Not too long ago, Runnymede Healthcare Centre in Ontario, Canada, used to be a completely paper-based health system, which made it difficult for patients and physicians to seamlessly navigate the organization.

THE PROBLEM

One of the organization's biggest problems was a lack of access to actionable, real-time patient data, which made it challenging for staff to make prompt, informed decisions and easily communicate across the care continuum. 

In addition, a lack of medication automation and distribution made processes arduous and had the potential to lead to medication errors.

PROPOSAL

Runnymede decided to partner with Humber River Hospital (HRH) to implement Meditech Expanse.

"Our goal in partnering with HRH on a single electronic health record was to streamline care delivery, automate clinical processes, put patients at the center of all interactions, and improve community health outcomes as well as the patient experience," said Kevin Fernandes, chief technology officer at Humber River Hospital and Runnymede Healthcare Centre.

Humber River Hospital proposed a partnership that would take Runnymede from a completely paper-based system to a fully electronic health record in an accelerated time frame. This would not only solve Runnymede's issue with a lack of interoperability and automation, but also meet the government of Ontario's vision for a connected and sustainable health system.

"The proposal was appealing to us, because we saw how Meditech's technology was helping to drive HRH's success, as it enabled physicians at the hospital to see patient data in real time and make decisions efficiently," Fernandes said. "Additional major attractors for the partnership included having access to full lab services from HRH, which would enable us to automate and expedite our lab processes."

With the new EHR, physicians and clinicians have access to data in real time so they can make effective medical decisions, focus more time on patients, foster engagement and build better partnerships with the community, he added. All of these help contribute to good patient outcomes, he said.

MARKETPLACE

There are many vendors with electronic health records systems on the health IT market, including Allscripts, athenahealth, Cerner, DrChrono, eClinicalWorks, Epic, Greenway Health, HCS, Meditech and NextGen Healthcare.

MEETING THE CHALLENGE

Humber River Hospital worked closely with Meditech and third-party medical-device vendors to develop, design and architect the solution for interoperability between both health systems.

"The collaborative effort brought Runnymede live on Meditech Expanse within just eight months," Fernandes recalled. "In this time frame, we implemented many modules and components of the EHR – including patient registration and admissions, nursing and physician documentation, computerized physician order entry, inter-professional documentation, bedside verification, and total pharmacy modifications – resulting in a massive reduction in errors."

Runnymede worked with Meditech, Swisslog Pharmacy and Pyxis Medication Distributing Units to implement a closed-loop medication ordering process at the organization. Closed-loop medication enables orders to be sent directly from the EHR to the central pharmacy, where a robotic system picks, packages and labels medications with bar codes for bedside administration.

Other components of the EHR that Runnymede is using include Nuance voice dictation for physicians and Meditech's Accounts Payable and General Ledger for financials.

RESULTS

The major result Runnymede has noticed since implementing Expanse is a reduction in medication errors. Since automating charting at the bedside, Runnymede has brought medication errors down to zero.

In addition, the new medication management system allows Runnymede to maintain total accountability for medication inventory, which keeps it from purchasing unnecessary medications.

"We've also taken the existing Humber River Hospital total lab automation process and integrated it with Runnymede's access to the EHR," Fernandes explained. "Now, Runnymede sends its specimens to HRH, as the two hospitals are less than 10 kilometers apart, to eliminate the need for a third-party lab service. Results are available within just one to two hours, as opposed to up to three days using the outsourced lab."

Having an automated clinical decision support system has enabled Runnymede to maximize patient safety because it helps to eliminate errors and omissions while simultaneously streamlining physician workflows. With the CDSS, Runnymede clinicians can stay engaged, even while placing orders or documenting.

ADVICE FOR OTHERS

"Collaboration between health systems is a good thing," Fernandes advised. "Partnering with Humber River Hospital to extend their EHR license was a huge reduction in costs for us, because we could implement advanced clinical processes without having to reinvent the wheel.

"This kind of arrangement really benefits smaller hospitals like Runnymede, which may not have access to the same resources or personnel as larger organizations," he continued. "When Runnymede decided to partner with HRH, we inherited all of HRH's best practices, which saved us a lot of time. There was also an exceptional change management process, which made it possible for all staff within the organization to complete training within 60 days."

By partnering to share a single EHR with another healthcare organization, as well as leveraging their clinical expertise and harnessing their strengths with the technology, healthcare providers can enhance care while maximizing the healthcare options for patients within their community, he concluded.

Twitter: @SiwickiHealthIT
Email the writer: bsiwicki@himss.org
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