Longwoods Blog

Re: “Apples Or Blackberrys Clinical Use and Evaluation of The iPhone Platform in a Blackberry-dominated Hospital Environment” By Sherman Quan Et Al., Electronichealthcare, Vol. 9 No. 1, 2010

Published: Sunday December 12th 11PM

Link: http://www.longwoods.com/content/22068

Description: Re: “Apples or BlackBerrys Clinical Use and Evaluation of the iPhone Platform in a BlackBerry-Dominated Hospital Environment” by Sherman Quan et al., ElectronicHealthcare, Vol. 9 No. 1, 2010 read more »

Smart Card Technology: The Cornerstone of The Application of Health Information Technology in Lombardy, Italy

Published: Friday September 24th 11PM

Link: http://www.longwoods.com/content/21947

Description: The diffusion of smart cards within the health field is common in many countries and regions throughout the world. Italy’s Regione Lombardia enjoys one of the more successful applications of health information technology in Europe, and the current state of its accomplishments is examined in this article. Other European countries and regions are also using health smart card programs, and some are moving beyond using the card simply for health insurance. Programs in Andalucia, Austria, Belgium, Finland, France, Germany and Slovenia are reviewed here, too. read more »

An Exploratory Study To Examine The Use Of SNOMED CT in a Palliative Care Setting

Published: Sunday December 12th 11PM

Link: http://www.longwoods.com/content/22069

Description: This paper describes a one-year pilot implementation of SNOMED CT in a Canadian palliative care setting. There were three phases: The design phase involved the creation of a palliative SNOMED CT subset, a real-time encoding system and relevant evaluation metrics. The trial phase had clinicians use the system to create SNOMED-encoded consult letters. The evaluation phase involved clinician interviews, case analysis and system review to identify usage, issues, lessons and implications. The initial palliative SNOMED CT subset had 1,939 terms covering most palliative diagnoses and problems at referral. Six clinicians used the system for ten weeks to create 164 SNOMED-encoded consult letters, which were perceived as more legible, professional looking and shareable. When compared with 20 manually prepared consult letters, the SNOMED-encoded letters had a similar number of clinical terms but a higher degree of consistency with a smaller range of terms selected. All clinicians felt the system read more »

Disease Management and E-health: Can a Synergistic Partnership Measurement Strategy Magnify the Health and Economic Benefits of Each Care Model

Published: Sunday December 12th 11PM

Link: http://www.longwoods.com/content/22070

Description: As the future unfolds, two major issues are challenging the Canadian population: progressive aging and chronic ailing Montague et al. 2009 . The burden of managing these related challenges is complicated by an already-large investment of the national treasury in healthcare that is often perceived as returning less than optimal outcomes, at a cost that constrains investments in other areas of innovation necessary for society’s advance. Optimal return on healthcare investments demands a strategy that effectively and efficiently manages health and disease, particularly for older, community-based citizens with chronic illnesses. To this end, consensus has formed around partnerships of inter-professional and non-professional providers and patients, using regular measurement and feedback of data on gaps between usual and best care, to drive improvements in both clinical and economic outcomes. In this patient-centred health and disease management model, key drivers of success are clinical me read more »

Does E-health Adoption Enable Improved Health Outcomes Encouraging Evidence From Ontario Hospitals

Published: Sunday December 12th 11PM

Link: http://www.longwoods.com/content/22071

Description: To date, Canadian healthcare provider organizations, along with provincial and federal governments, have made significant financial commitments to e-health. The US government is providing billions of dollars to support the adoption of “meaningful use” of technology applications in that country’s hospitals and physician practices. Canadian public and political awareness of the potential role of information technology to improve healthcare is higher than it has ever been. The claims of e-health proponents are that the use of information technology to support clinical practice will positively impact health outcomes. read more »

Newfoundland And Labrador’s E-health Journey: Implementing Canada’s First Interoperable Provincial Electronic Health Record

Published: Sunday December 12th 11PM

Link: http://www.longwoods.com/content/22074

Description: The last eight years have been promising times for Newfoundland and Labrador’s NL e-health journey. Canada Health Infoway has identified the province as an emerging leader in developing an EHR. The province’s unique personal identifier could be replicated to other jurisdictions that are developing a Client Registry. To date, NL has implemented a Client Registry, Provider Registry, and all its diagnostic imaging/picture archiving and communications systems are linked to a single provincial system. As of late 2009, the Centre realized another important milestone when it executed on years of planning and development to begin deployment of the provincial drug information system – the Pharmacy Network. In the early years of the new millennium, the province’s efforts to lead Newfoundland and Labrador’s healthcare stakeholders, as well as the rest of Canada, can be seen in developing a fully functional interoperable EHR iEHR , integrating the foundational components of client and read more »

Realizing the Benefits of Standardized Measures of Clinical Outcomes

Published: Monday July 19th 11PM

Link: http://www.longwoods.com/content/21877

Description: Funded by the Ministry of Health and Long-Term Care MOHLTC , Ontario’s Health Outcomes for Better Information and Care HOBIC captures standardized patient outcome data related to nursing care in four sectors: acute care, long-term care, complex continuing care and home care. Implementation began in 2006, and by March 31, 2010, over 183 organizations in the province were collecting HOBIC measures and providing daily live feeds to the HOBIC database. The HOBIC database has two purposes. It provides ” aggregate data for researchers and decision-makers to use in examining clinical outcomes, and it gives clinicians access to individual clinical outcomes to use in planning for and evaluating care. Each participating site has access to its HOBIC data for conducting its own analysis. Furthermore, in light of the recent Excellent Care for All act in Ontario, these clinical outcomes provide the first consistently measured and documented set of metrics by which qua read more »

Computer-based Risk Assessment: Evaluating Use in Primary Care

Published: Thursday August 19th 11PM

Link: http://www.longwoods.com/content/21903

Description: Family physicians could enhance patient health through disease prevention by addressing individual’s health behaviours. With increasing interest in improving prevention activities and health information technologies, we developed a computer-based risk assessment tool to facilitate prevention counselling in primary care. Using a touch-screen computer, patients provide information regarding various risk behaviours, and the assessment tool generated a physician report for use during the patient’s visit. The main objective of this pilot study was to evaluate the process of implementing the assessment tool, using patient questionnaires as well as physician and clinic staff focus groups. The tool was found to be an easy and acceptable means for collecting and conveying information about patients’ health-related behaviours. Physicians found the information useful, and most clinics could integrate the tool into practice. Empirical evidence and users’ opinions are an important step toward optim read more »

How Much Does It Cost To Adopt an Electronic Medical Record Part 2 of 2: Financial Implications of Socio-technical Factors On Physician Office Productivity

Published: Monday July 19th 11PM

Link: http://www.longwoods.com/content/21878

Description: We conducted a series of interrelated studies to understand primary care physicians’ experience with adopting physician office systems. Physicians’ electronic medical record EMR adoption experience is affected by the degree to which physician office system functionality integrates with practice workflow. A financial analysis was used to quantify the socio-technical costs of adopting the EMR. The duration and cost of the adoption period depends on the fit between the physician office workflow and the physician office software. The type of implementation approach also has an effect on the adoption duration and cost. The socio-technical cost of the adoption can be calculated by examining the lost revenue due to reduced billings during the transition period. For practices that ultimately realize an increase in patient volumes, the payback period can be calculated by comparing any incremental increase in patient billings to the socio-technical cost. read more »

Key Cloud Computing Issues and Questions for the Health Industry

Published: Thursday August 12th 11PM

Link: http://www.longwoods.com/content/21894

Description: Early use of cloud computing is already transforming the nature of competition in commercial sectors see Amazon, Google and Facebook . In the next few years, health industry organizations will likely see similarly sweeping changes by leveraging cloud computing. Development of a health industry information ecosystem, centred on electronic health records located in highly secure cloud-based environments, is one major area of expected change. Increasing digitization of health information e.g., images, test results will be another likely outcome, as will the growing integration of mobile devices with cloud-based applications to support wellness programs and remote health monitoring. Cloud computing is too important to the future of any organization to be left entirely to its technologists. Decision-makers outside of IT organizations have important roles to play in making sure their organization achieves the desired benefits and reduces the risks of cloud computing. Among other issues, h read more »

Health PEI’s Vision: Completing the Island’s E-health Bridge to Healthcare Delivery Integration

Published: Tuesday September 14th 11PM

Link: http://www.longwoods.com/content/21924

Description: Branded as “One Island Community, One Island Future, One Island Health System,” the recently renewed primary care–focused vision for PEI’s integrated healthcare delivery requires changes in clinical practices across the island-wide continuum of services and facilities. Critical to effecting changes in the clinical environment is completion of the provincial interoperable electronic health record iEHR . The heart of the EHR is its Clinical Information System CIS , with the planned implementation to be completed in three phases. Health PEI will then implement an EMR solution in physician offices and integrate it with the Island’s hospitals. For Health PEI’s seven acute care facilities, the mean 2009 HIMSS Analytics EMRAM score was 2.0727. From the pan-Canadian perspective, Health PEI currently ranks fifth among 13 provinces and territories for mean EMRAM score. read more »

Apples or Blackberrys Clinical Use and Evaluation of The iPhone Platform in a Blackberry-dominated Hospital Environment

Published: Wednesday April 28th 11PM

Link: http://www.longwoods.com/content/21764

Description: The University Health Network equipped the Gastroenterology consult service with Apple iPhone devices and provided access to push e-mail, phone and Internet access to clinical content and applications. We used pre-post surveys to assess the iPhone’s impact on clinical communication, and we held interviews to obtain subjective user feedback, comparing it to prior experiences with Research In Motion RIM BlackBerrys where possible. The iPhone’s phone and e-mail capabilities improved team communication, allowing more efficient coordination of patient care. Compared with the BlackBerry, it was also the preferred personal device due to its touch screen navigation and breadth of applications available. However, users felt the BlackBerry was the more productive communication device, mainly due to its physical QWERTY keyboard. The mobile device market in healthcare continues to be competitive, and the vendor who can most effectively combine a good interface with long battery life and access t read more »

Is Business Intelligence Including Analytics Having an Impact on the Delivery of Care

Published: Monday June 7th 11PM

Link: http://www.longwoods.com/content/21767

Description: Organizations in industries outside healthcare have been able to demonstrate the successful application of Business Intelligence BI and analytical tools to gain a competitive advantage. Within the healthcare industry, organizations are successfully using BI and analytical tools to support their financial and operational functions. With the adoption of electronic health records and other investments in health information technology, there is potential for these tools to transform clinical care. This paper explores the degree to which BI and Analytics are having an impact on the delivery of care and presents some thoughts on where BI could have the greatest impact in the future. It also explores some of the challenges organizations are facing in maximizing return on these investments. read more »

The Emerging Role of Canada’s Health Professional Colleges in The Regulation of E-health Technologies

Published: Monday June 7th 11PM

Link: http://www.longwoods.com/content/21768

Description: In Canada, the majority of healthcare professionals are governed by independent, profession-specific Regulatory Colleges. These Colleges regulate the conduct and practice of physicians, nurses, pharmacists and other healthcare professionals by registering them, establishing standards of practice, administering quality assurance programs, investigating complaints and, where appropriate, taking disciplinary action. Professional Colleges are not responsible for regulating health-related technologies. However, many Colleges have recognized that certain technologies will dramatically change practice environments and have taken steps to ensure these technologies are used safely and ethically. This paper starts by providing a background on e-health technologies and an overview of their regulation in Canada. It then explores the emerging role of Professional Colleges in the regulation of e-health technologies by discussing specific examples from British Columbia, Alberta and Ontario. Strategie read more »

Why Does It Take So Long To Adopt an Emr Part 1 of 2: A Model of the Effects of Socio-technical Factors on Physician Office Productivity

