Transcript Information Technology at North Bay General Hospital

Information Technology at
North Bay General Hospital
Introductions
Lori Thibodeau,
Information Systems Applications Analyst
 Sunnybrook Health Science Center
1999 – 2003
 CTS Canadian Career College 2003 – 2005
 NBGH 2004 - present
Introductions
Tim Wells, Network/Systems Administrator
Electronics Engineering Technology –
Cambrian College
 Technical Support – Cambrian Computer
Consultants
 1996 – present – North Bay General Hospital
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Introductions
Brenda Monahan, PACS/RIS Coordinator
 1990-92 Lab Technician, MDS Sudbury
 1992 Nuclear Medicine Technologist, NBGH
 2003 Information systems RIS Analyst
 2004 PACS Project Manager
NBGH Overview
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Previously 2 separate hospitals, the Civic and St.
Joseph’s Hospitals merged in 1995 to form the
North Bay General Hospital.
204 beds
1200 Staff
Level “C” hospital - district referral centre
Catchment area covers an area of
30,717 km², serving a population of 129,000
Currently building and planning for transition to the
North Bay Regional Health Centre
Information Systems Dept.
Centralized model, 14 staff
 Some “super” users in other departments
 Currently provide services for:
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•North Bay General Hospital
•NBGH Foundation
•NBGH Board
•NBRHC
•Nipissing
Planning
Detox./Substance
•Children’s Treatment Centre
Abuse Program
(currently building new facility)
•Mattawa General Hospital
•Surgeon’s Offices
•(Currently building new facility) •Remote access for physicians
and health care agencies
Information Systems Dept.(cont’)
Manage approx. 80 servers and 700 workstations
 Manage remote connections with many outside
agencies and vendors
 Wireless LAN spanning both campuses for VoIP,
wireless computing, etc.
 Provide remote connectivity to hospital’s Electronic
Health Record (EHR) for community based
healthcare providers including physicians,
specialists, homecare, etc.
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Building the Electronic Health
Record
The ultimate goal is to build a complete EHR, accessible
across the continuum of care in Ontario and eventually
across Canada
Challenges:
 Common Patient Identifier
 Legacy medical equipment
 Disparate Systems
 Privacy laws
 Resources- $$$ and people
 Existing medical record
Building the Electronic Health
Record cont’
EHR should contain all medical information including:
 Patient demographic information
 Visit history
 Drug profile
 Lab tests and results
 Diagnostic tests and results
 Psychiatric assessments
 *Patient consent directives*
Current H.I.S. Applications
Patient Registration (ADT)
 All patient demographic info, visit info and insurance
info is managed in a single application
 Application utilizes Health Card Validation
 This becomes the source system for all other clinical
applications in the HIS environment.
 The objective is to eventually interface all hospital
ADT systems to the Provincial Client registry… a.k.a
the EMPI. This will provide a common patient
identifier to link patient records across multiple
systems and jurisdictions.
Current H.I.S. Apps (cont’)
Community Wide Scheduling
 Master scheduler for hospital visits, surgery,
appointments, etc
 Interfaced to Admissions to reduce redundant data
entry
 Also collects data to fulfill Wait Time Information
System (WTIS) reporting.
 Eventual objective is to allow physicians and/or
admin staff access to a scheduling portal for their
patients.
Current H.I.S. Applications
Laboratory Information System
All lab instruments are connected to the Laboratory
Information System (L.I.S.)
 Test is ordered through the LIS and a bar coded label
identifying the patient and the test ordered is printed and
affixed to the specimen
 Specimen is loaded in to the appropriate lab analyzer ,the
bar code is scanned, and the appropriate test is performed.
 Patient ID, test ID and results are sent back to LIS to be
added to the patient’s record.
 Ordering physician is notified of the results.
 Lab results are also shared with provincial repositories to
provide centralized longitudinal access to lab results.
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Current H.I.S. Applications
Radiology Information system
 Manages radiology patient visits, exams and
reports.
 Is interfaced with the ADT system, Billing system
and PACS application.
 PACS application is interfaced to many 3rd party
plug-ins to manage the DI workflow. Ex: paper
scanners, electronic forms, 3D apps, dictation.
 The environment is virtually paperless, filmless.
Current H.I.S. Applications
Pharmacy - Automated Medication Dispensing
Cabinets
 Access patient medication information directly
 Secure access
 Secure vault and refrigeration
Individually packaged medications with
barcode technology
 Bedside verification for delivery of medication
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Current H.I.S. Applications
Scanning and archiving
 Provides ability to scan printed medical
information and attach it to the electronic
health record
 Can be used to integrate data from legacy
equipment (if it can be printed, it can be
scanned)
Current H.I.S. Applications
Patient Care Inquiry (NBGH’s EMR)
 Hospital wide view of patient record including all
visits, consultations, diagnostics, reports.
 Role based access for all users. This gives us the
ability to customize the user’s menu to their needs.
 Ability to audit user or patient. (ex. VIP)
 Eventual objective is to manage patient consent
directives and leverage to comply with Privacy
legislation. (PIPEDA, HIPPA)
Current H.I.S. Applications
Dictation Systems
 Electronic dictation system, accessed
throughout the hospital via phone system for
the purpose of dictating results and findings
by healthcare providers.
 Voice recordings are accessed from network
remotely and typed in to the E.H.R.
 Some voice recognition is being done but
must still be reviewed by someone
Current H.I.S. Projects
Nursing Documentation
 Ability for Nurse to do all charting electronically at
the bedside. Currently done on paper and therefore,
not completely captured in E.H.R.
