Nova Scotia Health Authority - June 2022

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DIGITAL REPORT 2021

DIGITAL REPORT 2022

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COLLABORATE TO DIGITALLY TRANSFORM HEALTHCARE

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Nova Scotia Health teams up with EY to create better healthcare solutions

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anadian healthcare provider Nova Scotia Health has been working closely with leading global consulting firm, EY, to use data and insights to better serve its clientele. “We’ve been working collaboratively with Nova Scotia Health, supporting them through their ambitious digital transformation agenda,” says Steven Maynard, EY Canada Government & Public Sector Consulting Leader. “Having worked with others on similar journeys, both across Canada and around the world, we know how increasingly important data – and making insights consumable to clinicians – has become to improving overall outcomes in healthcare.” In addition to its digital transformation, the organisation has restructured to evolve over the years. Prior to 2015, it was composed of nine separate district health authorities. “Nova Scotia Health is now the single provincial health authority covering the entire population of the province,” says Matthew Murphy, Senior Director, Strategy and Performance and Chief Data Officer at Nova Scotia Health. “We provide care across the entire spectrum from public and primary health care to acute care, as well as long-term and continuing care.” Unlike other for-profit public healthcare systems around the world, Canadian healthcare operates under a single-payer, publicly-funded system, with each province administering healthcare in alignment with the Canadian Health Act, and Nova Scotia Health is no different. nshealth.ca

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“We have the benefit of administering the entire spectrum and that really comes into play when we start looking at how we plan services and deliver care to meet the needs of the population,” says Murphy. “We use analytics to support that delivery of care because it gives us access to information across the entire patient journey.” Ambitious healthcare goals Nova Scotia Health has a broad purview when it comes to healthcare operations in the region. Due to this positioning, the organisation is able to map a patient's experience from beginning to end to best understand the resources and interventions needed along the way. “Understanding what has happened in the past and using that to plan for the future helps us identify where new innovative technologies or approaches might be able to be leveraged in something like virtual care,” continues Murphy. As part of the journey-mapping process, Nova Scotia Health recognised that, across the province, not everybody had equal or equitable access to services. “One of the core focuses in the last couple of years has been to team up with different organisations or consultancies, like EY, to leverage their expertise in priority areas that Nova Scotia Health is driving toward but lacks the bench strength to fully deliver,” says Murphy. “We work really closely with our analytics team and have scientists and some of our own people focused on evaluation, but we do everything in partnership, which is, I think, quite different from other organisations,” says Dr. Gail Tomblin Murphy, Vice President of Research, Innovation and Discovery, and Chief Nurse Executive at Nova Scotia Health. 6

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Backed by over 300,000 people around the globe and a purpose to build a better working world, EY Canada’s Government and Public Sector practice focuses on helping governments and public sector organisations, like Nova Scotia Health, create new ways of working to achieve better outcomes for its citizens and better experiences for its teams. “Our work with Nova Scotia Health has been in support of its vision to improve and deliver personalised healthcare services to the residents of Nova Scotia,” says Maynard.


Title of the video Nova Scotia Health uses AI & analytics to improve healthcare

“ We knew that we needed the end goal to be using real-time data. We simply didn't have the technical competency to get there” MATTHEW MURPHY

CDO AND SENIOR DIRECTOR OF STRATEGY & PERFORMANCE, NOVA SCOTIA HEALTH

“We brought deep expertise and an understanding of the business of healthcare to help identify the big questions and advise on solutions that break through technical issues to deliver quality and value for key stakeholders.” Evolving the digital landscape The digital transformation of Nova Scotia Health was catapulted forward by the pandemic, which identified areas of vulnerability across the province’s healthcare system. nshealth.ca

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EXECUTIVE BIOS MATTHEW MURPHY TITLE: CHIEF DATA OFFICER AND SENIOR DIRECTOR OF STRATEGY & PERFORMANCE COMPANY: NOVA SCOTIA HEALTH Matthew Murphy is the Chief Data Officer and Senior Director of Strategy and Performance at Nova Scotia Health Authority and has 15 years of healthcare experience. He is the first one to have a tenure as chief in the data realm for the organisation. Prior to his current position, he worked in quality, risk and analytics with his background in research.

