Inside the March 2002 print edition of
Canadian Healthcare Technology:
Feature Report: Electronic medical records
announced for computerized heart hospital
North Americas first all-digital cardiac hospital will open its
doors in early 2003, in Indianapolis. The US$60 million facility will be paperless and
filmless, and will use an advanced clinical information system and the latest imaging
OHA launches national e-learning initiative for healthcare
The Ontario Hospital Association hopes to improve the delivery of
education and training in the healthcare sector with the launch of Healplex, a web-based
Using EMR to practice evidence-based medicine via a virtual library
By licensing content from publishers and library consortia and
co-licensing material with the University of Toronto, the University Health Network (UHN)
of Toronto has created a Virtual Library to provide a core of biomedical information
resources for its clinical community.
Doctors house calls, via web
Instead of driving for hours and waiting in crowded doctors
offices, some rural patients in California are staying at home and conferring with their
physicians via Web-based videoconferencing. The new service is already attracting 400
calls a month.
Training spurs I.T. operations
Regular training sessions held over lunch time for a period of
40 weeks transformed the I.T. department at Torontos Baycrest Hospital. Staff
gained professional designations, and system uptime has now surpassed 99 percent.
Canadas first program in emergency tele-psychiatry is providing
rural patients in New Brunswick with faster access to mental health professionals.
Reducing medical error
As part of a program to enhance patient safety when it comes to
medications, the Grand River Hospital in Kitchener, Ont., has acquired a $1 million
robotic system. The hospital has become a national leader in this area.
PLUS news stories, analysis, and features and more.
Specialized cardiac hospital in Indianapolis to be completely digital
By Jerry Zeidenberg
INDIANAPOLIS North Americas first all-digital cardiac
hospital meaning no paper records or diagnostic film will be used is
scheduled to open its doors in Indianapolis early next year. Instead of keeping and
shuffling hard copy records, all documents and images at the new, US$60 million facility
will be created, stored and transmitted by using computerized equipment and networks.
We believe this will be the best way of providing care for the
future, said David Veillette, chief executive officer of the new facility, called
the Indiana Heart Hospital.
What we have today [in most hospitals] is a tremendous amount of
paper, he said. What we want, on the other hand, is to get more information to
doctors and nurses at the bedside, so that they dont have to chase things in
different parts of the hospital.
Veillette said there wont even be any nursing stations at the new
hospital, because, we dont want nurses to go back an forth to a station, we
want them at the bedside.
He commented that digital technologies and new methods of working are
expected to lead to care thats both more efficient and more effective.
The aging of the baby boomers means we have to find more
efficient ways to take care of three times as many patients, with staffing levels that
will be decreasing, said Veillette. The only way to do that is with
The hospital will have 88 patient beds, 32 outpatient rooms, four
surgery suites, six cardiac catheterization labs and a cardiac emergency department. It
will offer a wide range of services, from open-heart surgery to emergency care, rehab,
screenings, research and education.
Wired and wireless computerized systems are expected to save a great
deal of time and trouble by delivering patient information right at the bedside. At
the stroke of a key, I will have the patients history, I will have a list of his or
her medications, I will know his or her allergies, said Dr. Michael Venturini,
cardiologist and chief medical officer of the Indiana Heart Hospital. I will be able
to review not just reports, but actual images of echocardiograms, of EKGs, of cardiac
catheterization films. It will make me and all my peers better physicians.
Dr. Venturini said that caregivers will be able to document, write
orders and review at the point-of-care. That is critically important, he
noted. By doing that, we will enhance quality and safety.
For example, physicians and nurses will be able to quickly check
whether patients are receiving the correct drugs, in the right dosage. He contrasted this
with current procedures in many hospitals, where information gathering is a hurdle, and
obtaining a paper medical record or retrieving a diagnostic film can take several hours.
