Inside the June/July 2002 print edition
Canadian Healthcare Technology:
Feature Report: Directory of healthcare I.T. suppliers
area devises regional health information system
The Capital Health Authority, based in Edmonton, is currently
assembling a region-wide health information system that will integrate the electronic
records of seven acute-care hospitals within 18 months, and a mental healthcare hospital
shortly after that.
Remote access for doctors
Hospitals in Sault Ste. Marie, Ont., have created a relatively low-cost
method of securely connecting outside physicians to their HIS. Over 80 percent of the
citys doctors came aboard on day one.
Electronic physician practice
Toronto-based Cogient Inc. says it has produced doctors office
technology that will improve the financial performance of physician practices. The system
is also ASP-based, reducing technical headaches for busy doctors.
When computers fail, important data can be lost and the work of
healthcare facilities can be thrown out of kilter. Baycrest Centre shows how it took four
weeks to recover from a data meltdown last year.
READ THE STORY ONLINE
Heart Institute uses Internet to transfer records swiftly and securely
The University of Ottawa Heart Institute has created a secure, Virtual
Private Network to share cardiac-related patient information with 12 regional hospitals.
Ultrasound has emerged as one of the most important diagnostic imaging
modalities. Its non-invasive, inexpensive in comparison with other tests, and
its also portable. We look at some of the recent improvements in ultrasound,
including 3D technology and the rise of handheld units.
PLUS news stories, analysis, and features and more.
Edmonton area devises regional health information system
By Jerry Zeidenberg
The Capital Health Authority, based in Edmonton, is currently
assembling a region-wide health information system that will integrate the electronic
records of seven acute-care hospitals within 18 months, and a mental healthcare hospital
shortly after that.
Its an ambitious plan, and one that involves networking at least
five disparate computer systems. The initial phase of the program will integrate lab,
pharmaceutical and radiographic records, giving clinicians the ability to pull together a
meaningful picture of the medical history of patients who may have been treated at a
variety of hospitals in the Edmonton area.
Many hospitals across Canada face a similar situation as they form
regional networks their information resides in several different computer systems
that are incompatible. By showing how to bridge the systems, the Capital Health Authority
may create a model for other regions across the country.
The goal is bring together information thats pretty much in
silos today, information thats not easily accessible on a system-wide basis,
said Donna Strating, chief information officer for the Capital Health Authority. We
plan to pull together all of the patient data, from all of the sites, and present it in a
As an underlying technology, the Capital Health Authority is employing
Oracle Corp.s Healthcare Transaction Base (HTB), an electronic information system
for the healthcare sector that was announced by the company last year. Ms. Strating says
that Oracles system is acting as something of an integration engine, but has
abilities that go beyond traditional integration products.
For example, the HTB contains a master patient index, enabling
clinicians to quickly find charts and other data by plugging in patient names. It also has
security systems built in, along with audit trails and workflow tools.
The system can be integrated with Oracle financial and enterprise
systems, which the Capital Health Authority intends to do in the future. As it happens,
the region is a heavy user of Oracle systems, and has built up a good deal of expertise in
the companys technologies. Weve always been an Oracle shop, and we feel
their technology is very good, said Ms. Strating.
Moreover, the Capital Health Authority plans to eventually integrate
facilities and providers from across the continuum of health namely, continuing
care, home care and physician practices.
Initially, however, the region will allow these providers to view
hospital information without contributing their own records to the system by
tapping in through the Internet. They will use secure connections and software, and
observe the appropriate rules and regulations regarding the confidentiality of patient
information. For example, healthcare providers entering the system will do so on a
need to know basis, with the consent of patients.
This kind of access will enable referring physicians to follow the
progress of their patients in hospital. It will also allow nursing homes to obtain
baseline data they need to provide for the arrival of patients, or to check on medical
The Capital Health Authority also intends to provide this type of data
access to clinicians at northern Alberta hospitals, as many of them send patients to the
Edmonton area for specialized treatment. Thirty percent of our patients come from
outside of the region, said Ms. Strating. Were the referral centre for
all of northern and central Alberta, as well as the Northwest Territories.