Published: Wednesday April 28th 11PM

Link: http://www.longwoods.com/content/21728

Description: We sought to understand the drivers and influencers that affect the time needed to adopt a health information management system in primary care offices. The results from three independent but interrelated studies were crystallized to understand how socio-technical factors affect the adoption of physician office systems. The duration of the adoption period is affected by differences between the culture and workflow of a clinic and the workflow design of its health information management software. While customized software could make adoption seamless, the cost of such systems drives physician offices to select a commercial off-the-shelf system from a list of systems pre-qualified by the jurisdictional certification organization. Jurisdictional physician office certification programs maximize the fit between physician office and health information systems by selecting a wide range of solutions to fit different practice types. read more »

New Brunswick’s E-health Strategy and the Evolution of Regionalization

Published: Monday June 7th 11PM

Link: http://www.longwoods.com/content/21769

Description: New Brunswick’s E-health Strategy and the Evolution of Regionalization read more »

Evaluating the Value and Impact of an Electronic Health Record in a Complex Health System

Published: Tuesday March 30th 11PM

Link: http://www.longwoods.com/content/21655

Description: NetCARE is Canada’s first region-wide electronic health record EHR Hospital News 2004 . It is a clinical, web-based, view-only record of an individual’s key health information drawn from multiple sources. NetCARE is available in both hospital and community settings and is accessed by a variety of clinical users. A systematic evaluation showed that an average of 88 of respondents agreed or strongly agreed that netCARE provided valuable lab test results, event history, diagnostic imaging and transcribed reports. Seventy-six per cent indicated that it helped provide quality patient care, and 82 felt it integrated easily into their clinical workflow. A 15-fold increase in EHR use over two and a half years was accompanied by a 56 decrease in physician use of a major legacy system p=.004 and an average decrease of 24 in requests for paper-based records p=.03 . The average time for netCARE to decrease both legacy system use and patient-chart requests to desired levels was two years. read more »

Electronic Health Records: Examining Information Privacy

Published: Wednesday March 31st 11PM

Link: http://www.longwoods.com/content/21656

Description: Information governance considers the principles, processes and policies for protecting personal information and personal health information. In particular, information governance frameworks draw upon legal, “best practice” and quality requirements to ensure that personal information and personal health information is kept confidential and secure at all times. This article examines the role of information governance frameworks in electronic health record EHR systems by discussing four key factors of information governance. The authors draw on approaches to EHR information governance across Canada and define the components of information governance that provincial agencies should consider to appropriately implement and manage EHRs. read more »

An Evaluation of a Patient-Centred Information Technology Tool for the Management of Chronic Diseases by Primary Care Interdisciplinary Teams

Published: Wednesday March 31st 11PM

Link: http://www.longwoods.com/content/21657

Description: Introduction: Chronic disease management has become a major concern for healthcare systems in industrialized countries. There is a significant care gap between the best care, based on results from clinical trials, and usual care. Most patients with multiple chronic diseases are followed in primary care. Yet there are few tools to help primary care health professionals manage the complex care these patients require and even fewer systems that systematically assess the outcomes of care of these patients. The DaVinci system proposes a comprehensive clinical and technological approach to assist primary care interdisciplinary teams PCITs in the management of patients with multiple chronic problems. The project aims ultimately at improving the process of care as well as patients’ health outcomes, thus helping close the healthcare gap. Intervention: An IT-supported health-management system DaVinci system that gives timely, flexible access to many functionalities relevant to management of read more »

Improve Office Efficiency by Putting Your Patients to Work: Patients’ Perspectives Regarding Online Self-Service Appointment Scheduling in Family Practice Part 3 of 3

Published: Wednesday March 31st 11PM

Link: http://www.longwoods.com/content/21658

Description: This case study is the third part of a three-part study examining the impact of an online appointment scheduling system on physician office scheduling. The purpose of the study was to understand patients’ experiences when booking appointments through an online appointment scheduling system. A 24-question patient survey gathered perspectives from registered adult patients who had booked by either channel from August 8, 2008, to February 28, 2009. The online scheduling system was used by 128 unique patients, while 1,831 booked by telephone. Of the respondents, 186 were aware of the system but had not booked online, 107 were not aware of the system and 105 had booked online. Patients chose to book online for convenience, control and choice. Most patients found the online system to be as easy as booking by telephone, and all who booked online said they would do so again. Chi-square tests showed a dependent relationship between a patient’s likelihood of using an online scheduling system and read more »

Saskatchewan’s Strategy For Moving E-health Forward: Prepared To Implement Patient First Review Recommendations

Published: Wednesday March 31st 11PM

Link: http://www.longwoods.com/content/21659

Description: Saskatchewan’s Strategy for Moving e-Health Forward: Prepared to Implement Patient First Review Recommendations read more »

Improving Communication in Acute Trauma

Published: Wednesday March 17th 11PM

Link: http://www.longwoods.com/content/21201

Description: In 2008, approximately 4,500 people in Germany died in traffic accidents and around 71,000 people were badly injured. Altogether, yearly productivity loss caused by these injuries is estimated to be around 5 billion Euros. International and national studies revealed the trauma centre level of the primary hospital as the major predictor for trauma-related mortality. In 2006, the German Society for Trauma Surgery DGU called its members to form regionally based networks of hospitals engaged in trauma care. In April 2008, 45 hospitals in the north-west region of Germany, two hospitals from the Netherlands, and the local emergency services founded the “Trauma Network NorthWest TNNW .” The major goals of these networks are: 1 To shorten the time between accident and admission to the appropriate hospital, 2 to create effective ways of communication, and 3 to implement common pre- and in-hospital standards for trauma care. In order to improve acute trauma care, we looked read more »

Innovation in ALC Evaluation and Lessons Learned from a Pilot of Electronic Resource Matching and Referral to In-patient Rehab/CCC in an Acute Care Organization

Published: Wednesday March 17th 11PM

Link: http://www.longwoods.com/content/21172

Description: Introduction: One of the root causes for Emergency Department ED overcrowding stems from challenges with patient flow from acute to post-acute care institutions. Significant improvements to the referral process can be made by moving to an electronic Resource Matching and Referral RM&R system, which could be used to facilitate accessing accurate and consistent data relating to referral patterns, waitlists, response times, referral efficiencies, and gaps in programs/services. Objectives: To elicit user views, identify challenges, and measure acute care providers’ performance and satisfaction of the RM&R system for Rehabilitation and Complex Continuing Care. Setting: The General Internal Medicine ward at the Toronto General Hospital TGH , part of the University Health Network UHN , affiliated with the University of Toronto, Toronto, Canada. Method: This study included both quantitative and qualitative assessments of the electronic RM&R process. A random effec read more »

Improve Office Efficiency by Putting Your Patients to Work: The Financial Viability of an Online Self-service Appointment Scheduling System in Family Practice Part 2 of 3

Published: Wednesday March 17th 11PM

Link: http://www.longwoods.com/content/21202

Description: This case study is the second part of a three-part study examining the impact of an online appointment scheduling system on physician office scheduling. The purpose of this case study was to develop a method for determining the financial viability of the self-serve appointment scheduling system. Pay mechanisms for selling software were examined in other industries to offer insight into a financial model used to calculate viability. The analysis produced a financial model to help physicians determine if their practice would benefit from an online scheduling system. Viability was assessed first by ensuring the physician office is busy enough to justify the ongoing costs of system operation. The model then determined the period over which savings resulting from using the system will pay back capital costs. The model compared the costs avoided to the costs incurred in implementing the system. The main costs avoided by the system are receptionist’s pay. The financial model showed that an on read more »

The E-network Solution for Mental Health and Addictions Information Management

Published: Wednesday March 17th 11PM

Link: http://www.longwoods.com/content/21203

Description: ConnexOntario Health Services Information’s genesis was over 18 years ago. Back then, it was known as the Drug and Alcohol Registry of Treatment DART . At that time, it was – and remains today – an innovative initiative that acted as an e-network solution for mental health and addiction information management. Using state-of-the-art technology and professional information management standards, DART was designed to offer a form of electronic healthcare by way of resource matching and referral for those who were seeking treatment for substance abuse problems. DART was also designed as a means to help improve the alcohol and drug treatment system in Ontario by providing easily accessible, up-to-date and accurate data about the availability of those services. This paper explores the development and growth of DART through its metamorphosis into ConnexOntario. Acting as a hub to the electronic network, the computerized database housing the Registry information provides t read more »

Manitoba’s E-health Strategy: A High-tech Collaboration Between Primary and Acute Care

Published: Wednesday March 17th 11PM

Link: http://www.longwoods.com/content/21204

Description: Introduction Since 2007, Manitoba has been committed to a unified and comprehensive e-Health strategy that relies on information and communications technology ICT to enable a province-wide system of connected and effective healthcare delivery and management across the full continuum of healthcare settings. Originally, the provincial government invested 150 million CAD in healthcare ICT. Going forward, the province is planning for expenditures of up to 40 million annually to fund ongoing and new projects that, over time, flesh out the complete e-Health Strategy Province of Manitoba News Release 2007 . Like other provinces and territories, Manitoba is employing ICT to create a paperless and seamless unified healthcare system that connects all stakeholders and overcomes the silos of legacy healthcare information existing in a sea of paper. Manitoba’s e-Health approach is distinctive in that it combines a foundation of province-wide primary care delivery through collaboration with p read more »

Participatory Storytelling Online: A Complementary Model of Patient Satisfaction

Published: Friday August 14th 11PM

Link: http://www.longwoods.com/content/20991

Description: Measuring patient satisfaction is an important quality improvement technique. The World Wide Web offers new approaches to understanding patient satisfaction and stories about healthcare encounters. In this paper, we suggest that there is a wealth of patients’ stories being told online, in real-time, on social networking and on social rating Web sites. This patient-generated, publicly available information can complement existing patient satisfaction data and can provide insights into patients’ values, perspectives and expectations – and can suggest ways to improve the patient’s experience along the continuum of care. read more »

A Case Study Examining the Impacts of Conferencing Technologies in Distributed Healthcare Groups

Published: Wednesday October 14th 11PM

Link: http://www.longwoods.com/content/21141

Description: As healthcare groups continue to communicate and collaborate at a distance, information and communication technology ICT has come to play an increasingly important role in supporting such interactions. In this paper, we describe key lessons learned from a two-year case study 2004-2006 on the impacts of conferencing technologies on social interaction norms within knowledge exchange groups. read more »

Improve Office Efficiency By Putting Your Patients To Work: Workflow Implications of an Online Self-service Appointment Scheduling System In Family Practice – Part 1 of 3

Published: Monday September 14th 11PM

Link: http://www.longwoods.com/content/21052

Description: Many industries are decreasing overhead costs and providing more convenience by involving customers in service delivery. This case study is part one of a three-part study examining the impact of an online appointment scheduling system on a physician office’s scheduling. The purpose of the case study was to understand the impact of an online self-booking system on primary care physician office workflow. Conventional telephone and online appointment scheduling workflows were reviewed using process engineering techniques. Online appointment scheduling substantially reduced the receptionist’s role in the scheduling function, which freed receptionist resources for other tasks. Practices with predictable and repetitive scheduling workflows benefitted the most from such systems. Staff provided technical support to patients who called the office if they encountered technical issues. Explicit documentation was required to lead patients through the online booking process; otherwise, system benef read more »

Benefits Realization Framework For a Large Complex Health System

Published: Friday August 14th 11PM

Link: http://www.longwoods.com/content/21014

Description: Benefits Realization is a strategy for quality improvement used by the Alberta Health Services Information Technology Department. The approach is currently used within the enterprise-wide, ambulatory care IT initiative “eCLINICIAN.” By using Benefits Realization together with the implementation of eCLINICIAN-Scheduling, the University of Alberta, Division of Endocrinology and Metabolism eliminated 10 steps in the patient follow-up booking process. In addition, over 2,000 phone calls were saved per year, which translates to at least 170 hours of time that can be allocated to other priority tasks by the Division of Endocrinology staff. read more »