Whats more, the software will allow the hospital to track and
analyze its own performance. Well have real-time metrics, and well be
able to look at clinical performance, staff and costs, said Dr. Venturini. For
example, we can learn how good the hospital is at coronary bypass operations, or how
successful individual physicians are at placing stents. We can use this information to
improve the performance of the hospital and the delivery of medicine.
To create a complete digitized facility, the Indiana Heart Hospital is
working in close collaboration with GE Medical Systems, of Milwaukee, Wis. While in the
past, GE Medical has been chiefly known as a supplier of diagnostic imaging equipment such
as X-ray systems, CTs and MRIs, more recently it has been expanding the scope of its
In this instance, it will provide a complete clinical information
system thats integrated with diagnostic imaging and patient monitoring systems.
The technology thats being installed includes the GE Centricity
Information System, which is said to be an enterprise-wide clinical information system
that integrates patient data such as images, waveforms and medical history
from every care area of the hospital into a single electronic record that can span a
patients entire lifetime.
Whats more, GE will also supply leading-edge diagnostic
technologies, including an all-digital cardiovascular imaging system, called the GE Innova
2000. It will also provide gender-specific ECG technology to test womens heart
waveforms, and a system that conducts 30-minute cardiac exams via MRI technology.
OHA launches national e-learning initiative for healthcare
By Jerry Zeidenberg
TORONTO The Ontario Hospital Association hopes to improve the
delivery of education and training in the healthcare sector with the launch of Healplex, a
web-based e-learning service. Healplex organizers say the on-line courseware and
management software will dramatically reduce the cost of on-going education for hospitals
and make continuous learning much easier for employees.
Theres been an explosion of information in healthcare, and
its a real challenge for hospitals to keep up with it, said John Ferguson,
senior e-commerce advisor for the OHA and one of the key developers of Healplex.
Along with the OHA, the Toronto-based Change Foundation is a co-creator
Traditionally, to upgrade the skills of personnel, hospitals have sent
nurses, doctors, administrators and technologists on half-day or full-day training
courses. This has often proved difficult, as the medical centers are then left scrambling
to find replacements for these employees.
Moreover, training can be expensive, and educational costs have piled
up for rural hospitals, which often need to send staff to urban centers for skills
upgrades. In these cases, they must also foot the bill for transportation, hotels and
By contrast, most Healplex courses take 90 minutes or less to complete
and can be performed on a plain-vanilla computer with web access. Employees can squeeze
the work into spare hours day or night. Its available to them around
the clock, and because its on the web, it can reach anyone, anywhere, anytime,
To start, Healplex has gained a source of high-quality content by
teaming up with Healthstream Inc. of Nashville, Tenn., the biggest provider of on-line
healthcare training in the United States. Healthstream supplies e-learning services to
over 1,200 U.S. hospitals and has developed 3,000 hours of web-based courseware, covering
a wide range of medical, legal and administrative topics.
For its part, Healplex is working with experts here to
Canadianize the content, making sure that it covers Canadian issues and uses
As it goes along, Healplex also plans to work with Canadian hospitals,
technology vendors and other enterprises to create new courseware, which in turn could be
marketed to healthcare providers across Canada and the United States. This entrepreneurial
aspect of the program offers a revenue stream to Canadian hospitals, and a way of further
developing the high-tech skills of employees.
Officially launched last November, at the time of the OHA convention in
Toronto, Healplex has now validated 27 Healthstream courses to ensure that they meet
Canadian standards. This initial set of courses is aimed primarily at nurses and
administrators, and includes topics such as:
Preventing slips, trips and falls.
Security and workplace violence.
Standard precautions blood and body fluids.
The art of customer service.
Working with hazardous chemicals.
Carpel tunnel syndrome.
Latex allergy overview.
Lifting and transporting patients.
Performance improvement in the workplace.
Were bringing credible experts to review the content and
validate the courses for the Canadian market, said Heidi Bilas, content development
manager for Healplex. She has been seconded from Baycrest Hospital, where she was
telehealth site manager.