The Edmonton area hospitals are working with Oracle and systems
integrator CAP Gemini Ernst & Young to produce a system thats to the health
authoritys liking. Once this is done, the parties will enter a commercial agreement
regarding its purchase or licence.
Ian Fish, Canadian healthcare director for Oracle, asserted that the
Healthcare Transaction Base is something new under the sun a healthcare information
system capable of integrating a large number of users and technologies across a wide
geographical area, using open standards such as HL7 Version 3.
This is a key difference between our software solution and other
large-scale, health information systems, said Mr. Fish. The other systems tend
to use proprietary technology or data models, and have trouble integrating various
hospital and community systems into a standard, non-proprietary format. They have a hard
time bringing, say, lab information into a record in a meaningful way, so that you can
compare at the data level radiology or pharmaceutical information alongside
He said that Oracle is making use of HL7 Version 3 as a standard for
data exchange. Its also adopting the HL7 Reference Information Model for organizing
According to Mr. Fish, in the future not only a wide variety of
healthcare providers, but patients may also interact with Oracles system. That will
be made possible by the security and database capabilities in HTB. As a result, patients
will be able to update their own demographic information, or book their own appointments.
Patient involvement in their own records could also improve the quality
of the care they receive and assist in region-wide planning. Theres the whole
area of follow-up and outcomes assessment that could be improved by a solution that
integrates data across disparate systems, and that also gets patients to tie-into the
network, said Mr. Fish.
For example, he said its currently difficult to follow up on
patients after their discharge from surgery. Often, physicians must wait until their
patients return for a follow-up visit which could take months. However, by using an
Internet connection to the system, post-op patients could apprise their doctors and nurses
of their progress each week, or even each day.
This could lead to far better healthcare outcomes studies,
said Mr. Fish. It would let doctors and other professionals know far sooner if their
patients experience infection, pain or other problems after theyve left the
Dr. Thomas Jones, vice president and chief medical officer for Oracle
Corp., noted that HTB has database and workflow capabilities that can be used to improve
the delivery of healthcare.
For example, when a patients lab test arrives, the results can be automatically sent
to the attending physician. If responses arent made within a certain period, alarms
can go off and as a backup, the results can be sent to other physicians or care providers.
Workflow capabilities can also be used, for example, to automatically
book the tests needed when a patient is scheduled for surgery. The system could provide
the best sequence and locations for lab and diagnostic imaging tests that are required
before a procedure thereby offering the greatest convenience to the patient.
In the area of drug compliance a major problem area for many
patients and the healthcare system, in general the HTB network could be set up to
electronically send prescriptions to pharmacies (once electronic signatures for scripts
are permissible in Canadian jurisdictions.)
Using the system, the pharmacist could easily let the physician
know if the patient picked up the prescription, said Dr. Jones. Beyond that,
the system could send cell-phone reminders each day to the patient to take his or her
medication. If you like, there could also be feed-back mechanisms, allowing the patient to
confirm whether the medication has been taken.
Dr. Jones observed that three other sites are currently developing
large-scale information systems using Oracles Healthcare Transaction Base. They
include a health system in Cardiff, Wales the third largest National Health Trust
in the United Kingdom; the Methodist Health Care System, based in Houston, Tex.; and the
University of California at San Francisco.
Sault hospitals connect referring physicians to information systems
By Ann-Marie Wilton
Sault Area Hospitals (SAH), located in Sault Ste. Marie, Ont., is a
partnership of two acute-care hospitals Plummer Memorial Public Hospital (public)
and Sault Ste. Marie General Hospital Inc. (Catholic). We also have two satellite
hospitals one that provides emergency care 45 minutes out of town, and another that
provides both in-patient and emergency care 60 minutes out of town.