E-health Leads Nova Scotia’s Healthcare Transformation

Published: Wednesday October 14th 11PM

Link: http://www.longwoods.com/content/21142

Description: Introduction Nova Scotia’s healthcare policy direction seems well-defined and well-established for the foreseeable future. This is the case, despite the recent electoral transition from a Progressive Conservative to a New Democratic Party government for the first time in the province’s history; and despite the threat of the province’s net direct debt increasing through 2012, after eight years of declining net direct debt as a percentage of the province’s gross domestic product. As well, little public consideration is being given to disrupting the current regional healthcare organizational structure by further consolidating the province’s nine district health authorities DHA , as occurred last year in Alberta and New Brunswick. Moreover, the Health Information Technology Services Program of Nova Scotia HITS-NS , the province’s shared IT services or provincial service delivery organization, is steadily expanding the inventory of clinical, financial, and administrative software applicat read more »

A Review of General Practice System Certification Programs in Seven Countries and Five Canadian Provinces

Published: Sunday June 14th 11PM

Link: http://www.longwoods.com/content/20855

Description: Introduction: Health information technology can improve quality of care, reduce medical errors and increase health system efficiency. Certification programs facilitate adoption by regulating the general practice GP systems market against functionality and interoperability standards, thereby reducing liability risk due to functional deficiency. Purpose: In a previous international literature review, certifications claimed to facilitate procurement and mitigate financial, procurement and liability risk. The purpose of this review was to assess the effectiveness of certification programs in driving the adoption of GP systems. Methods: We completed a literature review of English-language, peer-reviewed and grey literature, government and organizational Websites, as well as trade press, general press, and online sources published from January 1, 2005 to October 2008. We qualified these findings by consulting key informants. Results: Four databases, 11 journal websites, 15 websites from gr read more »

Genomic Medicine in Healthcare – The Tip of the Iceberg

Published: Tuesday July 14th 11PM

Link: http://www.longwoods.com/content/20848

Description: The role of genomic medicine in healthcare is at the tip of the iceberg. Rapid advances in genomics, as demonstrated by the tangible use of gene diagnosis and targeted therapies indicate that the impact of genomics in healthcare is only going to increase. The debate is not “if genomic medicine will impact healthcare” as much as how rapidly it will impact healthcare. However, caution needs to be exercised with respect to three key enablers whose success is critical in order to fully harvest the potential of genomics and successfully integrate genomics in healthcare. These include genomic literacy, privacy and security and IT and the EHR. Health service organizations and healthcare leaders will play a pivotal role in this regard, by beginning to strategize and plan for how they will incorporate genomics into healthcare delivery. read more »

Leadership For The Information Age: The Time For Action Is Now

Published: Tuesday July 14th 11PM

Link: http://www.longwoods.com/content/20849

Description: Dr. Lynn Nagle, the senior nursing advisor for Canada Health Infoway, writes the column on nursing informatics for CJNL Canadian Journal of Nursing Leadership . She and I have both been involved in the development and now the implementation of HOBIC Health Outcomes for Better Information and Care , a province-wide initiative funded by the Ontario Ministry of Health and Long-Term Care: I am the executive lead and Lynn is the informatics lead. HOBIC seeks to bring online functionality to nurses that supports systematic assessment of patients on eight outcomes upon admission and discharge in acute care, chronic hospital care, long-term care and home care, and quarterly for people in residential settings. There is strong research evidence that nurses make a difference in how well patients do on these outcomes. Nurses can now access the results of their assessments online throughout a patient’s stay, compare them to other patients of similar age or gender and begin to set benchmarks for i read more »

Himss Analytics 2009 ICT Study: The State of E-health in British Columbia

Published: Tuesday July 14th 11PM

Link: http://www.longwoods.com/content/20886

Description: Introduction In recent years, rhetorical and real support for e-health innovation has grown in Canada and elsewhere. Increasingly, healthcare stakeholders are impressed by positive healthcare outcomes from advanced clinical applications and new technologies, including hand-held devices. A growing body of evidence is confirming that information technology IT implementations in clinical care produce substantial returns on hefty financial and manpower investments, sooner rather than later. Not only does the continuity and efficiency of healthcare improve, but – more importantly – patient outcomes and patient safety increase. However, harder realities underlying the current healthcare environment clash with the optimism of e-health rhetoric. Whether it will be feasible to sustain the momentum favouring ongoing IT improvements and investments in Canada and elsewhere depends on the consequences of powerful political, financial and cultural factors that are slowing down and even threatening read more »

The Implementation Of Operational Processes For The Alberta Electronic Health Record: Lessons For Electronic Medical Record Adoption In Primary Care

Published: Saturday March 14th 11PM

Link: http://www.longwoods.com/content/20570

Description: Rapid and foundational change is underway in health jurisdictions around the world as they adopt electronic medical records, interdisciplinary teams and jurisdictional electronic health records EHRs to mitigate the intense care needs and health risks brought on by an aging population. The Canadian province of Alberta is no exception. Alberta has encountered adverse events because of a lack of coordination in its EHR software operations. Alberta’s EHR implementation team adopted the Information Technology Infrastructure Library, which uses best practice concepts for managing information technology operations to mitigate such risks. The team has learnt several lessons that are applicable to the adoption of health information systems in other care domains. A cautious approach, using pilots, standards and input from non-physician clinical and administrative staff, facilitates system adoption. This paper illustrates the software operations issues encountered by the EHR implementation team read more »

Targeting Adoption, Training and Device Deployment Strategies

Published: Saturday March 14th 11PM

Link: http://www.longwoods.com/content/20651

Description: The disposition of end-user devices in healthcare environments is often an ad-hoc affair with assumptions being made regarding utility. Occasionally workflow analyses will identify the type and location of a device required. Post-activation workflow and device use analyses are rare. Following the activation of an Admission Discharge and Transfer ADT and results reporting system in a tertiary care institution, device use was examined over a six-month time frame by user, location and type of device. Devise utilization varied from unit to unit, by specialty and by occupation. A detailed analysis of devices on a medical ward also identified high and low use devices, as well as the occupation of the majority of users. This evaluation allowed the institution to modify device locations, identify readiness in individual units, focus training and super-user resources for future activations which will include computerized physician order entry and institute clinical adoption strategies. read more »

EHR Arithmetic: Extracting Positives From Negatives. The Santa Barbara County Care Data Exchange Project

Published: Saturday March 14th 11PM

Link: http://www.longwoods.com/content/20629

Description: US regional health information organizations or health information exchanges have received widespread scrutiny because their persistent efforts often display disappointing results. This case study is based on a literature review of one of the earliest and most comprehensive health information exchange initiatives in North America, the Santa Barbara County Care Data Exchange. This project was proposed in 1998, commenced in 1999 and terminated operations on December 31, 2006. The project was ultimately unsuccessful. However, numerous lessons were learned, a greater foundation of knowledge is emerging and opportunities exist to gain further knowledge from this failed project. read more »

HIMSS Analytics Column: Growing E-health Information Technology Partnership: Canadian Healthcare and HIMSS Analytics

Published: Tuesday April 14th 11PM

Link: http://www.longwoods.com/content/20668

Description: In the last year, several Canadian provinces have restructured healthcare delivery in ways that are intended, in large part, to enhance the role and responsibility of electronic health information technology IT in contributing to efficient and effective healthcare services. New Brunswick and Alberta have downsized the number of regional health authorities RHAs . British Columbia and New Brunswick have established shared services organizations for purchasing – and managing – a variety of IT services. Ontario has created an agency and chief executive officer of e-health to consolidate the province’s e-health programs and efforts. Driving these provincial ventures is the conviction that cost-effective economies of scale will increase opportunities for smart, province-wide investments in IT systems and services that improve patient outcomes and save lives. read more »

A Literature Review of Developments In Health Information Banks

Published: Tuesday April 14th 11PM

Link: http://www.longwoods.com/content/20601

Description: A health information bank HIB is an organization that allows consumers of health services to collect, store, control and share health information with members in their circle of care. The term was first coined by Bill Dodd in 1998, and was revisited by Prof. Denis Protti in 2008. A review of the literature reveals that the HIB approach is being actively studied. Trial projects are being funded by governments. Furthermore, laws to promote the safe implementation of HIBs are being enacted in the USA and Canada. Although there is a high expectation that improvements in health and wellness will be obtained through the use of HIBs, their long-term economic viability remains uncertain. read more »

The Impact Of Diagnostic Imaging Investments On The Canadian Healthcare System

Published: Tuesday April 14th 11PM

Link: http://www.longwoods.com/content/20599

Description: This article describes the value of, and benefits to, Canada’s healthcare system that have resulted from Canada Health Infoway’s investment in diagnostic imaging DI system projects across the country. Infoway has facilitated a joint procurement process for jurisdictions, helped to establish the viability of irreversible compression technology in DI and supported benefit evaluation activities measuring the impact DI of systems on healthcare access, quality and productivity. The positive effects of Infoway’s DI system program are encouraging and demonstrate the transformative potential of electronic health record investments. read more »

An Exploratory Review of The National Health Service SNOMED Ct to ICD-10 Cross Map

Published: Tuesday April 14th 11PM

Link: http://www.longwoods.com/content/20600

Description: This paper describes our review findings on the Systematized Nomenclature of Medicine Clinical Terms SNOMED CT or SCT to International Statistical Classification of Diseases and Related Health Problems Version ICD-10 SCT-ICD10 cross map from the UK’s National Health Service NHS . The review focused on the characteristics of the NHS SCT-ICD10 cross map tables, the use of advices and related codes and the overall meaningfulness of the mapped terms from an outsider’s perspective. Our findings raised some questions related to the manner in which the mapped terms were created, how the codes were assigned, the type of documentation and tools needed and ways to ensure the consistency of the map over time. While the NHS cross map represents a major step forward in linking the clinical terminology standard SNOMED CT with the existing classification system ICD-10 for secondary use purposes, further investigations into refining the meaningfulness of the cross map, the logistics of deploying read more »

·         Inside The Health Blogosphere: Quality, Governance And The New Innovation Leaders

Published: Wednesday January 14th 11PM

Link: http://www.longwoods.com/content/20298

Description: Research has shown that “Health 2.0” – that is, user-generated health information often featuring blogging i.e., self-publishing or collaborative editing tools known as wikis – is increasingly popular among health professionals, chronic disease sufferers and the general public Giustini 2007; Seeman 2008 . However, concerns persist over the alleged inaccuracy, bias and poor governance of self-published health websites, or blogs, where an author’s entries are usually placed in chronological order, much like a diary Wikipedia 2008a . Prominent members of the lay media have voiced criticisms of blogs. For example, one leading Canadian journalist recently noted in The Globe and Mail that “reporters who are trained and paid to do the often dry work of gathering facts and interviewing people … provide the news stories, and the news sites gather them up and the bloggers comment on them” Smith 2008, April 3 . This statement implies that reporters are read more »

·         The Sims Partnership: Transforming Healthcare Delivery In The Greater Toronto Area

Published: Wednesday January 14th 11PM

Link: http://www.longwoods.com/content/20402

Description: In the 1990s, organized healthcare delivery systems were described as “networks of organizations that provide or arrange to provide a coordinated continuum of services to a defined population and who are willing to be held clinically and fiscally accountable for the outcomes and the health status of the population being served.” The concept has evolved and can be applied to a variety of contractual arrangements or strategic alliances, including those that exist within the Canadian public healthcare system. As care delivery in Ontario shifts from a centralized, organization-centric model to a more system-focused, local planning model similar to those of its fellow provinces to the west and east, 15 healthcare organizations in the Greater Toronto Area have responded by forming a partnership to collaborate using information management as a catalyst and enabler of change with the goal of transforming healthcare delivery. read more »

·         Prince Edward Island Implements Province-wide Drug Information System – A Small Step For Dis; A Giant Leap For The Pan-canadian Interoperable Electronic Health Record

Published: Wednesday January 14th 11PM

Link: http://www.longwoods.com/content/20346

Description: On March 13, 2008, Friendly Pharmacy in Charlottetown made a small but significant piece of Canadian healthcare history. It was the first drugstore to go online with Prince Edward Island’s Drug Information System DIS , the centrepiece of the province’s All Drugs All People program. PEI is the first province to implement a DIS solution using a common pan-Canadian messaging standard based on Health Level 7 Version 3 HL7 V3 , an internationally recognized set of standards for clinical, financial and administrative messaging. HL7 V3 allows for interoperability, permitting different information systems to not only exchange information but, more importantly, understand and use it in computer-supported algorithms such as clinical decision support. read more »

