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Capital Health
Nephrology Information System
Medical Records System Crosses Healthcare Borders
Edmonton-based Capital Health, one of nine regional health authorities funded by the Government of Alberta, serves 1.6 million people across central and northern Alberta. It is one of Canada's largest integrated health regions and is known to be one of the country's top-rated health systems.
Capital Health's Northern Alberta Renal Program (NARP) provides renal care (i.e. kidney-related care) to patients in an area encompassing central and northern Alberta, northwest Saskatchewan, northeast British Columbia and the Northwest Territories. The area includes multiple health regions, various hospitals and many community health centres involved in the diagnosis and treatment of kidney diseases.
Challenge
The NARP program was based largely on manual processes. Patient information was being accessed through a multitude of paper charts and records from various departments and locations across the NARP coverage area, and duplicate charts were often maintained in satellite locations. The processes associated with program administration and patient management, including preparation of patient records, assessment reports and progress notes, were manual and so were resource-intensive, time-consuming and prone to error.
Information captured during patient assessments was often inconsistent from patient to patient and from clinician to clinician; and staff wanting to access patient information or review lab test results often had to spend time on the phone locating patient information in different locations and then consolidate all this information by having charts or reports faxed or even mailed.
Worse yet, it was difficult to track patients, patient care and required intervention actions across the numerous disciplines, institutions and locations involved. There were also problems with the legibility of patient progress notes and medication information.
Solution
NARP has implemented the Nephrology Information System (NIS), an electronic medical records and tracking application for renal patients that captures all information related to care provided and interventions.
NIS is hosted through Capital Health's intranet and is accessible by all renal program sites throughout the NARP coverage area. It enables all patient-related information to be captured electronically and shared by authorized staff throughout the region.
Patient visits are tracked through all institutions. Assessments, education plans, medication profiles, medical events, progress notes and medical alerts are all entered into the system and can be viewed through a Web-based interface across the entire program. Lab values displayed in NIS are accessed from various lab repositories and available in real time, as lab tests are completed.
Collaboration was a critical factor in the successful implementation of the NIS, and involved ten NARP business units, the Information Systems group within Capital Health, Fujitsu Consulting and the eight other health regions in Alberta. This not only resulted in a project that was completed on time and under budget, but also ensured the high quality of the resulting system and, more importantly, the continued focus of the program on the patients rather than on the needs of any one particular business unit.
The NIS project is the first time within Capital Health that patient information has been electronically shared through multiple healthcare regions from a central site.
Results
By providing a rules-driven environment for data entry, automating many aspects of the workflow, consolidating patient information in a single repository and making that information readily available to any authorized user with a Web browser, NIS is delivering substantial cost, time and efficiency improvements to the NARP program.
Staff can access complete patient records online, eliminating the need to contact multiple locations and fax or mail charts back and forth. Progress notes, assessment results and other patient information are now typed into formatted text boxes to speed entry and ensure that all required information is captured. The added legibility this provides reduces the possibility of human error.
The automated tracking and alerting for outstanding action items and intervention events saves considerable administrative time and contributes to better care delivery by ensuring that required tasks in the care path are performed. Time savings created by NIS can be redirected to enhancing patient care.
Innovative Use of Technology
The NIS application employs pattern-based design, object-oriented development and relational database technology to deliver a friendly and intuitive Web application to the geographically distributed user community based on the NARP workflow.
NIS adopted a service-oriented architecture approach, making use of existing investments in information repositories that are already well established within Capital Health, including the Patient Repository, Lab Results Repository and Allergy & Medication Lists. By accessing information from the Patient Repository, for example, NIS can display patient information in near-real time, as it is entered into many other source applications.
A 2007 CIPA Winner!
For its excellent application of information technology to transform processes and bring benefits to its stakeholders, Capital Health has been awarded a 2007 CIPA Silver Award of Excellence in the Collaboration, Not For Profit category.
Technology partners
Fujitsu Consulting (Canada) Inc.
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