Over two years ago, SAH implemented results reporting for all
laboratory and diagnostic imaging patient results with the Eclipsys Sunrise Clinical
Manager (SCM) system. Also included with the diagnostic imaging result interface are brief
textual ECG, Holter Monitor and Stress Test interpretation results. We have recently
implemented dictated documents into SCM. These implementations form the core of our
Electronic Medical Record (EMR).
Part of the results-reporting project included the elimination of
printing for all inpatient laboratory results until a patient is discharged. This
initiative was encouraged by our care-providers to reduce paper and also eliminate
A summary report of all lab results for the inpatient encounter is
printed in Health Records at the time of chart completion. SAH currently has 95 percent of
physicians using SCM for results reporting, along with all nursing staff, other
disciplines and allied healthcare workers basically anyone who needs access to
results and patient information in order to provide care.
Significant patient information (surgical and medical history,
allergies, height, weight etc.) is recorded in SCM for clinic, pre-surgical and many
inpatients. This information shows across encounters in SCM, and becomes relevant to all
care-providers when a patient uses the services of SAH.
With such significant data held in SCM, it became increasingly
important to provide remote access to our physician offices. Most physicians in Sault Ste.
Marie practice in one of four doctor buildings within the city. Therefore, it was a fairly
inexpensive and easy initiative to extend a Wide Area Network to three of these buildings,
in order to provide access. The fourth building, the Group Health Centre, which is a
multi-disciplinary physician group practice, had previously been set up with an ISDN
connection to SAH.
Until we implement the latest version of SCM, which is web-enabled, an
interim solution was sought that would be cost-efficient, highly secure, and also provide
the least amount of support required by the Information Technology department at SAH. Our
experience in a remote access pilot taught us that as soon as we installed our virtual
private network (VPN) software and the SCM client on a physicians PC, any problems
encountered by the physician or his staff on that PC became a problem for IT to solve. We
wanted to avoid this if at all possible.
With recycled PCs from our nursing units and various hospital
departments, we re-imaged these to be thin-clients basically standalone PCs with
only four icons to provide the simplest method of access. We also disabled all floppies
and utilities in order not to encourage configuration change.
The four icons we provided on the desktop were for SCM login, Internet
Explorer, SAH internal e-mail and SAH intranet. Our Internet Explorer denies access to
specific web sites and limits some incoming mail. Our intranet provides online access to
all hospital policies, procedures and newsletters, a telephone directory, current
emergency physician on-call schedule, and links to medical libraries. We purchased ink jet
printers, power bars and the terminal server licenses we needed for each physician
To connect each building to the SAH LAN, we purchased Soho Firewall,
Microsoft Terminal Server 2000, switches and UPSs. We negotiated with a local computer
vendor to install each office for a flat rate of $79. We also negotiated with the same
vendor to provide the monthly Internet connection fee and hardware support for each
physician office for a flat rate of $35 a month. This eliminated the need to find
resources within IT to either install or support our remote users, which would have posed
scheduling problems since our staff consists of only four technicians and our current
compliment of hardware within the four sites is already at greater than 500 PCs.
The remote access physicians who maintained offices outside of the main
doctor buildings were connected via Watchguards VPN client and a Linksys
router/switch that is capable of NATing (network address translation) to provide a secure
connection. The same four icons were put on their thin-client desktops. The $35 monthly
flat rate for Internet connection and hardware support had been factored in for connection
of these offices also. Our goal was to provide the same service to every physician in our
community for one price.
The combination of terminal server, VPN and firewall provides the
highest level of security for SAH. The terminal server provides video and keyboard entry
so data stays within the SAH walls. The VPN ensures the data being sent is secure since it
is encapsulated between the firewalls at each end, so a third-party cannot see in. The
firewall eliminates the remote access PC being a back door to the SAH network.