STEVEN MAYNARD TITLE: MANAGING PARTNER, GOVERNMENT & PUBLIC SECTOR CONSULTING COMPANY: EY Steven Maynard is EY Canada’s Government & Public Sector Consulting Leader based in Halifax, Nova Scotia. In his role, Steven empowers clients to evolve for the future through enterprise-wide technology programmes and modernisation initiatives. By bridging large-scale tech platforms with human-centred design, Steven and the EY Canada team help government and public sector organisations deliver better outcomes for Canadians.

DR. GAIL TOMBLIN MURPHY TITLE: CNE AND VP OF RESEARCH, INNOVATION & DISCOVERY COMPANY: NOVA SCOTIA HEALTH Dr. Gail Tomblin Murphy is the Vice President of Research, Innovation and Discovery, and Chief Nurse Executive at Nova Scotia Health. She is an internationally recognised expert in how population needs-based approaches to health systems strengthen workforce planning, evaluation, capacity-building, and research. Gail is a champion of innovation in healthcare, leading teams and partners to seek creative solutions to provide high quality and timely access to care for Nova Scotians.


“A year ago, we saw an increase in the number of people in Nova Scotia who did not have a primary care provider,” says Tomblin Murphy. “We were asked to come up with an innovative solution to link each unattached Nova Scotian with access to care. So we launched VirtualCareNS.” The organisation then went through a diligence process, looking at approximately 50 companies offering virtual platforms before selecting a provider. Today, patients can get same-day medical advice via their tablet, computer, or smartphone.

Integrated view for clinicians “Nova Scotians were sent emails encouraging them to participate and access care through VirtualCareNS. Once registered, they've been able to speak with a family doctor or nurse practitioner for health care advice, have prescriptions renewed, or get referrals as needed,” says Tomblin Murphy. “We started in two areas of the province that had the highest number of people on the registry of patients without a provider. And then, because it was becoming very successful, very fast, we were asked to scale it quickly, province-wide.” nshealth.ca

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How do you care for today while building health care for tomorrow? Health care transformation will be built on innovation and interconnected ecosystems that work in concert to make health care simpler and more seamless for all. Learn more: Health – Our latest thinking | EY Canada


HOW EY IS MAKING PUBLIC HEALTHCARE FUTUREPROOF Effective public health care is the backbone of our civilization — and it’s under threat. Global consultancy firm EY is at the heart of strategies to bring health care into the digital age. Its work in Canada is proving to be a blueprint for global change. Digital integration and the technology driving it are the key to ensuring health care has a future. As the Health Care team at EY explains, it is bringing together central government funding, corporate providers and passionate health care professionals to ensure public health care is available and effective for all. John Bethel heads up EY’s Health Care team in Canada. He says EY is striving to transform the system into a different way of caring for people. “Care is getting more personalised through greater digitization,” he says. “This digital migration is moving many health care functions out of the hospitals, enabling hospital systems to focus on more complex care.” Bethel says health systems — much like banking, retail, travel and just about everything else in today’s world — face the same expectations from their user to engage quickly and seamlessly and to provide digital conveniences like scheduling appointments and sharing personal health data with physicians. Technology has also created a huge opportunity for building new capacity.

“People are living longer, but also facing more complex health issues” Bethel says. “This means the health care systems are dealing with far more comorbidity issues alongside the growth of conditions associated with aging, such as dementia.” This mixture of pressures on the system is creating a “convergence” in health care according to Bethel. “We are now seeing all kinds of ‘non-industry’ players enter our system and become part of the health care offering. It is technology that’s made this possible.” Finally, Bethel says the big game-changer was the pandemic. ”COVID forced us to change the way we deliver care overnight.” Vinna Vong, senior manager in EY’s Technology Transformation and national Health Care practice, says none of this matters if the public doesn’t trust the services on offer. ”To implement and deploy technology, AI and machine learning in a way that is effective and efficient, you must have trust at the core.” Anand Shah is a partner in EY’s Health Care practice based in Toronto. He says the way EY is collecting and analyzing vast amounts of data is providing the fuel to drive change. “Smart analytics is enabling health care to apply data in different and effective ways,” he says. “We can use data to define and hone true population health management to truly understand what our populations need and therefore to shape our services in a more proactive and sustainable way.”

Learn more


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Enhanced use of analytics The rapid onboarding of so many new patients to the virtual platform, however, would not have been possible without analytics to help understand and predict use rates. “It's really important to understand when, how many, and what type of patient or person is going to need and use the service,” explains Murphy. “Only then can we develop a human resource strategy to meet the need efficiently and sustainably.” Speeding up and adapting But despite the rapid uptake and progress experienced, the journey is far from over. Murphy and his team see lurking issues, including the overall speed of the reporting service. “The last few years, we've gone from three months to four hours for reporting. So there has been remarkable improvement, but with that, comes remarkable expectations and four hours was suddenly not quick enough,” he says.