·         Canada’s E-health Journey And Himss Analytics’ Canada Information And Communications Technology Study

Published: Wednesday January 14th 11PM

Link: http://www.longwoods.com/content/20422

Description: Why are so many Canadian provincial healthcare delivery organizations now participating in the Healthcare Information and Management Systems Society HIMSS Analytics’ Canada Information and Communications Technology ICT Study The answer is tied to the character of the HIMSS Analytics’ Study, the value offered to all participants and specific Canadian healthcare issues that are addressed by the Canada ICT Study. read more »

·         Transforming Organizational Culture Through Decision Support At Bloorview Kids Rehab

Published: Wednesday January 14th 11PM

Link: http://www.longwoods.com/content/20318

Description: The establishment of a decision support management and planning process at Bloorview Kids Rehab in Toronto, Ontario, has driven operational and physical changes at Canada’s largest children’s rehabilitation, teaching and academic health centre. Decision support provides Bloorview management with integrated, evidence-based and user-friendly tools to plan programs and allocate resources; measure organizational, program and staff performances; and provide timely accountability to the province’s Ministry of Health and Long-Term Care. Not only has Bloorview shifted the internal culture to engage staff in planning the decision support system and developing meaningful data, but the hospital has also situated decision support within the hospital’s Planning and Organizational Effectiveness Department, supporting an integrated model of organizational performance. Users’ and management’s endorsement of decision support processes is foundational to our organizational and program effectiveness. read more »

·         A Tale Of Two Projects: Challenges Faced By Research Projects During A Change In Electronic Medical Record Systems

Published: Wednesday January 14th 11PM

Link: http://www.longwoods.com/content/20319

Description: Background Electronic medical record EMR systems are a rapidly growing form of documentation that has the potential to improve quality of care, physician and practice efficiency and accessibility of stored medical information. However, the implementation of EMRs has presented administrators, information officers, clinicians, researchers and others within the healthcare arena with many challenges ranging from financial to functionality, accessibility, skills necessary for utilization and the potential for data loss Fitzgerald et al. 2007 . Recent reports have focused on the challenges and expectations surrounding the adoption of EMRs into organizations and the clinical workflow; the time and training required to implement and adopt the software; the emergence of an EMR champion or problem solver; and the readiness of healthcare providers to accept the system Hersh 2002; Littlejohns et al. 2003; Terry et al. 2008 . Understandably, the main focus has been the clinical use of EMRs; how read more »

·         Celebrating Leadership – Denis Protti – Recipient Of The 2008 Canadian Health Informatics Award For Leadership In The Field Of Health Informatics

Published: Wednesday January 14th 11PM

Link: http://www.longwoods.com/content/20426

Description: Founding Director, the University of Victoria’s School of Health Information Science. Inventor of the Protti Score – a National Health Service UK evaluation methodology to monitor the local implementation of a national strategy. Just two of a very long list of accomplishments. Denis has done it all. read more »

·         Implementation Of The Veterans Health Administration Vista Clinical Information System Around The World

Published: Sunday September 14th 11PM

Link: http://www.longwoods.com/content/20077

Description: The success story of the Veterans Health Administration VHA within the US Department of Veterans Affairs has been well documented and is generally well known. What is generally not known is that the VHA’s clinical information system, known as VistA, and the computerized patient record system clinical user interface front end have been successfully transported and implemented to a number of non-VHA healthcare organizations across the United States. Moreover, VistA software modules have been installed, or are being considered for installation, in healthcare institutions around the world in countries such as Mexico, Finland, Jordan, Germany, Nigeria, Egypt, Malaysia, India, Brazil, Pakistan and Samoa. read more »

·         Whose Record Is It Anyway Putting Patients’ Interests At The Heart Of The Implementation And Use Of Electronic Medical Records

Published: Sunday September 14th 11PM

Link: http://www.longwoods.com/content/20095

Description: With the dawn of electronic medical records EMRs and patient portals, there is an unprecedented opportunity to provide truly collaborative patient-centred care. These tools can promote communication between healthcare providers and patients, improve chronic disease management and enable patients to become active members in the healthcare delivery system, but only if the tools work for everyone involved – including patients. Without patient consultation and input, there will be limitations in the ways in which physicians and patients are able to capitalize on these tools. Decision-makers must begin to enact their commitment to collaborative patient-centred care by engaging patients in discussions related to EMR design, implementation and use. read more »

·         Demonstrating The Blackberry As A Clinical Communication Tool: A Pilot Study Conducted Through The Centre For Innovation In Complex Care

Published: Sunday September 14th 11PM

Link: http://www.longwoods.com/content/20079

Description: Canadians are living longer with chronic medical conditions, which have led to an increasing complexity and volume of care for hospitalized patients. Effective in-patient care depends on the effective coordination of care through rapid and efficient communication between various care providers. A delay in coordinating this care has downstream effects on other parts of the system, ultimately contributing to increased emergency department wait times. To address this system-wide issue, the Centre for Innovation in Complex Care at the University Health Network collaborated with Sunnybrook Health Sciences Centre to pilot the use of BlackBerry devices on the general internal medicine wards to improve clinical communication. We describe the implementation process, impact on clinical care and lessons learned from this experience. We observed that residents quickly adopted this new technology and felt that it improved their workflow efficiency and productivity. read more »

·         From Diagnosis To Cure: A Process Improvement Journey

Published: Sunday September 14th 11PM

Link: http://www.longwoods.com/content/20016

Description: There has been much excitement in the Canadian healthcare industry about possible benefits of adopting Lean methodologies to improve efficiency and effectiveness. Increasing pressures from financial deficits, wait times and access-to-care issues, along with capacity and resource constraints, have accentuated this excitement. This article shares the story of how University Health Network, a major healthcare organization in Toronto, Ontario, embarked upon clinical process improvement projects using Lean methodologies and principles. Focusing on improving patient flow and access to care and reducing wait times, efforts included the areas of medical imaging, palliative care, general internal medicine, the operating room department and the emergency department. read more »

·         Saving Ontario Healthcare Dollars Through E-health Standardization: A Quantitative Study

Published: Sunday September 14th 11PM

Link: http://www.longwoods.com/content/20017

Description: Health information and information technology professionals intuitively sense that the broad implementation of standardized processes and interoperable information technology throughout the health system is a good thing. We present a quantitative model that compares the financial costs and benefits of Ontario investing in standards-based interoperability versus integration that is not standards based. read more »

·         Initial Experience In Mapping Minimum Data Set Home Care To Snomed Ct

Published: Sunday September 14th 11PM

Link: http://www.longwoods.com/content/20015

Description: This article describes our initial experience in mapping the Minimum Data Set Home Care MDS-HC instrument to the reference terminology known as the Systematized Nomenclature of Medicine – Clinical Terms SNOMED CT . The purpose of the study was to determine the extent to which SNOMED CT can be used to encode the MDS-HC instrument. Our mapping method consisted of reviewing all the MDS-HC items, sub-items and responses one at a time to find the corresponding SNOMED CT terms that best represent the concepts involved. Of the 683 MDS-HC terms identified, we could map only 466 or 68.2 of them through exact matches to existing SNOMED CT terms. The use of post-coordination increased the exact matches to 608 or 89.0 of the MDS-HC terms. For the remaining 75 terms, we mapped another 5.1 through partial matches, but left 5.9 unmatched. The findings from this study suggest that, while the use of SNOMED CT in home care settings is promising, further work is needed to incorporate it as the ter read more »

·         Speech Recognition 2008

Published: Sunday September 14th 11PM

Link: http://www.longwoods.com/content/20078

Description: Annual hospital patient visits in the United States number almost 300 million, with outpatient visits approaching one billion. While patient visits are growing at a compounding rate of 3 per year, the requirements for documentation are increasing disproportionately to that growth due to heightened regulations and the desire for greater transparency in preparation for pay for performance. Currently, dictation and transcription are the primary means of documenting these visits and populating the patient record with the relevant information. read more »

·         Toward A Model Of Successful Electronic Health Record Adoption

Published: Wednesday May 14th 11PM

Link: http://www.longwoods.com/content/19838

Description: There is nothing so practical as a good theory – Kurt Lewin The Canadian healthcare landscape abounds with pressures to address wait times, chronic disease management, aging at home, information and service integration, health human resource shortages, pandemic planning and most importantly health outcomes of individuals receiving care in our system. Investment in clinical information technologies is often touted as significant to the successful resolution of most if not all of these issues. For example, Baker and Norton 2001 uncovered an alarming rate of preventable adverse events occurring within Canadian hospitals. A particularly high error rate associated with the administration of fluids and medications suggests that there is a dire need to introduce processes and tools to reduce human error in healthcare facilities. The implementation of clinical applications such as computerized physician order entry CPOE with integrated electronic medication administration records MAR h read more »

·         New Study Finds One In Four Hospitalizations Is Drug Related

Published: Wednesday May 14th 11PM

Link: http://www.longwoods.com/content/19839

Description: A recent study by Samoy et al. 2006 found that almost 25 of patients admitted to the internal medicine ward of British Columbia’s largest hospital are there because of sickness brought on by adverse drug reactions. read more »

·         Listowel: An Electronic Health Record Success Story

Published: Wednesday May 14th 11PM

Link: http://www.longwoods.com/content/19841

Description: Listowel Memorial Hospital has successfully implemented a community-wide electronic health record with linkages to the community hospital, family health team, laboratories and other regulated health professionals. This case study describes the journey to success along with the factors that were critical in its implementation. read more »

·         A National Education Strategy To Develop Nursing Informatics Competencies

Published: Wednesday May 14th 11PM

Link: http://www.longwoods.com/content/19842

Description: Originally published in Nursing Leadership CJNL 13 2 2000: 11-14. Advances in the sophistication of information and communication technologies offer nursing practitioners opportunities for better information management, more complete documentation of their work and knowledge development to support evidence-based nursing practice. However, a nursing culture that recognizes and adopts the contributions of technology to practice is required to take advantage of these opportunities. The nature of this change suggests a shift in emphasis from specialists in Nursing Informatics NI to NI being integrated into all four domains of nursing practice. The magnitude of change required on individual, organizational and professional levels points to the need for Nursing Informatics education strategies on a national level. Recognizing the role and history of NI specialists, defining NI and the required NI competencies are necessary first steps in developing such a plan. Expanding and adapting th read more »

·         Clinical Documentation Standards – Promise Or Peril

Published: Wednesday May 14th 11PM

Link: http://www.longwoods.com/content/19843

Description: Originally published in Nursing Leadership CJNL 20 4 2007: 33-36. Imagine a future of integrated clinical information systems that transcend the physical boundaries of clinical units, institutions and community care, providing nurses with comprehensive access to information and knowledge to support the delivery of care to individuals and families. Imagine not having to gather the same information repeatedly, ask the same questions over and over again, or struggle to assimilate information from multiple sources and informants. Better yet, as a person needing the services of the healthcare system, imagine not having to rely on memory for details of family health history or repeatedly provide the same information to numerous caregivers over the course of a single encounter or multiple encounters to satisfy the requirements of their specific data collection forms. The future lies in the electronic health record – but are we taking the right steps to get there In particular, are we su read more »

·         Computerized Physician Order Entry Usage In North America: The Doctor Is In

Published: Wednesday May 14th 11PM

Link: http://www.longwoods.com/content/19840

Description: While computerized physician order entry CPOE is still in its infancy as far as adoption goes <10 of North American hospitals have implemented CPOE , most organizations are planning to utilize CPOE in the future. However, one of the major questions on most hospitals’ minds is, “Will physicians accept and use CPOE ” read more »

·         Us Regional Health Information Organizations And The Nationwide Health Information Network: Any Lessons For Canadians

Published: Friday March 14th 11PM

Link: http://www.longwoods.com/content/19625

Description: The creation of regional clinical data exchanges usually referred to as RHIOs is a centrepiece of the US national healthcare information technology strategy. How well are they doing and what lessons can we learn that might be applied here in Canada read more »