Along with the hardware install we also ensured our SAH policies
supported remote access to our clinical application. In addition to providing remote
access to physicians, we knew we also wanted their office staff online, to eliminate the
frequent phones calls required to our diagnostic departments for missing results.
Since these people are not employees of SAH, our policies had to
support their access to our systems, and clearly define lines of responsibility and the
consequence for a breach of confidentiality.
Phase One of our remote access project has been to connect interested
physicians within the city limits. Over 80 percent of our physicians came aboard on day
one, with many more following soon after project initiation. A handful of physicians are
waiting for Physician Order Entry (POE) to be implemented prior to needing remote access.
Phase Two of the project is to extend remote access to regional
patient-care facilities, since much of the diagnostic work for their patients is performed
We also anticipate connecting our physicians at home, as we have
received many requests for this application. Our timeline for Phase Two completion is over
the next couple of years.
Low-cost system said to boost revenue for doctors, enhance patient care
By Jerry Zeidenberg
Youd think Canadas 60,000 doctors arguably the
countrys brightest minds would be the earliest adopters of computers. In
reality, the opposite is true. According to the Canadian Medical Association, only 14
percent of doctors in physician practices have computerized the clinical and business
sides of their work. Indeed, doctors are among the least automated professionals in the
The reason? To date, specialized practice management systems have been
too expensive, offer little in the way of financial or clinical payback, and require too
much time for maintenance and upgrades.
Things may soon change, as software companies address these concerns.
Already this year, Cogient Corp., a Toronto-based developer of clinical
practice management software, has made several breakthroughs in the doctors office
marketplace. In May, the company announced a $600,000 contract with Urgent Care Canada, a
company establishing large, multi-disciplinary clinics in under serviced settings.
A month earlier, Cogient announced that Toronto-based Edward Street
Radiology, the largest private radiology practice in Canada, signed a contract to
implement the companys software at its two locations. Some 45 radiologists and
technologists will be using the software.
Also in April, Cogient became one of the first companies to obtain a
standing offer contract with the Alberta Physician Office System Program (POSP). The $15
million Alberta program is seeking to computerize doctors offices throughout the
province, and the government is working with the Alberta Medical Association to validate
software that can be offered to clinics and doctors.
For its part, Cogient has devised a solution thats relatively
inexpensive, and offers physicians the chance to actually improve the financial
performance of their practices while enhancing clinical results. Were not
trying to get doctors to change the way they practice medicine, said John Soloninka,
president and COO of Cogient. Were providing doctors with something
thats low cost, will save them time and earn them more money while improving
Instead of asking doctors to pay cash up-front for a package of
hardware and software, Cogients Application Service Provider (ASP) model charges 50
cents for each patient visit. For the average doctor, that works out to $3,000 or $4,000 a
The companys clinical practice management solution is called
ClinicalLogic. Its ASP approach means the servers and software are housed off-site in a
centralized, secure data center. Theres little in the way of capital costs
all that a doctors office needs is a reasonably up-to-date computer and a fast
By maintaining the software at a data centre, doctors arent
turned into computer geeks who end up spending countless hours tweaking their computers
and interfaces. Instead, the time-consuming maintenance tasks and software upgrades are
performed by Cogient at its data facility.
Physicians might be concerned about the security of the data, since it
is housed at an off-site data centre. But according to Soloninka, Cogient has invested $2
million in its data center on security, redundancy and backup systems.
Whats more, Cogient can provide physicians with regular downloads
of their data just so they can have records on hand, as well. According to
Soloninka, while Cogient manages the data centre, the data belongs to the practice.
ClinicalLogic appears to be a comprehensive EMR and practice management
package that covers everything from front office patient scheduling and billing, to
real-time health card validation, as well as charting the physician-patient encounter.
Cogient has created links to commercial labs such as Gamma/Dynacare and
Canadian Medical Labs, enabling lab results to be sent electronically to the doctor as
soon as the practice office goes online.