In terms of costs, a hospital could provide 1,000 employees with access
to the current Healplex package of 27 courses for about $50,000 annually. Thats
considerably lower than traditional forms of training.
E-learning typically amounts to one-third to one-half the cost of
on-site education, said Ms. Bilas. Its much more economical.
Ferguson explained that Healplex not only includes courseware, but also
offers a student and instructor management system. Administrators can track course
completion rates, view marks obtained by students, post messages, and massage the data in
Students can also obtain access to their own transcripts.
Ferguson noted that web-based education isnt meant to replace
classroom training and other forms of teacher-student instruction. Instead, its
another means of providing education. Healplex is complementary to face-to-face
training, which will always be important, said Ferguson.
Healplex has been holding meetings across Ontario, promoting the new
service to hospital managers. This year, it expects to sign-on two to three dozen
hospitals across Canada. Information about the new company and its services can be found
Using EMR to practice evidence-based medicine via a virtual library
By Tim Tripp, B.Sc, MLIS, and Matthew W. Morgan, M.D., M.Sc.
According to a recent PriceWaterhouseCoopers survey, one hour of
inpatient care and emergency care generate 36 minutes and one hour of paperwork,
respectively! Multiply the time clinicians should spend on patient care by the number of
hours they must spend on paperwork and its easy to understand why keeping up with
reading quickly falls to the bottom of their priority lists.
The hospital library has always played an important role in clinical
decision support, helping clinicians stay up-to-date on the latest medications, procedures
and other advances aimed at improving the quality of patient care. However, faced with
hundreds of medical articles published weekly, no simple way to access them and no time
for anything short of quick glance, the average clinician finds keeping up with evidence
virtually impossible especially if doing so requires visiting the hospital library.
But one large Canadian teaching hospital group has figured out how to
help clinicians stay on top of things. By licensing content from publishers and library
consortia and co-licensing material with the University of Toronto, the University Health
Network (UHN) of Toronto has created a Virtual Library to provide a core of biomedical
information resources for its clinical community.
The Virtual Library Project: UHN embarked on its innovative Virtual
Library project in 1999. The projects purpose was twofold: To provide a seamless,
single-interface access to all library resources irrespective of the resources or
users physical location, and to integrate the resulting virtual library into
UHNs electronic patient record (EPR).
By licensing content through direct deals with publishers, negotiating
with library consortia and taking advantage of co-licensing arrangements with the
University of Toronto, UHN is able to provide a core of evidence-based information
resources for the clinical community. Implementing a Web-based interface to these various
resources on the hospital intranet that is also integrated into the electronic patient
record ensures wide exposure and easy, integrated access to these crucial knowledge
UHNs four-step implementation process began with an inventory of
UHNs resources and services. Next, UHN benchmarked other healthcare organizations
and university libraries. Then, the library and intranet staff developed an initial design
and made it available to a select group of users. Finally, after incorporating feedback
from test users, developers worked with UHNs Public Affairs office to roll out the
Virtual Library in the spring of 2000.
The Technological and Information Foundations: Unquestionably, the
Virtual Library is an idea whose time has come. But it is just evolving from idea to
reality because it rests on two equally evolving technologies, the Internet and the
electronic patient record.
Books have been around since 2800 B.C.; libraries since somewhere
around the 5th century B.C. The Internet? About 20 years. And while it has become the
vehicle of choice for access to information, the Internet cannot effectively deliver such
resources as biomedical databases and electronic full-text journals demands without an
access-driven infrastructure. Recognizing this, UHN recently implemented a major
infrastructure upgrade, providing Internet/intranet access to more than 4,500 desktop PCs
across its three hospital sites to create the technological foundation for the Virtual
To create the foundation, UHN had to integrate the Virtual Library into
its EPR. UHNs first step was to implement a Web-based interface to the hospital
Intranet via its EPR solution, Patient1 from Per-Se Technologies. Patient1 provides access
to such core biomedical databases as Medline, Ovid and CINAHL; evidence-based full text
collections, such as the Cochrane Database of Systematic Reviews and the ACP Journal Club;
and more than 1,400 full-text electronic journals, electronic texts, interactive request
forms and quality Internet links selected by library staff.