·         Why Rhios Aren’t Working: Views From An American Who Can See White Rock, British Columbia, From His Backyard

Published: Friday March 14th 11PM

Link: http://www.longwoods.com/content/19633

Description: Commentary on the article, <a href=”http://www.longwoods.com/product.php productid=19625&cat=541&page=1>US Regional Health Information Organizations and the Nationwide Health Information Network: Any Lessons for Canadians </a> by Denis Protti The problems with RHIOs often referred to as health information exchanges in the United States have as much to do with the structure of the American health ” as they do with non-existent business models for funding them after the grant runs out and lack of interoperability standards. read more »

·         The Information Management Strategy Cascade: Strategy-based Performance Management Of A Flu Recall Practice

Published: Friday March 14th 11PM

Link: http://www.longwoods.com/content/19626

Description: The Health Results Team for Information Management HRT-IM was formed at the Ontario Ministry of Health and Long-Term Care in the fall of 2004 to engage and work collaboratively with the healthcare community to implement change in health system information management. The information management strategy focused on producing better data, supporting accountability and quality improvement through performance measurement and supporting evidence-based decision-making. This paper reviews how an IM strategy framework was applied in a health service provider setting to support linking flu recall practice data to broader organizational strategy and accountability at the Sherbourne Health Centre in Toronto. read more »

·         The Health Information Bank: Revisiting Bill Dodd’s Idea Of 10 Years Ago

Published: Friday March 14th 11PM

Link: http://www.longwoods.com/content/19628

Description: Ten years ago a Scottish general practitioner, Dr. Bill Dodd wrote a two-page paper in the British Journal of Health Computing titled “An Independent ‘Health Information Bank’ Could Solve Data Security Issues.” It was a groundbreaking piece of thinking and has since been picked up by others over the years. Though some of the terminology used e.g., Electronic Patient Record has since been dropped from the English vocabulary, the essence of the paper still resonates with many readers. read more »

·         Everything I Know About Informatics, I Didn’t Learn In Nursing School

Published: Friday March 14th 11PM

Link: http://www.longwoods.com/content/19629

Description: Originally published in Nursing Leadership 2007; 20 3 : 22-25. To date, efforts to initiate future graduates and nurses currently in practice into the world of information and communication technologies ICTs have been provided by relatively few nurse educators. In the past decade, nursing informatics leaders have developed a profile of informatics competencies for nurses, novice to expert – for example, the National Nursing Informatics Project Hebert 2000 – and have demonstrated actual Kaminski 2006 and possible informatics integration into curricula Nagle 2001 . Findings from recent studies Infoway 2007; Nagle and Clarke 2004 suggest that a minority of Canadian schools of nursing have tackled the challenge of integrating informatics throughout their nursing curricula. When asked to respond to a recent survey Infoway 2007 , some schools decided not to participate because there were no faculty members with appropriate expertise in the area, while other schools did not regard read more »

·         Community Picture Archiving And Communications Systems: Burgeoning Market

Published: Friday March 14th 11PM

Link: http://www.longwoods.com/content/19627

Description: Choosing a Picture Archiving and Communications Systems PACS is tougher than it used to be. More and more vendors are offering solutions in the smaller hospital space, and analyzing the sheer number of vendors, the various technology choices and breadth of product offerings is challenging. read more »

·         Web 2.0 And Chronic Illness: New Horizons, New Opportunities

Published: Monday January 14th 11PM

Link: http://www.longwoods.com/content/19506

Description: Judging by the early evidence, Web 2.0 heralds a breakthrough opportunity to empower healthcare consumers of all types, especially those suffering from different forms of chronic illnesses. In this article, I use data gathered from a popular social networking website – MySpace.com – to show that this opportunity may be greatest for heavily stigmatized chronic health issues, such as obesity and mental illness. I also discuss how hospitals and health regions can benefit from and contribute to this fast-growing phenomenon. read more »

·         Electronic Health Records And Patient Safety: What Lessons Can Canada Learn From The Experience Of Others

Published: Monday January 14th 11PM

Link: http://www.longwoods.com/content/19507

Description: No abstract available for this article. read more »

·         Building A Comprehensive Clinical Database: Collaboration In Stages

Published: Monday January 14th 11PM

Link: http://www.longwoods.com/content/19509

Description: The Princess Margaret Hospital Breast Site Group expressed the need for a comprehensive clinical database for breast disease to increase access to detailed high-quality clinical data for research and administrative purposes. The database sought to capture patient history, diagnosis, treatment and follow-up information for over 1,200 new breast disease patients per year. The extensiveness of this information combined with the size of the patient cohort made this a challenging project. The project began with a simple database tool that was flexible and adaptable so that it could be customized to suit the needs of the clinicians in the Breast Site Group. Since the early simplistic implementation, novel data collection techniques have been added to the improve quality and completeness of data. This approach facilitated increased confidence in the project on the part of clinicians, which allowed for more constructive input from all parties, and has resulted in a tool that is useful and rele read more »

·         Data Warehouses In Healthcare: Fundamental Principles

Published: Monday January 14th 11PM

Link: http://www.longwoods.com/content/19510

Description: A data warehouse is a centrally managed and easily accessible copy of data collected in the transaction information systems of a corporation. These data are aggregated, organized, catalogued and structured to facilitate population-based queries, research and analysis. As healthcare becomes more computerized, particularly with the greater adoption of electronic health records, there will be an accompanying and inevitable evolution from workflow automation and data collection to process optimization and data analysis. Data warehouses offer a technological tool to enable data analysis and process optimization and have proven their enormous value in other applications, including manufacturing, retail, space exploration, marketing and e-commerce. However, as these other industries learned in their journey toward data analysis, data warehouse projects are also prone to large and expensive failures. As a result of these failures, data warehousing has evolved in recent years into a subspecialt read more »

·         Improving Patient Safety Through Computerized Drug Management: The Devil Is In The Details

Published: Monday January 14th 11PM

Link: http://www.longwoods.com/content/19511

Description: This commentary was originally published in HealthcarePapers 2004; 5 3 : 52-68. To see the lead paper and accompanying commentaries, visit <a href=”http://www.healthcarepapers.com” target=”_blank>www.healthcarepapers.com</a>. Electronic prescribing and computerized drug management can improve the safety, quality and cost-effectiveness of prescribing. However, if the problems that lead to avoidable adverse events are not addressed by information technology IT , there is a risk of making considerable investment without the expected return of error reduction and improved patient safety. Improving the safety of prescribing is particularly important in ambulatory care, where most drugs are prescribed. To improve patient safety, IT solutions should be developed that provide 1 access to the list of all currently active drugs; 2 alerts for relevant prescribing problems therapeutic duplication, excess doses, dose adjustment for weight children, elderly read more »

·         Ambulatory Electronic Medical Records For Large Practices

Published: Monday January 14th 11PM

Link: http://www.longwoods.com/content/19508

Description: Recently, KLAS studied ambulatory electronic medical record EMR solutions for practices with 100-plus physicians. While KLAS has previously studied EMR solutions, this was the first study focused on practices with over 100 physicians. The results provide thought-provoking insight into physician adoption, common obstacles, workflow issues and overall physician satisfaction. read more »

·         Legislative Barriers To Outpatient E-prescribing In A Randomized Trial

Published: Friday September 14th 11PM

Link: http://www.longwoods.com/content/19335

Description: Newer outpatient electronic prescribing software programs produce typewritten paper prescriptions with electronically created signatures. Current Canadian federal legislation forbids static unchanging signature images on prescriptions.We conducted a randomized trial of electronic prescribing in outpatients at a university-affiliated hospital. The application was a wireless Palm-based system that creates a prescription that is either printed and given to the patient or faxed to a pharmacy. Using the software, the physician creates a unique signature image for each prescription.We successfully overcame challenges related to wireless network reliability, local printer availability and physician training. However, to comply with federal legislation and provincial regulations, we were required to design workarounds to create acceptable prescribing processes.   Our experience suggests that the legality of the electronic signature must be clearly defined to realize the full potential o read more »

·         Reporting The Performance Of Hit Vendors: Smart Pumps

Published: Friday September 14th 11PM

Link: http://www.longwoods.com/content/19337

Description: In 2006, the Institute of Medicine IOM reported that “when all types of errors are taken into account, a hospital patient can expect on average to be subjected to more than one medication error each day.” To help counteract patient safety issues, the IOM report suggested that hospitals “make greater use of information technology in prescribing and dispensing medications including the adoption of smart infusion pumps.”Recently, KLAS conducted a study on smart pump usage, with extra attention being given to issues such as the functional strengths of the available pumps, missing functionality, pump tracking and quantifiable benefits reported by providers. KLAS found that while there are difficulties in using, tracking and quantifying benefits for smart pumps, 90 of purchasers would buy their smart pump again. However, there are kinks to be worked out in the areas of functional strengths, missing functionality, pump tracking and benefits. read more »

·         Engaging Clinicians: Ontario’s General Surgeons Develop A Multidisciplinary Approach For Prioritizing Patients Using The Electronic Wait Time Information System

Published: Friday September 14th 11PM

Link: http://www.longwoods.com/content/19332

Description: In Ontario, the electronic Wait Time Information System WTIS was introduced to capture surgical wait time data and improve the coupling of resource allocation with public need. A key feature of the WTIS is its ability to triage patient care using a priority assessment tool PAT . However, how do you ensure that surgeons will use the WTIS when it is deployed in a clinical setting Early clinician engagement has been identified as a critical success factor for system adoption. As such, the General Surgery Clinical Expert Panel used a modified Delphi consensus technique to engage surgeons in the development of a PAT. This physician-driven process yielded two important lessons: 1 the use of a multidisciplinary team is critical for process validity and 2 positioning the PAT as a tool developed by and for local surgeons will likely improve clinical adoption. It is anticipated that the General Surgery experience will shape WTIS’s expansion to other surgical specialties as electronic dat read more »

·         Moving Toward A Single Comprehensive Electronic Health Record For Every Citizen In Andaluc A, Spain

Published: Friday September 14th 11PM

Link: http://www.longwoods.com/content/19336

Description: In 2001, less than 3 of primary care physicians were fully automated in the region of Andalucía, Spain. Now, six years later, more than 70 use a computer system called DIRAYA Arabic for knowledge , which integrates all the information on each patient so that it is available when and where it is needed for his or her care. A patient-centred philosophy begins with patients having ownership of their health records. Access to the information is provided using a “smart card,” which holds the key to all clinical data in the system. Patients authorize individual physicians to access their health information using this card. A digital signature also allows patients to view their record online, see who has accessed the record and modify specific demographic information. read more »

·         Vendor News

Published: Friday September 14th 11PM

Link: http://www.longwoods.com/content/19338

Description: No abstract available for this article. read more »

·         Infoway’s Ehr User Engagement Strategy

Published: Friday September 14th 11PM

Link: http://www.longwoods.com/content/19331

Description: Canada Health Infoway Infoway was launched in 2001 following an agreement by Canada’s First Ministers to strengthen a Canada-wide health infostructure that would include the development and benefits of electronic healthcare solutions. With a goal to have an electronic health record EHR for 50 of all Canadians by population by 2010, Infoway is investing in some key areas of health information management i.e., drug information, telehealth, laboratory and diagnostic imaging systems . Investments in systems to support the management of health information has necessitated a parallel investment in strategies to ensure that health professionals embrace these tools. The need to address the engagement of nurses, physicians and pharmacists in the use of EHR tools led to the creation of a Clinician Advisory team within Infoway. The mandate of this team is to liaise and work with relevant stakeholder communities to advance Infoway’s mission. read more »

·         Shopping For High-technology Treatment In Another Province

Published: Friday September 14th 11PM

Link: http://www.longwoods.com/content/19330

Description: In order to address long healthcare waits, political and professional groups have recommended sending patients to other provinces for diagnostic procedures or treatment. We investigated the feasibility of such recommendations, specifically, whether residence in one province can impede access to MRIs in another province. We contacted all public MRI facilities in Canada and found no difference in wait times between prospective in- and out-of-province patients, although wait times were highly variable from province to province. Over one-fifth 19/86=22 of centres imposed barriers for out-of-province patients to access care. We discuss several jurisdictional, financial and logistic considerations regarding the feasibility and appropriateness of implementing a national strategy of interprovincial patient transfer for healthcare.   read more »