Some of the most attractive features of ClinicalLogic reside in its
ability to boost income for clinics. According to Soloninka, eliminating missed charges,
reducing OHIP rejections, trapping invalid OHIP cards and increasing third party
collections alone can lead to 15-25 percent in additional revenue.
The system also generates codes for billing, supports real-time EDT
claim submission and line-item reconciliation, and virtually eliminates mistakes that
arise due to incorrect billing, said Soloninka.
Cogients director of marketing, Bekhe Purkis, said the security
provisions built into the Web-based ClinicalLogic provide doctors with the ability to
access the system from a variety of locations.
Physicians can see their patients while at the clinic, hospital or
home, call up patient charts, and also submit claims using the ClinicalLogic program.
You log into the Internet, using either your thumb-print or a secure login from any
Internet location, and you have instantaneous access to your practice, she said.
Cogient is a strategic partner of Hewlett-Packard (Canada) Ltd.
According to Bob Miller, HPs healthcare and education business development manager,
there has been noticeable growth recently in the physician I.T. marketplace. Doctors
are under severe cost pressures, and theyre seeking ways to improve the performance
of their practices, said Miller. Theyre looking at ways of improving the
tracking and management of their clinical encounters, and theyre trying to speed up
the turnaround for billing. In addition, there has been significant uptake in
the growth of mobile computing among physicians, said Miller. This has included
solutions ranging from handheld computers such as the Jornada and iPAQ to
linking these devices with satellite phones for emergency encounters in the North.
IT disaster-recovery requires technological expertise, human relations skills
By Stephen Tucker
Last December, the information technology team at Baycrest Centre was
conducting routine maintenance on the network when a cable on a principal server came
loose. When it was replaced, it triggered a scrub of the hard drives primary index
field. This caused the corruption of more than 180 gigabytes of data.
While patient and accounting information were not affected by the
problems on this particular server, more than 900 Baycrest personnel faced the loss of
years of data. This included PhD dissertations, book manuscripts, presentations, reports,
general files, correspondence, prescription and hearing aide billing information, and much
A massive four-week disaster recovery effort ensued. This effort cost
more than $80,000 and involved the equivalent of 1,000 worker days to correct. In the end,
we recovered all but 14 days of data. I learned more in that month about handling a
disaster than I did in a year on the job. This is the story of an IT disaster and many of
the important lessons learned during recovery.
No one knew our new backup system was faulty: Earlier in 2001, we
installed a new backup system. The system tested perfectly before installation. We did not
know, however, that when the new system went live, human error caused a critical fault. It
wasnt until we went to restore the corrupted information that we discovered we did
not have a functional backup. All the data stored on 12 hard drives of the affected server
were seemingly lost.
We immediately contacted a data recovery service, hoping the picture
wasnt as bleak as it looked. The hard drives were a total loss, but the disaster
recovery technicians were able to recover the information stored on tape. That was the
good news. The bad news was that taking the recovered data and restoring it to users was
going to be a nightmare.
The best analogy I can offer is this: Vandals go to a public library
and tear out every page of every book and then scatter the pages. Your job is to
reassemble all the pages in the right order, in the right books, in the least amount of
time. That was the task ahead of us. We eventually did this. It wasnt easy, but it
Lessons learned from IT disaster recovery: The first lesson we learned,
and this may be the most important thing, is that a disaster recovery effort must have an
effective internal communication component. We were in a triage situation. Through
frequent communication, we were able to determine which departments needed the fastest
response. In the meantime, we let the staff know why we were making specific recovery
Had we simply been working to fix the technical problems without
actively communicating through e-mail, phone, in-person meetings with each department,
frequent communications with senior management, and later on through newsletter copy, we
would not have been as effective. Communication is a two way process. Through frequent
communication, we plowed through the critical files, to the important ones, to the
glad its back stuff.
