Gone will be the days when staff are waiting to access charts to get the information they need. Soon, data from across VCH, PHSA and PHC will be available at the touch of a button as part of the Clinical & Systems Transformation (CST) project.

Enter data remediation and legacy: it might be a mouthful, but these terms explain how CST will achieve its vision of an integrated clinical information system.

Data remediation (amending data)

On day one, when the Health Organizations switch over to the new CST platform, staff will have access to accurate historical patient records. Prior to this occurring, some data will need to be remediated. This is where Karen Davids, data remediation lead, and her team come in; they’re a small team with a big job to do.

“When you first start looking at the data, it seems like it would be simple, but it’s not,” says Karen.

Davids and her team are working closely with the Ministry of Health (MOH), which is analyzing our Health Organization patient data records and linking them with the provincial healthcare identity of the client. This identity is stored within the Enterprise Master Person Index (EMPI).

When the MOH analyzes the data, they look at name, date of birth, gender, address and/or Provincial Health Number, and highlight records that require remediation. For example, there might be duplicate records for a client that should be merged, or incomplete or inaccurate information for clients that need to be corrected.

In some cases, the team will pull and review physical charts to ensure the correct identity is established. This reduces patient safety risks from identity errors and costs from duplicate services like repeat exams, says Karen.

With so many records to remediate, the commitment is to ensure the records for clients who have presented for service within the last five years are remediated and linked appropriately to their provincial healthcare identity.

Legacy data (historical data)

Through our data legacy work, we will ensure all staff has access to the key patient information they have today. That means making key data from dozens of systems available in the new clinical information system. CST’s Data Legacy Team is tasked with making this happen.

“As each go-live occurs, we need to ensure that the data sets are available from day one,” says Tony Mitchell, data legacy lead.

It’s no easy task. The systems range from small specialty ones to major clinical systems. To streamline the new clinical information system, data in existing systems will be analyzed to ensure important information – like alerts and allergies – is migrated. It’s still being decided how far back the team will go to capture legacy data.

The goal is for the data to be accessed through external viewers, so clinicians can easily access key patient data – without having to leave the context they’re working in.

Putting patients first

There is a strategy to electronically capture and combine paper charts with the patient’s electronic record, using document imaging to capture the paper-based records. This ensures patient documents are accessible electronically and reduces costs for storage and retrieval of records. After we go-live with the new clinical information system, historical paper records will still be available in paper format because document imaging will be done starting from go-live.

Both Karen and Tony agree that remediation and legacy are about taking care of patients first.

“We want to make sure that staff has access to all historical data that might be pertinent,” says Karen.

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 and ambulatory 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 (experts from IBM Technical Services, Deloitte, Leidos Solution Builders and the University of Pittsburgh Medical Centre), 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 Donna Stanton, CST Executive Director/Transformation Lead, VCH at donna.stanton@vch.ca.

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