·         Go Home And Get Well Soon

Published: Friday September 14th 11PM

Link: http://www.longwoods.com/content/19333

Description: Thanks to innovations in communications and biomedical technology, hundreds of thousands of patients the world over will soon be able to recover from operations and major illnesses in the comfort of their own home, with no greater risk to their health. No hospital would ever allow a patient to go home who is not sufficiently recovered to do so. It is the slim risk of post-operative complications that often results in patients lying in a hospital bed many weeks after an operation. But doctors would allow them to go home if their vital statistics could be monitored there as effectively and regularly as on a ward. The technology now exists to let patients convalesce at home, a place with less stress and a reduced risk of infection. read more »

·         Adoption Of Information Technology In Primary Care Physician Offices In Alberta And Denmark, Part 1: Historical, Technical And Cultural Forces

Published: Monday May 14th 11PM

Link: http://www.longwoods.com/content/18933

Description: Denmark and Alberta are both advanced in the application of the Western scientific model of healthcare and both currently enjoy similar levels of economic prosperity. Each has a significant investment in medical care, including the use of acute care hospitals, health provision by scientifically trained medical practitioners and dispensing of pharmaceutical agents. Given these similarities, we felt it would be instructive to evaluate the adoption of the latest wave of medical technology, computerized medical records and associated supporting capabilities.   This article evaluates the current state, driving forces and general health system factors that have impacted two culturally and historically different medical jurisdictions – Denmark, a member of the European Union, and Alberta, Canada. Although similar in many respects, there are subtle differences between these two relatively autonomous health systems that have led to varying rates of uptake of medical office computing. T read more »

·         Adoption Of Information Technology In Primary Care Physician Offices In Alberta And Denmark, Part 2: A Novel Comparison Methodology

Published: Monday May 14th 11PM

Link: http://www.longwoods.com/content/18936

Description: This article follows on from part 1 on the history of medical computing in Alberta and Denmark Protti et al. 2007 . It provides background to the driving forces for automation in primary care physician offices in Denmark and Alberta. It also summarizes the functionality of electronic medical records EMRs in both jurisdictions and compares the status of primary care physician office computing in Alberta to that of Denmark. The scoring system used is based on data gathered from publicly available sources on the Internet, databases held by the respective jurisdictional programs MedCom and Physician Office System Program POSP and interviews with individuals involved in the deployment of systems. The article offers a novel method of scoring the adoption of computerized advances in the office setting that may be applicable to other health jurisdictions, at country, state or provincial levels. read more »

·         Electronic Daily Reporting Of Community-wide Healthcare Information

Published: Monday May 14th 11PM

Link: http://www.longwoods.com/content/18854

Description: In recent years, the development of electronic healthcare data systems has proceeded rapidly in North America and Europe. It has been suggested that these systems can improve the efficiency of care, as well as the diagnosis and treatment of some conditions Hilstead et al. 2005; Walker et al. 2005 . It has also been proposed that the technology can measurably reduce per capita healthcare spending at the national level Anderson et al. 2006 . read more »

·         Recognizing The Importance Of Proactive Reporting At A Large Urban Teaching Hospital

Published: Monday May 14th 11PM

Link: http://www.longwoods.com/content/18937

Description: Incident reporting focuses on correcting system and process issues after an incident has occurred. By comparison, near-miss reporting is a means of proactively reporting events that could have resulted in an incident but did not because of timely intervention. Near-miss reporting allows organizations to identify and remedy potential incidents before harm befalls any patients. Recognizing the value of near-miss reporting, University Health Network UHN implemented a recognition program to encourage individuals to report near misses. Since the program’s implementation in May 2006, near-miss reporting at UHN has increased 38 compared with the same time the previous year. read more »

·         Vendor News

Published: Monday May 14th 11PM

Link: http://www.longwoods.com/content/18934

Description: No abstract available for this article. read more »

·         Hit Report From Klas: Nurse And Staff Scheduling: Tightening Up The Ship

Published: Monday May 14th 11PM

Link: http://www.longwoods.com/content/18935

Description: With the current nursing shortage, tight budgets and minimum staffing requirements, some providers say their staff and nurse scheduling technology is helping them run a tight ship. KLAS recently conducted a study of staff and nurse scheduling products in an effort to determine vendor and product performance. Vendors and products included in the study are listed in the sidebar. Study participants’ responses offer insight into overall vendor performance, each vendor’s value proposition and providers’ real-life experiences with the software. read more »

·         Comparison Of Information Technology In General Practice In 10 Countries

Published: Saturday April 14th 11PM

Link: http://www.longwoods.com/content/18833

Description: A study commissioned by Canada Health Infoway provides a comparative analysis of automation in general practice in 10 countries. The most common clinical application is the automation of medication prescriptions – even if it is not a mandatory requirement as it is in Norway. It is the clinical application that provides one of the biggest benefits to general practitioners as it addresses legibility concerns, can be a significant time saver particularly for repeat prescriptions and offers the potential to make use of decision-support capabilities. The transmission of laboratory results is the most common electronic clinical communication application. read more »

·         Developing An Electronic Incident Report: Experiences Of A Multi-site Teaching Hospital

Published: Saturday April 14th 11PM

Link: http://www.longwoods.com/content/18834

Description: A user-friendly tool is key in facilitating incident reporting. In 2001, University Health Network UHN implemented an electronic incident-reporting tool. Recently, the organization dedicated resources to upgrade the system with phase one of the new system, released in December 2006. Qualitative comments have been positive and implementation went as planned, with no technical problems reported. Planning for the second phase of improvements is now under way. The following article describes UHN’s experience with developing the electronic incident-reporting system.   read more »

·         Cracks In The Foundation: The Precarious State Of Canada’s Primary Care Infrastructure

Published: Saturday April 14th 11PM

Link: http://www.longwoods.com/content/18837

Description: Primary care is widely acknowledged by politicians, pundits, policy makers and healthcare providers to be the foundation of Canada’s healthcare system. A recent Commonwealth Fund survey of primary care physicians in seven countries – Australia, Canada, Germany, New Zealand, the Netherlands, the United Kingdom and the United States – has vividly illustrated the sorry state of that foundation’s underpinnings Shoen et al. 2006 . The survey examined information technology, clinical information systems, care coordination, use of teams, participation in quality initiatives and financial incentives. read more »

·         Annual Review Of Im/it In Healthcare

Published: Tuesday December 4th 11PM

Link: http://www.longwoods.com/content/18843

Description: Hear Michael Guerriere’s thoughts and analysis of successful and disappointing projects involving IT in healthcare. How are wait times progressing What have the achievements and challenges been for netCare, OLIS and SSHA among others What lessons can be learned from diabetes and chronic care management read more »

·         Informatics: Emerging Concepts And Issues

Published: Saturday April 14th 11PM

Link: http://www.longwoods.com/content/18838

Description: This new column demonstrates the wisdom and foresight of CJNL’s editor for agreeing to include regular commentary on issues of ” and informatics as they pertain to nurses. In my work as the Senior Nursing Advisor to Canada Health Infoway on the “End-User Engagement Strategy,” I have found a need to clarify the many acronyms and concepts applied to this work and address the persistent confusion related to them. Without a shared understanding of core elements, the notion of “engaging nurses” will likely continue to be fraught with frustration and miscommunication. In this first column, I offer some points of clarification of the “alphabet soup.” In future columns, I will attempt to address other terminally confounded issues and topics of relevance to nurses. read more »

·         Vendor News

Published: Saturday April 14th 11PM

Link: http://www.longwoods.com/content/18835

Description: No abstract available for this article. read more »

·         Hit Report From Klas: Extensive It Outsourcing: Advice From Providers

Published: Saturday April 14th 11PM

Link: http://www.longwoods.com/content/18836

Description: In the past year, the demand for outsourced staff and expertise has intensified as providers upgrade and replace their clinical and financial information systems and related infrastructures. However, providers are often at a loss to decide which firm best fits their specific needs and expectations. Recently, KLAS a research firm specializing in healthcare technology spoke with providers about their information technology IT outsourcing experiences. Study respondents were acute care organizations in North America that outsource more than 50 of their IT personnel. Among other details, the study explores the quality, effectiveness and benefits of extensive IT outsourcing. In addition, providers shared information on expectations that were not met by the outsourcer/professional service firm PSF and why some providers discontinued outsourcing.   read more »

·         Sharpening The Case For Returns On Investment From Clinical Information Systems

Published: Sunday January 14th 11PM

Link: http://www.longwoods.com/content/18656

Description: For years the debate has raged: Is it possible to see a return on the huge investments it takes for hospitals to purchase and implement sophisticated clinical information systems CIS Some have asked whether the very notion of healthcare information technology IT return on investment ROI is an oxymoron Healthcare Information and Management Systems Society HIMSS 2003 . The question is an important one. The cost of these systems is enormous, easily ranging into the millions of dollars, and IT is coming into its own at a time when the healthcare system in general is in deep financial trouble, as hospitals struggle to avoid seeing their bottom line dive irretrievably deep into the red. read more »

·         A Proposed Benefits Evaluation Framework For Health Information Systems In Canada

Published: Sunday January 14th 11PM

Link: http://www.longwoods.com/content/18657

Description: This article describes a benefits evaluation framework for the health information systems currently being implemented across Canada through Canada Health Infoway with its jurisdictional partners and investment programs. This framework is based on the information systems success model by DeLone and McLean, the empirical analysis by van der Meijden on the use of this model in the health setting and our own review of evaluation studies and systematic review articles in health information systems. The current framework includes three dimensions of quality system, information and service , two dimensions of system usage use and user satisfaction and three dimensions of net benefits quality, access and productivity . Measures have been developed and work is under way to establish detailed evaluation plans and instruments for the individual investment programs to launch a series of benefits evaluation field studies across jurisdictions later this year. read more »

·         Signing On To Sign Out, Part 2: Describing The Success Of A Web-based Patient Sign-out Application And How It Will Serve As A Platform For An Electronic Discharge Summary Program

Published: Sunday January 14th 11PM

Link: http://www.longwoods.com/content/18658

Description: Sunnybrook Health Sciences Centre developed and implemented a physician-focused web-based patient sign-out application in January of 2005 with 40 different groups throughout the hospital now using it. More groups are continuing to request access to the system, including nursing and other multidisciplinary groups. The success of the system is attributable to its simplicity and usability as there is rarely any downtime and no formal training for physicians is ever necessary. The next step is to create an electronic discharge summary program. Using an electronic system to complete discharge summaries will allow more efficient completion of discharge summaries, improve the quality of discharge summaries and improve the timeliness of delivery to the family physician. Integrating the electronic discharge summary program with the current sign-out application is a logical approach because the two processes follow each other in the flow of care, information from the sign-out application is tran read more »

·         Publisher’s Page

Published: Sunday January 14th 11PM

Link: http://www.longwoods.com/content/18659

Description: No abstract available for this article. read more »

·         Multichannel 1.5t Magnetic Resonance Systems: The Good, The Bad And The Ugly

Published: Sunday January 14th 11PM

Link: http://www.longwoods.com/content/18660

Description: Recently, KLAS studied multichannel 1.5T magnetic resonance MR systems as part of a new research initiative in medical equipment. Vendors and products included in the study are listed in Table 1. KLAS found that MR vendors as a whole scored slightly higher than the medical equipment scoring average in the KLAS medical equipment database. KLAS also found that providers are rapidly expanding beyond traditional MR diagnostic areas, such as neurology, into advanced applications such as cardiac and whole-body imaging. Respondents to KLAS research indicate plans to use the magnet in as many different scan types as possible to maximize their patient mix and throughput. read more »

