Nova Scotia Health provides healthcare to the Atlantic Canadian province and an array of specialized services to the Maritimers who live there. The health system operates hospitals, health centers and community-based programs across the province. Its team of more than 30,000 includes employees, doctors, researchers and volunteers.

THE PROBLEM

When COVID-19 reached the province in March 2020, leaders at Nova Scotia Health recognized contacting patients with test results would be a human resource challenge. As testing ramped up, more than 60 of the health system's public health staff were delivering test results by phone to more than 40,000 Nova Scotians. Most results were delivered within a 48-72 hour time frame – an unsustainable pace with the potential to overwhelm staff.

Recognizing that challenge, people in leadership began considering ways to notify patients with negative test results via email to save the staff time. They turned to the information management and technology team (IM/IT) to develop a solution to notify automatically by email those who tested negative for COVID-19.

"A system-wide effort across leading stakeholders sought to create an improved notification system to communicate COVID-19 testing results in order to optimize resource utilization," said Andrew Nemirovsky, RN, senior director of Nova Scotia Health IM/IT and CIO of the provincial health authority.

"In collaboration with vendor Lyniate, the Nova Scotia Health IM/IT and public health teams, in partnership with the province's Department of Health and Wellness and the Department of Service Nova Scotia and Internal Services, we created a secure, in-house notification application to reach out to those who tested negative for COVID-19."

PROPOSAL

The technology solution, Lyniate Corepoint, would enable the Nova Scotia Health lab information system and patient registration systems to talk to each other.

"This would allow patients with negative COVID-19 results to receive an email to access their results rather than public health employees having to call patients with their results," Nemirovsky explained. "Patients could still choose to have someone from public health call them with their negative results rather than receive an email."

MEETING THE CHALLENGE

The negative COVID-19 test-result technology solution produces and sends an email with a unique link for patients to view their negative results by entering the last four digits of their provincial health card number.

The application combines data from two different systems (registration system and lab information system) to identify which patients should receive an email notification of their results.

RESULTS

The solution went live in June 2020, and now in the majority of cases patients are receiving negative test results within a day, where results prior to this technology would have taken two to three business days. A decrease in wait times provides patients and their families peace of mind sooner, reducing overall stress and anxiety, Nemirovsky said.

"Since the launch of the COVID Negative Results application in June 2020, 248,819 emails have been sent to Nova Scotia residents to go to the website, and 189,124 have accessed that link. That's 248,819 phone calls that public health staff didn't have to make," he noted. 

"Estimating that each phone call or voicemail to deliver a negative test result takes an average of 2.5 minutes, the solution is estimated to have saved staff 10,367.5 hours from June 2020 through April 2021.

"The staff time saved achieved an approximate savings of $311,025 CDN for Nova Scotia Health," he continued. "This also builds capacity for public health team members to work at their full scope of practice, allowing them more time to assist local communities, schools and groups in responding to COVID-19, as well as supporting local vaccine clinics."

Nova Scotia Health and its partners received a 2020 UNIVANTS of Healthcare Excellence Award in recognition of their innovative best practice. The global awards program, created by Abbott and led in partnership with other healthcare organizations and societies, celebrates healthcare excellence.

ADVICE FOR OTHERS

"Consistent engagement with our partners throughout development of this application was critical to its success," Nemirovsky advised. "One of the more challenging aspects of this process was ensuring we were listening to – and addressing – the various needs of all our partners.

"Each stakeholder came to the table with different perspectives on how to ensure patient and data security," he added. "In the end, the various stakeholders, including the lab, public health, privacy, cybersecurity and risk management, the Department of Health and Wellness, the Department of Service Nova Scotia/Internal Services, the premier's office, and the chief medical officer, all provided valuable input in a condensed period of time."

Frequent reviews with the key stakeholders were held throughout the project to ensure all would be able to deliver the appropriate solution that met all stakeholder requirements. Their participation was fundamental to ensuring the design and development of the application met the needs and requirements of all involved, Nemirovsky said. It allowed for the team to fast-track decisions, to be adaptable to changes required and to work collaboratively.

"Utilizing the rapid application development/joint application development approach and engaging all stakeholder groups in the design and development of the application were key contributors to the success of the project," Nemirovsky said. "Traditional development life cycles – for example, requirements development, testing, etc. – would not have enabled us to be as agile and would have taken longer to complete.

"It also became apparent through this initiative that organizations and teams do not need to be limited to utilizing out-of-the-box software," he concluded.

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