As long as our users were aware of what was happening, they offered us
as much patience and understanding as one would hope under the circumstances. They
continued to help direct us to the critical areas. Once things settled down, our
communications tapered off. That was when the users started to make increased demands. We
realized we had to keep active communications in place all the way to the end of the
More lessons learned: The disaster occurred during Christmas season,
when many people were off, including those in the financial department. The disaster
recovery consultants wanted more than $25,000 before they would begin the data recovery
process. It was the middle of the night, and we did not have access to that kind of money.
Eventually I was able to convince them to start work. The second lesson we learned is to
line up important suppliers before the disaster strikes and have established lines of
The third lesson we learned is to have backup equipment on site that
can be rushed into service. Our test server was available, but it did not have 180
gigabytes of memory. We now have a server ready and able for disaster relief duty.
The fourth lesson: employees must take breaks. Our team worked the
first 36 hours straight. We arranged for hotel accommodations, where people rested and
then came back to work. As the disaster recovery effort continued on for several weeks,
people did not cut back from extremely long days. They wore down and began making
mistakes. I saw firsthand that people cant work long hours for an extended period of
time and remain at peak efficiency. No matter how committed the people are, they will
begin to falter.
In addition to fatigue, the staff exhibited outsized feelings of worry
and guilt. We worked with the HR department to help staff understand and cope with these
feelings. We subsequently gave staff members a week off to disconnect from the pressures
of work and recover peace of mind.
During the height of the recovery operation, we arranged with an
outside consulting firm to bring in 11 people, including a project manager, to augment our
team. It cost more than $20,000. This taught us our fifth lesson there is a limit
to how fast you can bring in outside help. We had to instruct the auxiliaries in the
basics of our network, and we could only do this at a relatively slow pace due to other
staff commitments. The expected relief from added hands did not arrive as fast as we
hoped. We now have an orientation program prepared. This will enable us to bring helpers
on board much more quickly.
When you send your disaster-recovery team out to various areas of the
organization, you start to develop problems of overlap, which generates confusion.
Basically it is a management issue of who is doing what, when, and why.
This taught us our sixth lesson have a task management strategy
in place. We developed a fan-out program to enhance the recovery effort. Fan-out teams
were assigned to specific locations. These teams worked with the users to uncover the most
critical problems and then to work down the priority list.
Stephen Tucker is Director, Information Technology, at Baycrest
Centre for Geriatric Care in Toronto.
Heart Institute uses Internet to transfer records swiftly and securely
By Ranald McGillis
As one of two Regional Cardiac Care Coordinators at the University of
Ottawa Heart Institute (UOHI), Lorna Bickerton has her work cut out for her. Lorna and
colleague Pat Doucette oversee the administration of records for cardiac patients at the
UOHI and the 35 Eastern Ontario hospitals whose patients are referred to the Institute.
All those referrals and subsequent assessments, responses and updates generate vast
amounts of paperwork, a considerable portion of it redundant.
For every patient, every referral, there are phone calls and
faxes, says Bickerton. You call referring physicians. You phone in assessment
results to hospitals. You send a fax then follow up with a phone call to be sure
the fax was received. And youre communicating with the referring physicians, the
assessing physicians, the patients, and the families of patients thats an
awful lot of calling and faxing. At any one time, you can have multiple copies of a single
document floating around.
It wont be long, however, before the sea of paper will be reduced
to a trickle and redundancy eliminated almost completely. Bickerton and Doucette
will be among the hundreds of healthcare workers in Eastern Ontario to benefit from
RASCHR: the Regionally Accessible Secure Cardiac Health Records system.
Scheduled for launch at the UOHI in May 2002, RASCHR will use the
Internet to link the Institute with 12 regional hospitals, enabling the transmission of
cardiac-patient information over a secure Virtual Private Network (VPN). In a system such
as this, security is critical.