·         Does Computerized Physician Order Entry Cpoe Kill Sick Kids

Published: Sunday January 14th 11PM

Link: http://www.longwoods.com/content/20430

Description: Paper Yong Y. H., J A. Carcillo, S. T. Venkataraman, R. S.B. Clark, R. S. Watson, T. C. Nguyen, H. Bayir, and R. A. Orr. 2005. “Unexpected Increased Mortality after Implementation of a Commercially Sold Computerized Physician Order Entry System.” Pediatrics 116: 6: 1506 – 13 < <a href=”http://pediatrics.aappublications.org/content/vol116/issue6/index.shtml” target=”_blank>http://pediatrics.aappublications.org/ content/vol116/issue6/index.shtml</a> >. Question Does CPOE reduce mortality in severely ill children requiring transfer to a university teaching hospital Study Design Pre and post intervention CPOE study, retrospective analysis 2002 at University of Pittsburgh Children’s Hospital. Methodology 18 month study 13 months pre-intervention and 5 months post-intervention . Population of 1942 acutely ill children transferred and admitted, mean age 9 months, 57 required ICU admission. CPOE system Cerner, Corporation’s PowerOrder. De read more »

·         Clinical Electronic Communications: A New Paradigm That Is Here To Stay

Published: Thursday September 14th 11PM

Link: http://www.longwoods.com/content/18423

Description: ” There is a wide and possibly widening gap between the need for sharing information with patients and the relatively limited opportunities for face-to-face communication between patients and physicians” Car and Sheikh 2004a . Electronic communication is addressing the need for convenient and timely exchange of information in virtually all facets of society. This paper outlines the current status of clinical electronic communication, including e-mail and secure Web messaging, among physicians and between physicians and their patients. It is intended to provide a summary of what is known about clinical electronic communications in healthcare: what is working, what the challenges are and what is promising. In addition, published guidelines and studies offer direction for incorporating electronic communication into daily practice. read more »

·         Low-cost Rapid Usability Engineering: Designing And Customizing Usable Healthcare Information Systems

Published: Thursday September 14th 11PM

Link: http://www.longwoods.com/content/18424

Description: It is essential that the healthcare systems we develop are usable, meet user information needs and are safe. To ensure system usability, a variety of methods have emerged from the area of usability engineering and have been adapted to healthcare. The authors have been applying methods of usability engineering, working with hospitals and companies to develop more usable healthcare information systems for over 15 years. Based on our current work at the University of Victoria, we describe how to set up a low-cost portable laboratory that can rapidly evaluate the usability and safety of healthcare information systems both in artificial mocked-up settings and in real clinical contexts e.g., in hospital wards . read more »

·         Vendor News

Published: Thursday September 14th 11PM

Link: http://www.longwoods.com/content/18425

Description: No abstract available for this article. read more »

·         The Hit Report From Klas: Medical Transcription Outsourcing

Published: Thursday September 14th 11PM

Link: http://www.longwoods.com/content/18426

Description: As providers seek to offset the shortage of qualified medical transcriptionists, reduce the overall cost of transcription, decrease turnaround time and more , outsourcing transcription can become a necessity. KLAS recently completed its first Medical Transcription Outsourcing MTSO study, examining vendor performance, the cost and benefits/ROI of outsourced transcription services and the impacts of off-shore transcription services and speech recognition. Among the findings of interest was information on benefits received, off-shoring provider experiences and the effect speech recognition is expected to have on future transcription outsourcing. read more »

·         Performance Indicators For Information Technology Services At Four Community Hospitals

Published: Sunday May 14th 11PM

Link: http://www.longwoods.com/content/18235

Description: During the 2004/05 fiscal year, the Directors of Information Technology Services ITS at four Toronto area hospitals agreed to participate in a detailed benchmarking exercise looking at ITS costs and services in their organizations. There was a high degree of interest since the hospitals were similar in size and were all community hospitals. Also, there was a good working relationship and a sense that the information would help us better understand the complexities of comparing hospital IT operations. An initial data template was completed for each site, followed by a meeting where the data elements and definitions were reviewed in detail. After initial calculations of the performance indicators, some data clarification was required and the final calculations were performed. The indicators presented in this report highlight some of the findings from this data analysis. read more »

·         The Hit Report From Klas: Cardiovascular Pacs: Recent Klas Findings

Published: Sunday May 14th 11PM

Link: http://www.longwoods.com/content/18236

Description: Cardiovascular medicine is a very profitable area of healthcare, yet it is several years behind radiology when it comes to technology adoption. Accordingly, providers are clamouring for more information on integrated cardiovascular IT solutions. Generally, these providers define an integrated cardiology solution as one that handles reporting, documentation and image management from a single system on a single workstation. read more »

·         Vendor News

Published: Sunday May 14th 11PM

Link: http://www.longwoods.com/content/18237

Description: No abstract available for this article. read more »

·         A Collaborative Approach To Building Capacity In Health Informatics

Published: Tuesday March 14th 11PM

Link: http://www.longwoods.com/content/18126

Description: With the demand for electronic health information systems EHIS in Canada on the rise, there is an urgent need for qualified health informaticians to ensure their proper deployment to maximize the intended benefits. In its 2003-2004 business plan, Canada Health Infoway 2004: 2 has estimated that “there will be a need for an additional 1,500-2,000 technology, health informatics and change management personnel over the next six years as Infoway’s investments are realized.” Similarly, the American Medical Informatics Association AMIA has estimated the need to train 10,000 health professionals in applied health informatics by 2010 to lead and facilitate EHIS implementation efforts in the United States AMIA 2005 . One strategy to meet such demand is to increase the supply of health informaticians through expanded formal postsecondary health informatics HI education programs. Yet another is to ” existing health and information technology IT professionals read more »

·         Bridging Information “islands”: Designing An Electronic Health Record That Meets Clinical Needs

Published: Tuesday March 14th 11PM

Link: http://www.longwoods.com/content/18127

Description: Transforming a health record system into one that is more responsive to patient needs is recognized as a critical problem faced by many health systems today. Although patients travel freely among facilities and sites, their records do not easily follow, mainly because the separate clinical information systems in which data are stored have not been built to ” to one another. Whereas many other industries – banking, airlines, Internet – have developed ways to bridge this information electronically, the healthcare industry has until recently continued to share paper-based records. This practice creates problems for both clinicians and patients. For example, transfer of information may be slow if a patient is treated by a family physician in one centre and then admitted to hospital in a different city. Clinicians may have to wait to obtain information by phone or request it to be transferred by fax. Patients may be unconscious, under duress or forgetful and unable to read more »

·         Ehealthrecord.info

Published: Tuesday March 14th 11PM

Link: http://www.longwoods.com/content/20443

Description: The ehealthrecord.info is designed to provide the latest news, best practices, policy and ideas about electronic health records. The ehealthrecord.info is short and to the point. The subject is salient to advancing the quality of care; our objective is to provide you with clarity and to keep you current. Think of it as a supplement to the journal ElectronicHealthcare. It is updated every two weeks. To view the entire eletter, please visit: <a href=”http://www.ehealthrecord.info” target=”_blank>www.ehealthrecord.info</a> read more »

·         Publisher’s Page

Published: Tuesday March 14th 11PM

Link: http://www.longwoods.com/content/18128

Description: No abstract available for this article. read more »

·         The Hit Report From Klas: Clinical Portals: A Win For Providers

Published: Tuesday March 14th 11PM

Link: http://www.longwoods.com/content/18129

Description: In today’s healthcare environment, clinicians must have the right data where and when it is needed, whether at the patient’s bedside, a physician’s office or in a home office. Currently, however, most providers’ data is spread across many disparate systems, with limited integrated access. To meet this challenge, some hospital organizations are striving to integrate these disparate products, which can be a formidable and painful task. Other organizations have implemented clinical portals as a preliminary step toward integration. Clinical portals allow physicians and staff to access disparate data through a portal which – to the physician – appears to be an integrated tool. A recent KLAS study on Clinical Portals shows that 1 portals can interface with numerous disparate and non-integrated systems, 2 portals are well accepted by physicians and 3 portals are relatively quick to implement. read more »

·         It Solutions For Patient Safety – Best Practices For Successful Implementation In Healthcare

Published: Saturday January 14th 11PM

Link: http://www.longwoods.com/content/17928

Description: Recent reports in the United States and Canada have suggested that healthcare systems in both countries fall short in delivering high quality and safe patient care Baker and Norton 2001; Institute of Medicine 1999, 2001 . In addition to these reports, empirical studies have stressed the enormity of the problem of adverse events in hospitals in terms of frequency and severity e.g., Evans et al. 1994; Budnitz et al. 2005; Classen et al. 2005 . Investigators in the Harvard Medical Practice Study, for example, found that adverse events occurred in approximately 3.6 of hospitalizations in New York State Brennan et al. 1991 , the majority of which were due to drug complications Leape et al. 1991 . Such adverse events and errors have also been found to be preventable and significantly associated with longer hospital stays, disability and increased healthcare utilization and costs Bates et al. 1997; Evans et al. 1993; Phillips, Christenfeld and Glynn 1998; Thomas et al. 1999; Classen et read more »

·         Implementation Of A Computerized Physician Order Entry System Of Medications At The University Health Network – Physicians’ Perspectives On The Critical Issues

Published: Saturday January 14th 11PM

Link: http://www.longwoods.com/content/17930

Description: While computerized physician order entry is recommended to improve patient safety, the implementation presents significant challenges. As physicians involved in the recent implementation of computerized medication order entry at University Health Network, we advocate the importance for physicians to be closely engaged in the implementation process. We discuss our experiences and solutions to critical issues such as physician adoption, training, user support, computerized decision support and technology. read more »

·         Publisher’s Page

Published: Saturday January 14th 11PM

Link: http://www.longwoods.com/content/17931

Description: No abstract available for this article. read more »

·         Ehealthrecord.info

Published: Saturday January 14th 11PM

Link: http://www.longwoods.com/content/20442

Description: The ehealthrecord.info is designed to provide the latest news, best practices, policy and ideas about electronic health records. The ehealthrecord.info is short and to the point. The subject is salient to advancing the quality of care; our objective is to provide you with clarity and to keep you current. Think of it as a supplement to the journal ElectronicHealthcare. It is updated every two weeks. To view the entire eletter, please visit: <a href=”http://www.ehealthrecord.info” target=”_blank>www.ehealthrecord.info</a> read more »

·         The Hit Report From Klas: New Clinical Implementations: Late But Worth The Wait

Published: Saturday January 14th 11PM

Link: http://www.longwoods.com/content/17932

Description: Providers looking to implement the latest commercially available core clinical products have a real interest in knowing the successes and challenges they can expect. Recent research suggests that while the implementations are often late, difficult and over budget, these applications do bring benefits, and software vendors are typically showing improvement in their ability to deliver.Through a recently completed report monitoring clinical product delivery, KLAS interviewed executives at 150 hospitals implementing core clinical products. The provider-sponsored research followed the delivery of those clinical products that have proven most challenging to implement, including: clinical data repository CDR , computerized physician order entry CPOE , clinical charting and pharmacy. read more »

·         The Effect Of Organizational Factors On The Effectiveness Of Emr System Implementation – What Have We Learned

Published: Friday October 14th 11PM

Link: http://www.longwoods.com/content/17704

Description: Objective To systematically review studies assessing the effect of organizational factors on the effectiveness of EMR system implementation. Research Methods MEDLINE and reference lists of articles were searched for English-language articles published between 1990 and 2005. Studies assessing the effect of management support, financial resource availability, implementation climate and/or implementation policies and practices on the effectiveness of EMR system implementation were selected for inclusion in the review. Relevant data on study objective, study design, study population and setting, measures of implementation effectiveness and organizational factors, and key results were extracted and tabulated. Results 1,684 citations were identified through the search and 23 studies were found to be relevant to the objective of this study. Evidence was found to indicate organizational factors do influence the effectiveness of EMR system implementation and several themes are presented. Conclu read more »

·         Signing On To Sign-out: Creation Of A Web-based Patient Sign-out Application

