2004 C.I.P.A. Winners
|
(back to 2004 C.I.P.A. Winners)
Mobile Community Care Solution Streamlines Remote Healthcare Planning & DeliveryBritish Columbia’s Interior Health Authority implemented the Care Anywhere mobile community care system to increase case manager efficiency and facilitate the delivery of better, faster
healthcare in remote areas. Patient data, collected electronically by case managers using portable
computers to conduct clinical assessments and complete patient documentation at remote points
of care, is automatically synchronized with a central system to update health records when case
managers reconnect to the IHA’s Local Area Network.
B.C.’s Interior Health Authority (IHA) operates its community care program based on a philosophy of keeping seniors healthy, stable and in their own homes as long as possible – out of institutional care. However, a number of factors have combined to challenge the program’s ability to meet increasing demands. The IHA, one of British Columbia’s six health authorities, provides quality, accessible healthcare through 183 different locations, including 34 acute-care hospitals, 91 residential facilities and 40 public health units. Headquartered in Kelowna, B.C., the IHA’s 17,000 employees serve 690,000 people – nearly 17 percent of the total B.C. population – spread over a vast region of B.C.’s interior. As a result of the number of seniors choosing to retire to B.C., including the interior, the IHA is experiencing a higher than average population of seniors – 20% of the population versus the national average of 12%. "We’re having to deal now with senior care issues and increased demand for services that the rest of Canada will only be seeing 5-10 years from now as the baby boomer population ages," says Norma Malanowich, Director, Electronic Health Records, IHA. Adding to this situation, the provincial government has legislated that health authorities delivering community care must adopt the new International Resident Assessment Instrument (interRAI). As the basis for developing individual care plans, this standardized clinical assessment tool is used at the point of care – usually the patient’s home – to measure a patient’s condition and capabilities. Remote Caregivers Need Better Information Access Within today’s hospitals, doctors, clinicians and other caregivers can easily and efficiently access patient histories and input results of clinical assessments and information for other patient documentation right at the point of care. This is usually done using a workstation or personal computer connected to the central healthcare system via a Local Area Network (LAN). When the point of care is no longer within the hospital however, but is out in the community – especially in remote areas – dependable networking, including wireless, is typically not available to caregivers, and connecting to the hospital system becomes a problem. Yet, for the IHA, delivering the best possible healthcare in the community still requires that caregivers have detailed patient histories available and that they complete interRAI assessments and other documentation such as progress notes or care plans. These administrative tasks take up much of a caregiver’s time, especially since patient information that is gathered at the point of care must then be re-entered once the case managers are back in their offices and connected to the central system. As one way to address a growing senior’s population and changes in assessment processes, the IHA turned to technology to enable case managers to manage patients in a more comprehensive and efficient way. "We believe that investing in technology is a critical strategy for ensuring the continued evolution of our community care program," explains Malanowich. Just What the Doctor Prescribed To improve remote data access and collection, and to meet the demands of an increasing number of patients, IHA implemented Care Anywhere, a mobile community care system that better supports remote assessments and the preparation of clinical documentation and care plans by caregivers at patient locations. Using Care Anywhere, the 275 IHA community case managers sharing 150 laptop computers have ready access to patient history information and can perform remote interRAI clinical assessments, resulting in better point-of-care decisions and patient/family support planning. With IHA’s new system, the same user interface and the same functionality that enables caregivers located in the hospitals and other IHA locations to access patient records, conduct clinical assessments and input updated patient information, is also available through the Care Anywhere software installed on the portable computers they carry with them out into the community. Before heading out however, and while their portables are still connected to the central system, case managers review their case load for the day and download patient histories and whatever forms they might need for assessments and other documentation. At the end of the day, when assessments have been conducted and other patient documentation has been completed, the case managers simply reconnect to the central system – by connecting to the LAN in any one of 60 IHA locations – and the new and updated data is automatically synchronized with central patient records and databases. "With Care Anywhere, there’s no more paper chase and no more need to re-enter data. Patient data is collected and entered only once, at the point of care, and is automatically uploaded into the system to update all records," enthuses IHA’s Malanowich. In This Case, It Was About People The Care Anywhere mobile community care system was developed for the IHA by Campana Systems, Inc., based on its GoldCare suite of healthcare software products. The server portion of the software runs on an IBM/Windows 2003 application server and uses a centralized database employing IBM’s Universal Database engine. IHA case managers use Toshiba laptops with the Care Anywhere software running on Windows NT, 2000 or XP professional. Although the IHA was implementing technology that was somewhat unproven on a large scale – a small pilot using a similar solution had been run by the province elsewhere in B.C. – the real challenge stemmed from the double-edged impact the new system had on IHA case managers. Not only did they need to get trained and become comfortable using the new, mobile technology, they were also confronted with the adoption of the interRAI assessment methodology. Commenting on the change management challenge, Norma Malanowich explains, "The new assessment methodology presented a significant change to the clinical process they’ve been using to conduct assessments." To help staff manage the transition, the IHA made use of ‘super users’ – front-line clinicians taken from the ranks and given more intensive training and support – who act as trainers and mentors to support their peers in their daily work and provide troubleshooting on an ongoing basis. In addition, change management workshops were conducted and all staff put through several levels of training on both the interRAI tool as well as the mobile technology. Follow-up education sessions are still conducted on an ongoing basis. Big Benefits … Expected and Unexpected Now, with Care Anywhere, IHA case managers need only enter patient information once – electronically, right at the point of care, no matter where that is throughout the IHA’s catchment area. Because the need for them to re-enter data once they’re back in the office has been eliminated, the collected information is more accurate; and the reduction in administrative time means caregivers are able to spend more time with their patients, resulting in better-quality care. Although it has enabled the IHA to achieve its primary goal of implementing a tool that fit into its clinical process, Care Anywhere is also providing the data needed by IHA management for better healthcare decision making and managing their community care program. Beyond these expected results however, there is one unique, additional bene. t that both case managers and patients are experiencing. During the course of an automated, point-of-care assessment, the Care Anywhere application will alert clinicians to potential problem areas for the patient that need to be investigated further. Based on the data being collected, assessment protocols use special algorithms in the software to identify various potential problems and risks for the patient – such as the risk of falling at home. This triggers the clinician to start looking at steps the patient can take to mitigate this risk; and because the mobile Care Anywhere system enables this to happen in real time in the patient’s home, the case manager can elicit participation by the patient and family in discussing the situation and developing appropriate care plans. "The Care Anywhere project demonstrates that the judicious use of technology can in fact support the delivery of improved, efficient services as our base of patients grows and as the demand grows for better healthcare to be delivered to more people quickly and cost effectively" concludes IHA’s Malanowich. A 2004 CIPA Winner! For its exceptional and innovative application of Information Technology to solve real-world business problems and bring greater benefit to all its stakeholders, British Columbia’s Interior Health Authority was awarded a 2004 Canadian Information Productivity Award of Excellence in the Mobile Solutions category.
|
