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N. Frias



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    OS13 - Delivering the Benefits of Digital Healthcare (ID 50)

    • Event: e-Health 2018 Virtual Meeting
    • Type: Oral Session
    • Track: Executive
    • Presentations: 1
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      OS13.01 - Improving Access, Navigation, and Communication About Health Services (ID 540)

      N. Frias, Centre for Addiction and Mental Health; Toronto/CA

      • Abstract
      • Slides

      Purpose/Objectives: Local Health Integration Networks (LHINs) provide strategic direction and fund health service providers (HSPs) in Ontario. To understand the current services available at the community level, the Toronto Central (TC) LHIN began collecting supplemental data from their HSPs in 2017. The analysis of this data set helps inform planning, and enables providers across the LHIN to collaboratively address common challenges to better serve Torontonians. Ultimately, the goal is to help improve access, navigation, and communication for patients. Some challenges faced by TC LHIN included manual and time-intensive data collection, analysis, and presentation through Excel. As HSP360 provides a centralized platform for HSPs and LHINs to access multiple data sets from various sources (for example, SRI, ALC, MLAA, Stocktake, etc.), incorporating this supplemental data set allows for greater insights through the following capabilities: - Web input form, allowing users to update their respective supplemental data at any time - Interactive dashboards, providing users with the most up-to-date information, as well as dynamic visualization, drill-throughs, and filtering capabilities (See figure 1) hsp supplemental dashboard.png Figure 1: Overview of LHIN Services

      Methodology/Approach: The web input form and interactive dashboards were built through close collaboration between TC LHIN and CAMH, with the scalability to expand these capabilities to other interested LHINs. First, the design and development were iterated upon through brainstorming sessions and mockup reviews. Secondly, user review and testing was incorporated to ensure that health service providers were involved in the process. Lastly, the release of the input form and dashboards were incorporated into existing SAA processes.

      Finding/Results: LHINs and HSPs have found great value in using HSP360 in data collection and analysis. With HSP360’s current automation of administrative and benchmarking processes, including HSP supplemental information on the same platform provides a new level of insight on community HSPs that was previously not available – further building the decision support capacity for LHINs and HSPs. The Toronto Central LHIN and their HSPs have found this information helpful as a starting point in planning for new services, and looking for efficiencies to improve overall system performance and the patient experience. LHIN and HSP users are now able to identify opportunities in: coverage of service area; priority populations and conditions; and availability of services: what, when and where.

      Conclusion/Implications/Recommendations: The progression of HSP360 has enabled LHINs and HSPs to set new standards in performance monitoring and a common view of performance metrics across LHIN boundaries. Including the HSP Supplemental data set on HSP360 enhances and supports the performance monitoring process, and improves access to comparable information for evidence-informed decision making.

      140 Character Summary: HSP360 supports service planning for HSPs and LHINs – most recently providing users with additional insights from data collected at the community level.

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    PS04 - Health Information Systems: Making Gains (ID 31)

    • Event: e-Health 2018 Virtual Meeting
    • Type: Panel Session
    • Track: Executive
    • Presentations: 1
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      PS04.02 - Becoming a Data-Driven Organization: The Journey to HIMSS Stage 7 (ID 327)

      N. Frias, Centre for Addiction and Mental Health; Toronto/CA

      • Abstract
      • Slides

      Purpose/Objectives: Over the last five years, a leading Canadian mental health organization has transformed itself into a data-driven organization. The purpose of this presentation is to provide an overview of the strategic and tactical elements used for this transformation and the results of these endeavors. This presentation will be given in the context of a Journey to HIMSS EMRAM Stage 7, which was achieved in June 2017.

      Methodology/Approach: The transformation to a data-driven organization began with the implementation of its clinical information system (CIS). The implementation of dashboards and a revitalized data analytics model has allowed information generated within the CIS to be used in research and quality improvement initiatives. Many other approaches were also used. Specifically, the implementation of computerized provider order entry (CPOE) has provided data to support research, quality improvement, and patient care initiatives. Closed loop medication administration was implemented in an effort to reduce preventable medication errors and improve patient outcomes. A Suicide Risk Dashboard was created that allows clinicians to view information about care plans and assessments for each patient. Care plan tasking ensured that automatic tasks were suggested for patients with a high or moderate risk for suicidality. Physician alerts / risk flags implemented include drug-drug interactions, drug-allergy interactions, cumulative dosage, and others. Clozapine-induced myocarditis monitoring and prevention protocols were deployed for all patients initiated on clozapine to reduce the risk of serious complications associated with Clozapine administration.

      Finding/Results: New incidence rates of Clozapine-induced myocarditis were determined. Eighteen patients were removed from Clozapine due to early warning signs of myocarditis. Orders data has supported research activities and provides accountability for providers. CPOE rates have been over 90% since December 2016. Medication errors are decreased as providers have discrete order options. Over 90% of patients have a suicide risk assessment completed within 24 hours of admission. Over 85% of patients showing a high or moderate risk for suicidality have a care plan created compared to 20% prior to interventions. Alerts are reviewed by an interprofessional team when overridden by an ordering provider. Drug-allergy and care planning alerts have changed practice by providing additional information. Medication scanning rates have been above 95% since December 2016. The number of scanning-related medication administration alerts has increased while self-reported preventable medication errors have decreased. High quality data for research studies and quality improvement initiatives is readily available to researchers, clinicians, and quality improvement professionals. This information can be used to track the performance of quality improvement initiatives. A capstone outcome has been the achievement of HIMSS EMRAM Stage 7, an environment where paper charts are no longer used.

      Conclusion/Implications/Recommendations: Implementation of a CIS must be clinician-driven to drive effective care practices and adoption. A value-driven approach to data collection and use is necessary to ensure that improvements and practice changes are realized. It is important to initiate an organizational culture shift prior to initiatives when shifting into a data-driven model. The organization has positioned itself with the complete vision to lead this paradigm shift into the future where there will be a true integration of care, research, and education.

      140 Character Summary: A leading mental health hospital has transformed into a data-driven organization. Strategic and tactical elements driving the transformation will be discussed.

      Only Active Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login or select "Add to Cart" and proceed to checkout.