical information system, CST will deliver HIMSS Level 5 functionality.
• Clinical design teams, made up of hundreds of highly-skilled, multi-disciplinary professionals from across the three Health Organizations and Team IBM, started work on April 7, 2014. These teams are tasked with designing our future workflows, based on leading practices. In doing so, they are defining the requirements for our new clinical information system.

For more information, please contact:

Dr. Kellé Payne, CST Executive Director/Transformation Lead, VCH (Joint) – Kelle.Payne@vch.ca
Donna Stanton, CST Executive Director/Transformation Lead, VCH (Joint) – Donna.Stanton@vch.ca

You’re invited to submit suggestions for future articles. If you have questions or feedback, please email info@CSTproject.ca.