 Many options are available for bedside computing:
Current H.I.S. Projects
Forms on Demand
 Enables staff to produce forms, charts, and packets
of forms when they are required
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Automatic delivery of paper forms for the right
person, right time and to the right place.
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Completed forms with patient information, including
barcodes for patient identifiers
Drug Profile Viewer (DPV)
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The Drug Profile Viewer system is an electronic
information system, which enables the ministry to
share prescription drug claim histories of Ontario
Drug Benefit (ODB) recipients (including Trillium
Drug Program) with health care providers for the
purpose of providing care.
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Over 2.5 million ODB patient’s consented
Ontario Emergency Departments are currently
using DPV
Expansion to Acute Care Hospitals in Dec 2007
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Current Facilities Support
Applications
Nurse Call
 Ability for Nurse to do all charting electronically at
the bedside. Currently done on paper and therefore,
not in E.H.R.
 Many options are available for bedside computing:
Telemedicine
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Telehealth is the use of information and communications
technology to deliver health care services over large and
small distances to remote, rural, under-serviced and
aboriginal communities in Ontario.
TeleHealth system is a member of the Ontario Telemedecine
Network (OTN), which deliver programs and services,
offering over 70 specialties and sub-specialties through a
number of well-established telehealth programs, including:
cardiology, dermatology, mental health services, public
health, burn/wound management, Telestroke, geriatrics and
rehabilitation.
Telerobotic Surgery
Pilot project, proof
of concept
 first telerobotic in
Canadian history,
Feb 23, 2007
 Infrastructure was
also used for
“Telementoring”
for CMAS
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Image Guided Sinus Surgery
System (IGS)
eCHN
Ontario's Paediatric Electronic Health Record,
delivered through the electronic Child Health
Network (eCHN), provides access to health
information in an electronic patient chart
format to paediatric health care professionals
in 52 hospital sites and nine Community Care
Access Centres across the province
Security
IT security
 Staff security
 Patient security
 Infant Abduction systems
 Asset security- RFID, card swipes, etc
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Remote monitoring systems
Renal - Home
 CCIS/Remote CCU
 Anything else you can think of that goes in
here Tim? Where does Bedside Appliance fit
in to this?
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Communication Systems
VoIP
 Wireless
 SSO
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Smart Systems for Health Agency
The Smart Systems for Health Agency is deploying a number of key
components of Ontario's e-Health strategy:
ONE Network is the common connectivity that is being made available
across the health care sector.
ONE ID is the systems and process that allows health care
professionals access to applications and systems hosted or
operated by SSHA.
ONE Mail is e-mail that is secure and reliable enough for health care
providers to send health and personal information electronically.
ONE Pages is the directory listing of health care providers to whom
information can be e-mailed securely using ONE Mail.
Health care providers will be able to share information about their
patients knowing that data sent over the Internet is fully protected.
Canada Health Infoway
http://www.infoway-inforoute.ca
 CHI is a federally-funded, independent, not-for-profit
organization whose Members are Canada’s 14
federal, provincial and territorial Deputy ministers of
Health. Infoway is Canada’s catalyst for
collaborative change to accelerate the use of
electronic health information systems and electronic
health records across the country.
 Since it’s inception, Infoway has approved more
than 227 projects in the following targeted program
areas:
CHI Investment Programs
Diagnostic Imaging Systems -shared DI repositories
 Drug Information Systems-including potential errors,
interactions and allergies.
 Laboratory Information Systems-standards based
 Infostructure-architecture, interoperability, standards, privacy,
security, maintenance and conformance.
 Innovation and Adoption-solutions should be COTS,
replicable and sustainable.
 Interoperable EHR-50% Canadians captured by 2010
 Public Health Surveillance-communicable disease tracking
 Registries- Client, Provider, and Service Delivery Location
 Telehealth- move the data, not the patient/physician.
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How much data is that?
Regionalization projects at NBGH
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eCHN- early adopter in 2002
OLIS- Information sharing among physician’s offices
and lab providers. (long. Record at point of service,
fewer unnecessary repeat tests, saving patient
stress, time and $$$
PNOPP- Pan Northern Ontario PACS Project,
LIHN13/14 DI Repository
Ontario Client Registry- Provincial EMPI
WTIS- Ontario’s Wait Time Information system.
Currently limited to OR/DI but expected to expand.
New Health Centre Project
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To open December 2010
Co-location of NBGH and North East Mental Health
Centre
Increased services/beds
“state of the art” facility – level of integration means
an expansion in scope and role for the hospital’s I.S.
department
Network will be key, must be 99.999% reliable
New Health Centre Project
New Health Centre Project
New Health Centre Project
Security Systems (CCTV)
CCTV systems
 Infant Abduction
 Patient Wandering
 Staff duress system
 Door access
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Building Automation Systems
HVAC
 Fire Alarms
 Intercom/Paging system
 Door access
 Continuous Emissions Monitoring System
 Master clock system
 Nurse Call System
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Others
VoIP
 Single Sign On
 Biometric authentication
 RFID
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Bedside Terminal
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Phone
Entertainment system
Internet
Education resource
Data terminal for Healthcare provider
Possible source of revenue
Further information?
www.nbrhc.on.ca
 www.health.gov.on.ca/ehealth
 www.northernontarioe-healthoffice.ca
 www.ssha.on.ca
 www.infoway-inforoute.ca
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Questions and Answers?
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Any questions?
Thank You!