3 May 2013 ... interconnected technologies used to support healthcare that are ... Dedicated
mobile documentation system .... Blackberry or Android hardware ...
eHealth is a journey … not a destination! 2013 eHealth Summit May 1-3, 2013
About Bayshore
• Founded in 1966 • Diversified health services company • 100% Canadian owned & operated • Operating in all Canadian provinces and territories
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What is eHealth
• eHealth has also been defined as a collection of interconnected technologies used to support healthcare that are client-centred and can be consumer-driven (Oh et al., 2005)
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Why did Bayshore need eHealth?
Better care / outcomes
Support efficient operations
Support new business initiatives
Support new business models & reporting standards
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Bayshore’s eHealth journey
Phase I • Initial experimentation w/ non-intelligent electronic forms (Word, Adobe, etc.) • No workflow or indexing for fast reference • Inexpensive to implement and deploy - costly and onerous to maintain
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Bayshore’s eHealth journey
Phase II • Moved experimentation to front-office solution • Rudimentary electronic forms • Basic workflow • Integrated w/ scheduling & coordination • Very slow, difficult and too costly to operate
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2G
Bayshore’s eHealth journey
Phase III • Dedicated mobile documentation system • Advanced smart electronic forms and flowsheets • Customized workflow • 3rd party integration w/ front-office scheduling & coordination software • Very onerous and costly to operate
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3G
Phase III Evaluation
Purpose: To assess the effectiveness of our implementation process. To examine the impact of the implementation process on frontline nurse, clients, and on the organization.
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Evaluation: Conceptual Framework Factors effecting sustainability Improved efficiencies Satisfaction with the device
Patient satisfaction
Moderating and mediating factors effecting implementation
Goal attainment
Organizational Factors
Nurse recruitment and retention
Characteristics of Nurses
Health care quality
Characteristics of Patients Environment Factors
Powell-Cope, Nelson, & Patterson (2008)
Characteristics of Technology 9
Phase III Evaluation: Outcome Executive Data
Nursing Data
(Qualitative)
(Quantitative & Qualitative)
If left on current trajectory, technology • platform would receive poor adoption across •the organization
Mediating and Moderating Factors
Satisfaction and Sustainability
Characteristics of Technology:
Characteristics of the Technology:
•
An increased focus on the characteristics of the technology is required.
•
Improvements to handheld devices and software programs are required to support the needs of a decentralized home care team.
The current hardware and software does not meet the needs of frontline nurses and is having a negative impact on nursing productivity, the nurse-client relationship, and recruitment and retention. Increased attention to the characteristics of the nurse and characteristics of our clients, and the potential impact of handheld technology on the delivery of care is required.
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Bayshore’s eHealth journey – Phase IV
EPSILON™Platform (Present Day) • Integrated front-office solution w/ enhanced mobile documentation system • Advanced smart electronic forms and flowsheets • Clinical Pathways and customized clinical workflow by staff-type • Time & Attendance, Expense Reporting
• Integration with customers (funders) &key data stakeholders (eg. ICES, CCAC)
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What is Epsilon™ ?
• w
An integrated process and technology platform for branch and field operations, that enables:
Flexible
Affordable
Scalable
1.
2.
Sustainable
3.
Interoperable
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Collection of clinical and operational data at the point of care Delivery of clinical and operational decision support at the point of care Administrative efficiencies and improved communication
Industry-leading components
• w Procura
Blackberry
• Front office, Field & Mobile Application Suite
• UCP Mobile Hardware / Software Platform
VMWare
• Virtualization & Cloud Platform
Microsoft
• BI platform & laptop OS
Lenovo
• Clinical Hardware Platform
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Application Suite Components
• w Automated Provider Reporting
Staff Portal
mHealth for Clinical Professionals
Intake Inbox
SelfScheduling
Mobile for ParaProfessionals
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Intake Inbox
Automated System-toSystem Communication • XML Messaging • Integrated to customer / funder systems • Direct data movement into Bayshore’s systems • Presently operating in Ontario – integrated to CCAC CHRIS pXML schema • Architected to connect to any other customer / funder across the country
Service Referrals
Service Changes
Service Offers
Notifications
Intake Inbox
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Intake Inbox enables … Automated Provider Reports
Customer Systems
• XML Messaging • Integrated to customer / funder systems • Direct data movement from point of care directly to customer / funder systems • Validated through extensive testing and FULL deployment in Ontario’s NSM CCAC (Planning / scheduling underway in Champlain) • Architected to connect to other customers / funders across the country
XML Messaging
Bayshore Systems
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Complete electronic exchange of data Customer / Funder Systems
Intake Inbox
APR
Field visit information
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Self-Scheduling
Leveraging system intelligence and automation Service Requirements (Clinical, HR)
Offer & Availability
Scheduling Genius
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• Allows for system to create schedules based on predetermined rules and conditions • Significantly decreases manual scheduling activity • Breaks down silos of knowledge and makes it easy to schedule 80% of the time • Will allow for easier regionalization of scheduling activities, if required
Mobile Docs for Para-Professionals
Native Blackberry / Android Mobile App • 100% integrated to core scheduling system • Seamless data flow from field branch back office • Built for UCP, with our input and workflow in mind • Stable and reliable • Blackberry or Android hardware platforms available
Electronic Documentation Time & Attendance
Care Plan
Handheld SmartPhone
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Mobile Docs for ParaProfessionals
eMail Offer / Portal Access
mHealth for Clinical Professionals
Administrative
Comprehensive clinical point-of-care system
EMR
Expenses & Mileage
Time & Attend.
Care Plan
Clinical Doc.
Client ROS
Access Portal
Availability Portal
Clinical Reference
APR
Schedule
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• 100% integrated • Field staff documentation and clinical support system • Designed and built with OBPR and Multi-Disciplinary needs in mind • Ability to create / edit own forms, clinical pathways, assessments and flow sheets • Able to scale and customize to regional needs
Staff Portal
Enhanced Functionality • Newer technology platform, better performance • Ability for staff to receive, review, accept / reject offers of visits / shifts • Staff availability update • Web interface to allow for access across platforms and mobile smart phones
Availability
Time & Attendance
Schedule
Offers
Staff Portal
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Challenges of mHealth – Pace of Change
Technology is important, but it changes every 6 months!
Store & Forward
Apps
Platform
Integration
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Complexity Pressure
Creation
Disposal
Location
Maintenance
Access
Security
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Security Pressure
Challenges of mHealth - Data
Commitment to eHealth
Improve access to home care data & information
Why?
Improve the quality of care
Inform health care funding models
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Questions
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