“We knew where our databases were, but we didn't have the technical capacity to shrink that run time. We also knew what we would be able to do with real-time data. We simply didn't have the ability in-house to get there quickly enough; hiring new staff with the core competencies would take too long.” Based on previous experience with EY Canada over the years, Nova Scotia Health knew they’d be able to sit down and sketch out a solution together. Murphy and his team worked alongside EY Canada’s

Nova Scotia Health & EY: AI analytics to improve healthcare

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“ We bring the capabilities to breakthrough technical problems. And at the same time, we bring a very strong understanding of the business of healthcare” STEVEN MAYNARD MANAGING PARTNER, GOVERNMENT & PUBLIC SECTOR CONSULTING, EY

technical teams to re-code the system and shrink run time from hours to minutes. In addition, by working closely with EY Canada, Nova Scotia Health has been able to capitalise on data assets that were previously unavailable, including those around its human capital analytics. “Within Canadian healthcare, as with other healthcare jurisdictions around the world, the compensation for our workforce accounts for anywhere from 60 to 80% of our budget and, within Nova Scotia, it's worth noting that the budget is over US$2bn,” says Murphy. “Until recently, we didn’t have access to a harmonised dataset covering both financial and human resources.” Together, EY Canada and Nova Scotia Health have brought about the creation of this new data mart that would reconcile these existing systems. Real-time insights According to Maynard, real-time data insights are critical for any industry. They help identify efficiencies and redundancies, manage costs, deliver better, more timely immediate and follow-up care with fewer mistakes, while presenting a more integrated patient journey map across care environments and practitioners. But, based on EY’s global experience, real-time data is a challenge for many healthcare organisations, due to significant legacy systems that exist within them. “The good news is there has been breakthrough capability through cloud computing and advanced technologies to be able to deliver integrated data without making a significant investment in re-platforming whole new systems.” During the pandemic, Nova Scotia Health and EY Canada tackled the unprecedented problems that arose, from automation nshealth.ca

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“ We do everything in partnership, which is, I think, quite different from other organisations” DR. GAIL TOMBLIN MURPHY

CNE AND VP OF RESEARCH, INNOVATION AND DISCOVERY NOVA SCOTIA HEALTH

to workforce, resulting in new insights that allow them to understand not simply where they're spending money, but the driving reasons behind it. “We learned significant lessons throughout the course of the pandemic,” says Murphy. “The last two years have been really difficult in healthcare with respect to the workforce. Understanding where we have potential gaps is essential to ensuring we have a sustainable system into the future.” “The pandemic and the stresses it placed on healthcare organisations around the world created a massive capacity crunch, yet the business of healthcare had to go on. Robotics process automation was a really useful tool to help deliver the business of healthcare and maintain core operations while many of the staff had been redirected to emergency operations,” says Maynard. During these challenging times, the EY Canada team helped deliver intelligent automation solutions that leveraged machine learning and artificial intelligence capabilities to enable the system to quickly learn and adapt to the environment, acting as essential support for a key component of the business. “That was a significant shift for us from an innovation perspective – to realise or address how we can keep providing services when 14

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the traditional mechanism of service delivery has been disrupted,” Murphy adds. “Again, the answer was wholesale digital transformation across the system.” Thanks to its work with EY Canada, Nova Scotia Health has a clear vision of where it wants to be in the next five to 10 years. “Historically, organisations have thought about private industry as funders,” says Tomblin Murphy. “We truly believe that private industry are partners, and so we engage them often. They're really important to the work that we are doing.” To deliver on Nova Scotia Health’s longer-term vision, there will be significant investments throughout the transformation roadmap – from new clinical information systems to cloud computing capabilities, as well as new techniques to help produce insights and help clinicians and other organisational leaders utilise new innovations. And, as the institution refocuses on how to provide better care for its residents, Murphy explains, it also aims to revamp the workplace to be more engaging and provide growth and opportunities for its employees and volunteers. “It's not about using technology to eliminate positions. New technologies are faster and more efficient, often eliminating more tedious, manual processes and freeing up our workforce to do what they do best: practising the art and science of healthcare.”

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90 Lovett Lake Ct Suite 201 Halifax NS B3S 1B8 Canada T +1-844-491-5890 nshealth.ca

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