The next step is to bring the Virtual Library and the EPR even closer,
truly integrating clinical decision support into clinical workflow. Primarily, physicians,
nurses and other clinicians access the Virtual Library from Patient1. Using Java and XML,
UHN is creating interfaces that can retrieve relevant, evidence-based content directly
from diagnostic and order entry screens within the patient record. So far, 18 alerts
accessible directly from the EPR and triggered at data entry have been
created and more are in the works.
Survey: But are clinicians using the Virtual Library? According to the
numbers, yes. According to ongoing use analysis:
400 users access the Virtual Library each weekday. The three
physical libraries average 550 users per day, 3,500 database searches per
month. Fifteen percent of use happens outside physical library hours.
65 percent of users access databases, while 25 percent peruse
And what do clinicians really think about the Virtual Library? Results
of a recent survey of staff physicians and residents showed:
95.7% believed the Virtual Library saved them time
96.8% said it helped them make clinical decisions
The evolution from cuneiform to HTML may have been a slow one, but
UHNs Virtual Library is ensuring that it wont take nearly as long for
clinicians to have the right clinical information, right when and where they need it to
make the right decisions.
About UHN: Comprising Toronto General Hospital, Toronto Western
Hospital and Princess Margaret Hospital, the University Health Network is the primary
teaching hospital for the University of Toronto. The 1,000-bed network employs 10,000
staff and averages 42,000 admissions, 560,000 ambulatory care visits and 66,000 emergency
Tim Tripp, B.Sc, MLIS, is Senior Project Manager, Clinical Decision
Support, Shared Information Management Services, University Health Network. Matthew W.
Morgan, M.D., is an assistant professor, Department of Medicine, University of Toronto, a
general internist at UHN and director of healthcare informatics, Per-Se Technologies.
Emphasis on training and certification transforms IT at Torontos Baycrest Centre
By Stephen Tucker
When I was hired in 1999 to manage Baycrest Centres Systems and
Operations Group, I saw huge opportunities as well as significant challenges. In terms of
challenges, the new team comprised six people, most of whom did not have much IT
experience. Our network, which supported 700 users, went down at least twice a day. Users
calling our help desk typically got voicemail. We had three different flavors of Novell
and system patches were everywhere. Staff turnover was high.
The opportunities included working for one of the leading healthcare
facilities of its kind in Canada, and helping to build its IT operations.
Now the system is up 99.913 percent of the time. We effectively field
more than 50 help desk calls a day, and there is a live human being at the help desk.
Staff turnover is low and the Systems and Operations group, now numbering 14, is comprised
of enthusiastic, trained, and certified IT specialists. We have a waiting list of people
wanting to join the team from other departments within the facility. Centre management
increased the IT capital budget significantly last year and salaries within the department
have risen. We have plans to become an out-sourcing system and support service provider to
other geriatric facilities in Canada.
This is the story of the transformation of the Baycrest Systems and
Operations group. I present it as an illustration to other department managers of the
transformational power of training linked to IT certification.
By way of background, Baycrest Centre provides a wide range of
residential, day programs, and specialized services for the elderly of the greater Toronto
area and is a recognized leader in geriatric research. The centre offers programs on-site
and in the home, as well as providing individuals and families with counseling, education,
The centre is a fully affiliated teaching institution with the
University of Toronto. More than 100 Baycrest staff members are full, associate, or
assistant professors at the university, and more than 500 students from universities,
colleges, high schools, and technical institutes receive educational training at Baycrest
Baycrests IT department is comprised of two groups
applications, and systems and operations. The Applications Group develops new
applications, particularly around business and healthcare systems. Systems and Operations
is responsible for telephony, hardware, software, and networking approximately
1,000 servers, PCs, and printers are on our Windows 2000 network. We serve approximately
700 people. Today, six people staff the help desk while another eight are network
When I started in 1999, I prioritized the problems I wanted Support and
Operations to tackle first. The most important problem was low network reliability. Uptime
had to be improved. The second biggest problem was that the staff overall did not have a
framework for problem solving. Thirdly, we needed to standardize hardware, software, and
protocols and eliminate as much as possible variation in the network. Unfortunately,
variation in an IT environment produces more complicated, time-consuming problems.