As anyone in healthcare knows, the laws surrounding patient
confidentiality and information privacy are strict, says Dr. Shu Tim Cheung, Chief
Information Officer at the UOHI. If patient information were not secure, there would
be a lack of confidence not only in patient record-keeping but in healthcare as a
RASCHR is a CHIPP initiative (Canadian Health Infostructure
Partnerships Program) and, as such, has received $1.5 million in government funding along
with equivalent support from project partners.
The project lead on RASCHR is Canadian IT-services company xwave. xwave
has built secure directories for organizations such as the Department of National Defence,
and Public Works and Government Services Canada. The company has also built secure,
wireless communication systems for several police forces including the RCMP.
Some kinds of information healthcare records included
are particularly sensitive, says Michael Martineau, xwaves director of
business development. We had to be certain this system was airtight.
Supporting the system is a centralized, reusable security
infrastructure provided by Bell Canada, another partner in the RASCHR project. Based on
Public Key Infrastructure (PKI) technology, Bells infrastructure is used by
customers such as UOHI who need to protect sensitive and confidential information as it
traverses the Internet.
Rather than build such a sophisticated security infrastructure from
scratch, RASCHR is leveraging Bells significant investment in the existing system,
as well as the companys extensive security expertise.
To further ensure a high level of security, the system architecture was
built in three layers. At the front end is the web layer the only part of the
system accessible to healthcare workers. Second is the application layer the layer
that contains the systems programming instructions. At the back end is the data
layer the database of patient information. And there are firewalls between each.
It would be nearly impossible, says Martineau, for
anyone to get through those layers and firewalls and tap into that database.
Bells PKI technology will be used to encrypt information being
transmitted, and will allow only users with registered digital certificates to decrypt it.
In addition, every person who uses the system will be assigned one of four clearance
levels that will determine the extent to which the user can probe patient records. And
users will also be audited; the system will track their queries and identify the person
who last modified a patient record.
When RASCHR is fully operational and all 12 regional facilities are
connected, the transfer of cardiac-patient information will be faster, more efficient and
more accurate. With security covered, healthcare professionals will enjoy the significant
Itll enhance patient-care big time, says Dr.
Catherine Greenough, an internist at Arnprior and District Memorial Hospital, one of the
facilities that will be linked through RASCHR. Right now, were running to the
medical labs. Were running to the echo labs. Were running to the floors. The
fax machine is going non-stop all in an effort to either track down or relay
information. I cant wait to be able to hop on a computer, punch in an ID number and
get all that information in one spot.
Lorna Bickerton at the UOHI points out that as well as being efficient,
RASCHR is also user-friendly. The new system mimics our old system, which means, for
instance, that people who arent inclined to fill out forms in the first place
wont have to acquaint themselves with new ones. Bickerton also likes the fact
that the system allows users to track patient referrals. The system will provide
notification of when a referral has been received, when its being assessed, and what
the outcome is.
While Bickerton acknowledges peoples concerns about the security
of medical information being relayed over the Internet, she points out that in many
respects, RASCHR helps improve security. Right now were having to send
information in faxed documents documents that sit in fax machines in open offices.
Thats not an ideal way to send patient records.
Catherine Greenough agrees. Theres no question that
security is vital. But truth is, you walk into any hospital ward particularly in
the evening when there are fewer nurses around and you could probably at some point
find the opportunity to crack open a chart and have a read. She adds, I think
that while security is on everyones lips these days, whats really going to
matter more to them on a day-to-day basis is availability: will the system be up and
xwaves Michael Martineau says yes, indeed. Remember those
three layers of architecture? Weve built redundancy into each of them. There are
multiple web servers, multiple application servers, and two database layers. If one server
or layer goes down, the other automatically kicks in.
This system is going to provide us with a more effective means of
tracking our cardiac patients and eventually, Im certain, all patients,
says Lorna Bickerton. They will be much better cared for as a result.
Ranald McGillis is Vice President, Central Business Unit, for xwave.