- Background: Capital Health is one of Canada’s largest integrated academic health regions, providing complete healthcare to central and northern Albertans.
- Challenge: Consolidate 14 disparate patient data silos to provide a complete patient view through a new electronic health record, netCARE.
- Solution: Data integration and remediation using Initiate software and QUOVADX™ integration technology.
- Results: Five million records from 1.8 million patients are stored in and ready for instant retrieval from the Initiate software. netCARE provides real-time, 24/7 patient information to 2,300 users through a secure Web portal.
When the 1.8 million residents of the central and northern regions of the Canadian province of Alberta need high quality healthcare, they turn to Capital Health, one of Canada’s largest integrated academic health regions. Capital Health’s comprehensive healthcare offerings include specialized services, such as trauma and burn treatment, organ transplants and high-risk obstetrics. Headquartered in Edmonton, the organization operates facilities in Edmonton, Fort Saskatchewan, Leduc, Spruce Grove and St. Albert, and the counties of Leduc, Parkland, Strathcona and Sturgeon, as well as the town of Devon and communities in the eastern part of Yellowhead County.
Seeking relief from inefficient data sharing
Blueprint for a Nationwide Master Person Index
Serving a large geographic region, Capital Health was challenged to manage 14 disparate silos of clinical data for its patients across its wide network of facilities. Each Capital Health facility had its own electronic data repository, which worked well only if a patient was treated on a repeat basis at that specific location. If the same patient was brought in for emergency care at a Capital Health facility in a different city, clinicians at that facility had to call or request a faxed copy of the patient’s records from the other hospital. In addition, registration personnel asked the patient the same demographic related information and recorded the answers into their own patient information system, many times creating a duplicate record that did not reflect the patient’s complete history of treatment.
“A physician could not look across the continuum of care and get a patient-centric view,” says Corinne Blair, EMPI Project Lead, Electronic Health Record Project, Capital Health. “We knew that the first step in getting to that stage was to consolidate all of our silos of data, clean up the duplicates and establish a robust, enterprise-wide EMPI.”
To overcome its challenges, Capital Health’s vision was to create an enterprise-wide electronic health record system by consolidating the data silos and empowering clinicians and registration personnel. By using its existing information systems to accelerate and facilitate the sharing of critical patient data, Capital Health could provide improved patient care.
“Early on, we realized that integration of our existing systems, in combination with the EMPI, had to be a key component of our electronic health records strategy,” Blair continues. “Our requirements were robust. We needed tools that could deliver active and passive EMPI in a Web environment, plus a flexible data model and a sophisticated search algorithm and matching algorithm. Our goal was to establish one enterprise wide ‘source of truth’ for patient identification and demographics. We knew we had to improve data accuracy, eliminate duplicates, and make the registration process more efficient, all while managing patient confidentiality.”
Initiate software: strong medicine for linking disparate data sources
In January 2003, after a rigorous selection process that included input from the region’s physicians and nurses, Capital Health engaged Central Station, a consortium of five computer system companies from Canada, the United States, and New Zealand, to implement the organization’s new netCARE electronic health record system. Central Station organizations include Sierra Systems, Orion International, Quovadx, Oracle, and Hewlett-Packard. Colorado-based Quovadx delivered core technology for netCARE, including Initiate software for EMPI and additional software and services to integrate Capital Health’s multiple health information systems.
Central Station began the design and development of netCARE in June 2003 and a successful pilot project involving the lab component of the system was completed by September 2003. In October, Capital Health implemented the first phase of its passive-mode EMPI. After additional pilots at 10 Capital Health sites were completed in February 2004, the organization launched the enterprise-wide rollout of netCARE in April 2004.
“Initiate software is the critically important foundation of Capital Health’s netCARE electronic health records strategy,” Blair says. “Data from the central EMPI gives our clinicians an immediate patient-centric view across the entire Capital Health region. They can share patient information instantly, without waiting for a return phone call or fax. It also makes the registration process more efficient and patient-friendly.”
Approximately 13,000 patient transactions are added to the Initiate software daily through Cloverleaf® Integration Services from Quovadx, and the patient records are instantly updated and made readily available in netCARE as soon as the new information is entered. Lab data, admission and discharge records, as well as demographic information is always available and can be shared in real time throughout the Capital Health enterprise. Other available information that is key to immediate and informed patient care includes demographic information, such as name, address, birth date, health care ID number, operative reports, discharge summaries, diagnostic reports, lab test results, event history, as well as medications taken and indications of allergies to specific drugs from Alberta Health and Wellness’ Pharmacy Information System (P.I.N.).
Capital Health audits access to netCARE on a regular basis and can detect attempts at unauthorized access, so information in the Initiate software and netCARE always remains secure. Confidentiality is maintained at several levels of access depending on job function, a capability supported by the EMPI.
Fast relief from time-consuming data accessibility and retrieval
The physicians and other clinical staff using netCARE aren’t acutely aware of the behind the scenes EMPI, however, they do agree that with complete and accurate patient-centric views, they are better able to deliver clinical care. “Feedback from our doctors and nurses is very positive,” Blair says. “They’re impressed with the sub-second response time and accuracy of netCARE that lets them have patient information at their fingertips, whether they’re in an emergency room, or in an acute care ward with an unconscious patient who can’t tell them about his medical history or drug allergies. It’s extremely valuable for the clinical staff to have instant access to all of the information they need to make an informed diagnosis and act on it quickly, regardless of which Capital Health facility the patient has gone to for treatment.”
Capital Health’s registration personnel also experienced tangible benefits, saving time and increasing efficiency, according to Blair. Now, instead of asking the same demographic questions and typing in the answers, registration clerks first check to see if the patient is already in the EMPI. This formerly time-consuming task is now performed with a few keystrokes and the clerk receives an immediate response from the Initiate software. If the patient’s record exists, the clerk needs only to have the patient validate the information, thus speeding up the admitting process and making it more patient-friendly. In addition, the average number of duplicate records created per month has been reduced by more than 95%.
Integrating Patient Medical Records in Pursuit of the EMR
Today, Capital Health’s patients continue to be impressed by the streamlined service and improved care they receive at Capital Health facilities throughout the region. “The Initiate software’s support of our portal environment, especially the robust search and selection capability at the point of registration, is a huge benefit for us and our patients,” Blair says. “Most of all, we have achieved the patient-centric view that was at the core of our vision of netCARE. Clinicians across our region can easily get an enterprise view of each patient with the most current clinical information and demographics, including emergency contact and name of the family physician. They now have access to more accurate patient information that is critical for a clinician to have at their fingertips when evaluating potentially life-or-death treatment decisions.”