Fourthly, we needed to begin to build the confidence and trust of our user community.
Options and implementation: One option we explored to solve some of our
problems was to partner with a leading hardware supplier and have them overhaul the entire
network. We rejected this option based on the projected downtime wed experience and
the high cost. A second option was to outsource IT support. We felt the cost of this
option was prohibitive.
A third option was to build a comprehensive solution from within
train and motivate our way toward high uptime and user confidence. We felt that this was
our most effective option. Our people wanted to do a good job; they simply needed the
tools. And if we were creative, I felt we could solve our problems cost effectively. There
are so many options for training. I felt I needed to narrow my search down to the
I was familiar with the Computing Technology Industry Association
(CompTIA) A+ and Network+ certifications and decided to explore these to a greater degree.
I learned that the A+ certification is appropriate for a computer service technician with
six months experience and covers a broad range of hardware and software technologies.
Also, its supported by all the major players in the computing industry, including
Microsoft, IBM, HP, Compaq, and Intel. Network+ measures the technical knowledge of
networking professionals with 18-24 months experience. Earning the Network+ certification
means that the individual possesses the knowledge needed to configure and operate a
variety of networking products.
I decided to pursue these options for my team. Training for A+ and
Network+ would give my team a comprehensive knowledge base. Another consideration was that
training linked to certification would give me an objective means of knowing that the team
shared a common base of knowledge. It would also make it easier for the team to talk with
one another and collaborate when solving problems. They would have a shared understanding
of terms and procedures.
Importantly, there was a wealth of course materials and options to
choose from for A+ and Network+ training. We began by buying, very cost effectively,
training manuals written by New Riders Publishing at a local Costco department store. We
set up a test lab complete with a 10 PC network by using old PCs. We set aside three lunch
hours a week for study. The department provided lunch.
Team members urgently wanted to learn and to become IT professionals.
We had volunteers who each were responsible for leading a discussion on a chapter from the
A+ and Network+ manuals. Additionally, each person went thought the manuals on their own.
Essentially, we opened a new door for them, and they ran through with enthusiasm.
I went through the training alongside the team. I felt that it was
extremely important to establish trust by showing the group that we were all in this
together. Study topics gave us an additional opportunity to talk about problems we were
having with the network and ways of solving them. As we went through the chapters, we
started to identify the various layers of technology and how they interact. I could see
light-bulbs going off in peoples minds as they saw how all of this impacted our
network and the issues we were struggling with.
In total we invested in 40 weeks of study. The cost for the training,
including manuals and tests, averaged $250 per person. We bought test vouchers in quantity
at a good rate which helped keep costs to a minimum. We spent about $5,000 on lunches. The
first time through only one person earned their A+ certification. The others maintained
their enthusiasm, and over time we have had 100 percent certification of the team for both
Now, if a Baycrest employee from an outside department wants to join
our team, we ask that they become certified first. We provide them with a self-study
course on CD from Learning Tree International. We pay for the exam only after they pass
Lessons learned: One of the things that is most important in a
transformation like this one is the department managers firm commitment to the
process. We went through periods where daily problems put a stop to the lunch sessions. We
got back to our learning regimen as soon as possible, but the interruptions delayed us. In
hindsight, Id not let daily problems slow down training.
Asking vendors to share their expertise is a great strategy for
continuous improvement. Vendor presentations provide a good picture of where vendor
specific technology is going. These presentations also spark good ideas. On average we now
have a vendor presented lunch-and-learn session twice a month.
