Enabling Excellence in Equity Through An Integrated EMR Viola Zhou, Mir Ali, Callum Tyrrell* Scarborough Centre for Healthy Communities Issue Statement: SCHC is a community-based service organization and holistic primary care and community supports Hub. The diversity of programming has resulted in the emergence of two distinct portfolios (Clinical and Community Programs) with two separate electronic health platforms that do not speak to each other. Result: • Our clients and community members access multiple programs and services from both portfolios, often having to repeat information, staff having inaccurate/out of date information, and a lack of insight into other programs within the same agency that are being accessed or could be. Impact: • Fragmentation of continuity of care • Obstacles to optimal data quality • Information flow throughout the organization not following the client both within and beyond the organization. As the organization is continuously growing, this issue would only cause further fragmentation and silo’ed service delivery, and is already highlighted in client and staff stories and feedback as well as missed opportunities to integrate services at the strategic level. Innovation Journey into the Unknown: • Whilst there were several EHRs (Electronic Health Record) vendors on the market, none promoted capabilities to support the differentiated needs of community and clinical program nuances. • With the Alliance directive to migrate to Telus Health’s Practice Solutions Suite (PSS), an extensive exploration of its functionality, adaptability and net new tool creation potential, determined the decision to embark upon a journey to integrating community programs into PSS. The vision ultimately was to unify the organization and transform holistic care both within and beyond our walls.
How Might We … integrate highly nuanced Program areas into PSS?
From Meals on Wheels dietary requirements, Transportation services route creation, Hospice Palliative Care Volunteer Units of Service, Food, Furniture, Clothing Banks stats reporting to Invoice creation for clients for fee for services programs, SCHC and Telus built into the PSS Environment customized tools that could support these processes. Where routes were scheduled as a “provider” and Ageing Reports were created as relational data base pulls into J-Reports, the workflow changes were required in order to adapt to the new environment constraints
FROM THINKING OUTSIDE THE BOX TO ERADICATING THE BOX What Can Be Made Possible… in Our Interface with the EHR to optimize client care?
With new workflows and changes in staff understanding of how to interact with a new and different EHR, a significant amount of co-design was required. The process of creating Master schedules as recurring appointments with a standardized date to review them, helped prevent lapses in accidentally billing cancellations/no shows. Despite 17 distinct program areas, with multiple workflow requirements, only 2 custom forms were required to meet all their needs
FROM CHANGE MANAGEMENT TO CHANGE LEADERSHIP What If We Could… Streamline the Invoice Experience Across All Programs?
Billing clients in program areas with multiple different fee codes requires significant capabilities that PSS is not conventionally built for as it is not a billing system. By creating a billing extract tool building on the same codes as services an appointments, we manipulated the capacity of Relational Database Management queries to customize a J-Report to push out a customdesigned invoice layout and Ageing Report that fulfilled the same requirements
FROM IMPROVEMENT TO TRANSFORMATION How Are We Transforming… The future of Client Care?
* Primary Contact: Callum Tyrrell VP, Innovation, Improvement and Engagement ctyrrell@schcontario.ca
We have set our organization up for 45-plus programs that can support seamless centralized intake, internal referrals, cross-functional huddles with care team members that would not have previously known their client was accessing other programs from different portfolios. It has also enabled unified data visualization through Power BI and set us on a course to reach out to other partners to join us on a journey of truly holistically informed, and thus aware, care.