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D. Jankowicz



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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)

      D. Jankowicz, 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.

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