Results: When I started, average network uptime was 98 percent. This
means that the network was down for a week each year. At the time this article is being
written, we have uptime of 99.9913 percent only 45 minutes of downtime a year. Our
goal is 99.999 percent uptime. User trust has gone way up as a result.
Team members have improved their problem-solving skills immensely. They
are resisting the impulse to jump to the easiest or most obvious conclusion. They instead
consider the possible root causes. The result is that we are solving user problems twice
as fast now compared to 1999.
The positive impact on employee turnover has been amazing. We went from
close to 50 percent annual turnover to less than 5 percent. This has had a huge impact on
the cohesion of the team and on our overall productivity. Time lost through illness is
also down significantly.
We have become proactive professionals rather than predominantly
reactive technicians. CompTIA A+ and Network+ certification supported this. Training for
the certifications help us organize and acquire the right kinds of knowledge.
Certification instilled pride and boosted confidence. We now have many examples of people
going above and beyond, where we did not before. It is truly wonderful to see and to
experience the impact on department level productivity and morale.
Others have recognized how far the team has come. In fiscal 2000,
roughly 70 percent of Baycrests annual capital budget was dedicated to upgrading IT
infrastructure the most ever committed at one time. We were told that this was a
direct result of the improvements we were making, the trust we were earning, and the
positive impact on operations. The upgrades solved many of the hardware and software
variation issues that existed at the start of the transformation.
Today, we are about to become a resource for other eldercare facilities
and extend the mission of Baycrest Centre. In an amazing turnabout, other healthcare
providers are sending benchmarking teams to Baycrest to see how we are performing this
magic. The road to transformation was not easy or straight. But the journey has been very
much worth it.
Stephen Tucker is Acting Director, Information Technology, Baycrest
Centre for Geriatric Care in Toronto.
Robotics, bar-coding used to improve patient safety with medication
By Dianne Daniel
Grand River Hospital is tackling the five rights of
medication administration head on ensuring the right drug in the right dose gets to
the right patient via the right route at the right time following the launch of an
automated drug dispensing system earlier this year.
Since mid-February, all units at the 500-bed facility in Kitchener,
Ont., have been receiving unit dose inpatient medications from a centralized robotic drug
distribution system and, according to director of pharmacy Cathy Kan, the roughly US$1
million investment in technology is actually quite affordable for the improvement in
quality its delivering.
People may tend to say, How can I afford it?, when really the
question is, How can I afford not to have it? says Kan.
In choosing the ROBOT-Rx system from McKesson Automation, represented
in Canada by Medis, Grand River becomes the second site in Canada to use the technology
since Torontos Sunnybrook & Womens College Health Sciences Centre brought
it onboard five years ago.
Whereas manual unit dose dispensing performed by human eyes and
human hands carries an average error rate of three in 1,000, the robot using
barcode reading technology improves that to one in 37 million, says Kan.
At Grand River, unit doses (enough medication for a 24-hour period per
patient) are barcoded and then picked by the robot, which receives a
computerized order and reads the barcoded information on the drug to ensure accuracy.
If a drug has expired, it will be rejected. Once picked, drugs are sent
to the appropriate floor of the hospital through a system of tubes (similar to those used
for cashier money drops by some retailers), capable of transporting three litre bags or
seven kilograms of medication. According to Kan, the picking time is four seconds and
average transport time is 23 seconds.
At Sunnybrook & Womens, the same robotic technology is used,
but instead of the tubes, drugs are placed in a special drug-dispensing cart that is then
taken to the various wards. The cart, standing about four feet high with a computer on
top, has drawers that will open to dispense a drug once a nurse enters the patient
information on the screen.
Though neither hospital has statistics to indicate the level of
medication error actually occurring at their facilities, both Kan and Sunnybrook &
Womens director of pharmacy Tom Paton, say recent evidence coming from the U.S. was
enough to prompt them to take action.
The most talked about statistic is one from the American Institute of
Medicine that indicates between 44,000 and 98,000 patients die each year as a result of
Approximately 7,000 of those deaths are the result of medication error,
says David U, president and CEO for the Canadian Institute for Safe Medication Practices
(ISMP), a non-profit, independent organization based in Richmond Hill, Ont., which
promotes the use of technology to reduce or prevent medication mistakes.
We extrapolate that to be about 700 deaths in Canada, says
U. We dont have any hard number to support that, but we will down the road.
Our focus isnt so much on the numbers, but more on the identified problem areas
were trying to address, he adds.
For example, research has shown that up to 49 percent of medication
errors actually occur at the ordering stage due to reasons such as illegibility,
incompleteness, or a lapse of clinical judgment, he says. The U.S. is responding by
legislating the use of computerized physician order entry software and U would like to see
a similar push for use of the technology in Canada, as well.
However, Ron Dunn, vice-president of McKesson Information
Solutions Canadian operations, sees a great deal of reluctance to adopt physician
order entry systems. In the U.S., most of the hospitals can compel the physicians to
adopt new technology because the physician is paid by the hospital. Canadas not the
same, he says. A lot of their reluctance over the past five years has been
because weve taken systems designed for other clinical people and tried to make them
applicable to the doctor. Frankly, that was the wrong approach and every vendor has had to
either re-engineer their products or design entirely new systems.
Such systems, like McKessons Horizon Expert Orders, can aid
physicians by supplying clinical decision support and evidence-based data by listing
potential drug orders after a specific condition is entered, along with patient
information such as latest laboratory values, radiology results or patient demographics,
to ensure the drug prescribed wont have an adverse effect on the patient.
Another area ISMP Canada would like to see addressed is the
administration phase the actual act of administering the drug to the patient
where studies have shown roughly 23 percent of errors take place. While robotic systems
help to ensure the right drug is selected, companion technology can be used on the nursing
floors to eliminate additional possibilities for error, says U.
Using handheld devices on a wireless network, for example, nurses could
take the drug picked by the robot, scan it, scan their hospital identification badge and
then scan the patient wristband all of which would be barcoded with pertinent
information that would then be fed to clinical software to ensure no errors are being
made. Grand River has set a goal to begin implementing such devices within 12 months,
while at Sunnybrook & Womens, Tom Paton would also like to follow suit.
This is where we start to piggyback on the notion that these
medications are barcoded, he explains. So you can use point-of-use scanning
devices that will check the package content to be sure its the drug you talked
about, scan the patient to be sure its the right patient and then scan the (nurse)
so theres a record of who gives the drug.
In the five years since implementing McKessons robot, Sunnybrook
& Womens has been pleased with its performance, says Paton. However, no studies
have been done to indicate whether or not fewer errors are being made. We went into
this with a view that it would be more efficient and that we could be spending
pharmacists time doing other functions that serve the patients better, he
In particular, the pharmacists role at Sunnybrook &
Womens has evolved into more of a cognitive one, including consulting with
physicians and nurses over the selection of a drug. They are also able to accomplish more
without hiring additional staff. I believe the acuity of care and the resource
intensity for patients has increased tremendously in the last three to four years,
says Paton. So, were able to do a little bit more with the same number of
staff, and I dont think we could get there without some of this high tech.
Right now, with only a handful of Canadian hospitals looking at
technology as a means to reduce and prevent medication error, two of the biggest
challenges are education and funding, says U. A lot of people would like to do
patient safety things, but they dont have the tools to allow them to systematically
implement some of these changes.
To help, ISMP Canada is providing self-assessment tools as well as tool
kits to assist in making changes, and has partnered with the federal government to help
get efforts under way. It has also created a Web-based system to facilitate the reporting
of medical errors in a culture of non-blame. The interest is there, but
unfortunately the dollar is not available yet, says U. Leaders need to take a
hold of the fact that this is not a small thing that the individual practitioner can do. I
think they need to recognize the priority of patient safety, promote it and genuinely work
towards some of these solutions.