Published: Friday October 14th 11PM

Link: http://www.longwoods.com/content/17705

Description: Background<a href=”http://www.sunnybrookandwomens.on.ca” target=”_blank>Sunnybrook and Women’s College Health Sciences Centre</A> Sunnybrook and Women’s is the amalgamation of three healthcare organizations, the Orthopaedic and Arthritic Hospital, Sunnybrook Health Science Centre and Women’s College Hospital. It was created by a Special Act of Legislation Bill 51 in June 1998 and is fully affiliated with the University of Toronto. The division of General Internal Medicine within the Department of Medicine consists of four medical teaching teams, each responsible for the care of patients admitted to their medical ward. At the end of each day, the primary inpatient house staff must transfer the care of their patients to the on-call team, a process referred to as “patient sign-out.” read more »

·         Ehealthrecord.info

Published: Friday October 14th 11PM

Link: http://www.longwoods.com/content/20441

Description: The ehealthrecord.info is designed to provide the latest news, best practices, policy and ideas about electronic health records. The ehealthrecord.info is short and to the point. The subject is salient to advancing the quality of care; our objective is to provide you with clarity and to keep you current. Think of it as a supplement to the journal ElectronicHealthcare. It is updated every two weeks. To view the entire eletter, please visit: <a href=”http://www.ehealthrecord.info” target=”_blank>www.ehealthrecord.info</a> read more »

·         Publisher’s Page

Published: Friday October 14th 11PM

Link: http://www.longwoods.com/content/17706

Description: No abstract available for this article. read more »

·         The Hit Report From Klas: Successes And Challenges With Full It Outsourcing

Published: Friday October 14th 11PM

Link: http://www.longwoods.com/content/17707

Description: Today’s healthcare is complex from both a business and an IT perspective. Decisions regarding care provided and the technology behind it are paramount to business survival and appear core to a facility’s ability to remain competitive. Additionally, automation in healthcare is viewed as an integral component to many quality and patient safety initiatives. To support this activity, many clinical and financial systems are in need of being updated or replaced, and there is much to be considered. Given today’s complex environment, sense of urgency and corresponding resource requirements, some providers are looking to outsource all or a significant portion of their IT operations. read more »

·         Evidence Of Public Value And Public Risk Of Electronic Health Records: An Issue For Social Justice

Published: Saturday May 14th 11PM

Link: http://www.longwoods.com/content/17172

Description: Since 1999, the federal and other governments in Canada have repeatedly emphasized the value to healthcare of electronic health records. In 2004, a substantial UK investigation questioned the evidence of public value of largescale, government initiatives in healthcare information technology, and of electronic health records in particular. Citing an authoritative source, which holds that justice requires meeting healthcare needs fairly under resource constraints, and that this involves limiting healthcare in a publicly accountable way, the present study drew upon social justice as the frame of reference. Within this frame, it examined the evidence pertaining specifically to electronic health records as represented in eight major health policy papers at the national level published in Canada from 1999 to early 2005. Using a quantitative method, the study found during the period a decline in the concerns expressed in the eight policy papers about privacy, security and availability of elec read more »

·         Fraser Health Pacs Project: Learning From Experience In Planning

Published: Saturday May 14th 11PM

Link: http://www.longwoods.com/content/17173

Description: Fraser Health – British Columbia’s largest health authority, which serves one in three British Columbians – has nearly completed the implementation of the largest picture archiving and communications system PACS in Canada. Fraser Health’s PACS implementation is also one of the largest in North America, linking diagnostic imaging equipment, including MRI and ultrasound, to a network of computers throughout the health region. Fraser Health’s PACS project is regarded by many as a great success. However, this paper outlines some of the lessons learned during the PACS implementation, as well as additional knowledge that, in hindsight, would have been beneficial to have had prior to starting the project. Canada Health Infoway partnered with Fraser Health in the PACS project, which provided a strong focus on sharing the experience and best practice of the implementation for the benefit of other Canadian jurisdictions. Fraser Health’s culture of learning and sharing has been augmented by the read more »

·         Publisher’s Page

Published: Saturday May 14th 11PM

Link: http://www.longwoods.com/content/17174

Description: No abstract available for this article. read more »

·         The Hit Report From Klas: Clinical Automation In The Physician Office: Focus: E-prescribing/ambulatory Emr 2005

Published: Saturday May 14th 11PM

Link: http://www.longwoods.com/content/17175

Description: As clinician awareness of the benefits of using computers as a tool to reduce medical errors increases, more physician offices are looking at an e-Prescribing/Ambulatory EMR strategy. The purpose of this study March 2005 was twofold: 1 to assess market perception of the e- Prescribing/Ambulatory EMR products offered as identified by survey participants and 2 to identify key decision factors used by survey participants when choosing an e-Prescribing/Ambulatory EMR vendor. read more »

·         Clinical Information Systems: Understanding And Preventing Their Premature Demise

Published: Monday March 14th 11PM

Link: http://www.longwoods.com/content/17103

Description: What hospital would not want a clinical information system IS where all information, orders and prescriptions for an individual patient are available in one place and accessible as needed Many hospitals introduce these systems to much enthusiasm. Yet, a few months later, this positive attitude often deteriorates into frustration and even organized resistance. Sometimes, faced with outright rebellion, management is forced to withdraw the system or its most disrupting features, reverting to former practices. Indeed, many hospitals interrupt such projects after investing millions in software acquisition and implementation Anderson 1997; Doolin 1999; Greene 2003 . read more »

·         Publisher’s Page – Infoway Update

Published: Monday March 14th 11PM

Link: http://www.longwoods.com/content/17102

Description: No abstract available for this article. read more »

·         Profile: Ed Brown

Published: Monday March 14th 11PM

Link: http://www.longwoods.com/content/17100

Description: On our quest to find the coolest invention of our times, we invited Dr. Ed Brown to tell us about one invention he swears by, and why. read more »

·         The Hit Report From Klas: Focus: Medication Administration Application Performance

Published: Monday March 14th 11PM

Link: http://www.longwoods.com/content/17101

Description: Medication Administration 2004. Bar code technology is emerging as a solution in support of closed loop medication administration and the “Five Rights” – the right patient receiving the right medication at the right time by the right route in the right dosage. These systems are all based upon positive patient identification at the time of medication administration. In addition, Bar Code Medication Management 52 was cited by healthcare industry professionals as their number one choice for most important computer application in the next two years 15th Annual HIMSS Leadership Survey sponsored by Superior Consulting . This extract, from the 2004 Medication Administration report 1 is the first such study from KLAS regarding this class of products and systems. The report is intended to provide a snapshot of current automation in regards to closed loop medication administration. read more »

·         Measuring Information Technology Investment Among Canadian Academic Health Sciences Centres

Published: Friday January 14th 11PM

Link: http://www.longwoods.com/content/17021

Description: Many recent studies have attempted to accurately measure the expenditure by hospitals in the area of new information technology IT , for example see Leonard 1998 and Pink et al. 2001. This is usually done as an exercise to compare the healthcare sector with other industries that have had much more success in implementing and leveraging their IT investment Willcocks 1992; Chan 2000 . It is normally hoped that such investigation would help explain some of the differences among the various industries and provide insight into where and how much future IT spending should occur in healthcare Leonard 2004 . Herein, we present the results from a study of eight Canadian academic health sciences centres that contributed data in order to analyze the amount of information technology spending in their organizations. Specifically, we focus on one specific indicator: the IT spend ratio. This ratio is defined as the percentage of total IT net costs to total hospital net operating costs, and aims read more »

·         Measuring It Investments: A Non-trivial Exercise

Published: Friday January 14th 11PM

Link: http://www.longwoods.com/content/20440

Description: In their paper, “Measuring Information Technology Investment among Canadian Academic Health Sciences Centres,” one gets the impression that Pederson and Leonard felt a need to share their frustrations. Not only was their task difficult i.e., trying to get a meaningful grip on how much is being spent on information technology , but the lack of co-operation they encountered must indeed have been exasperating. Having also experienced the “reluctance-to-reveal” phenomenon, this commentator can sympathize with their trials and tribulations. read more »

·         Publisher’s Page

Published: Friday January 14th 11PM

Link: http://www.longwoods.com/content/17024

Description: No abstract available for this article. read more »

·         Profile: Matthew Morgan

Published: Friday January 14th 11PM

Link: http://www.longwoods.com/content/17022

Description: From coffee makers to roller coasters there is at least one piece of technology we can’t live without. In our last issue, Bala Kathiresan, CIO of Niagara Health System nominated the telephone. We are continuing the series and asked Matt Morgan to tell us about the one technological invention he couldn’t live without, and why. read more »

·         The Hit Report From Klas: Professional Services 2004; Provider-based Professional Clinical And Financial Implementation Services 2004

Published: Friday January 14th 11PM

Link: http://www.longwoods.com/content/17023

Description: This first study of professional services, focusing on provider-based acute care clinical and financial implementations, is KLAS’s inaugural event and launch into performance monitoring of healthcare professional services. read more »

·         Computer Telephony In Healthcare

Published: Tuesday September 14th 11PM

Link: http://www.longwoods.com/content/17004

Description: The telephone provides an easy-to-use, reliable and cheap computer interface. We review computer telephony applications for patient care, clinical research and medical education. We describe uses at our academic health sciences centre and discuss strengths and weaknesses of this technology. Until more sophisticated interfaces, for example personal digital assistants with wireless Internet access, are commonplace, we believe computer telephony can play a useful role in electronic healthcare. read more »

·         Linux Thin-client Conversion In A Large Cardiology Practice: Initial Experience

Published: Tuesday September 14th 11PM

Link: http://www.longwoods.com/content/17005

Description: No abstract available for this article. read more »

·         Ehealthrecord.info

Published: Tuesday September 14th 11PM

Link: http://www.longwoods.com/content/20455

Description: The eHealthrecord.info is designed to provide the latest news, best practices, policy and ideas about electronic healthcare. The subject is salient to advancing the quality of care; our objective is to provide you with clarity and to keep you current. Think of it as a supplement to the journal ElectronicHealthcare. It will be updated every two weeks. To view the full database, please visit <a href=”http://www.longwoods.com/eHealthrecord/EHRindex.html” target=”_blank>http://www.longwoods.com/eHealthrecord/ EHRindex.html</a>. Subscribe to the eHealthrecord.info for free at <a href=”http://www.longwoods.com/mailinglist/index.html” target=”_blank>http://www.longwoods.com/mailinglist/index.html</a>. read more »

·         Publisher’s Page

Published: Tuesday September 14th 11PM

Link: http://www.longwoods.com/content/17008

Description: No abstract available for this article. read more »

·         Profile: Bala Kathiresan

Published: Tuesday September 14th 11PM

Link: http://www.longwoods.com/content/17006

Description: Bala Kathiresan is the Chief Information Officer for the Niagara Health System, an organization created in 2000 as a result of the Health Services Restructuring Commission’s recommendation to merge eight hospitals in the Niagara Peninsula. He is responsible for the Information Management Portfolio that includes information technology/systems, telecommunications, health records and patient registration. As the CIO of the Niagara Health System, Bala developed and implemented the first information systems strategic plan bringing together eight legacy organizations. Bala holds a Bachelor’s degree in Commerce and a Master’s in Business Administration. Prior to joining NHS, he was Vice-President of Healthtech Inc. His career as a consultant gave him the opportunity to work with many healthcare organizations across the country. read more »

·         The Hit Report From Klas: Focus: Dictation, Transcription And Speech Recognition 2004

Published: Tuesday September 14th 11PM

Link: http://www.longwoods.com/content/17007

Description: Healthcare dictation, transcription and speech recognition DTSR systems are a group of products geared to facilitate the recording and transcription of human speech so that dictated contents become part of a medical record. This extract, from the 2004 Dictation, Transcription and Speech Recognition Report, is the first such study from KLAS regarding this class of products and systems. The report is intended to provide a snapshot of current automation in regards to “text reporting,” through the eyes of both users and vendors in the provider setting. read more »

·         Lessons To Be Learned From England About The Potential Of Gp Computer Systems To Improve Patient Safety

Published: Monday June 14th 11PM

Link: http://www.longwoods.com/content/16195

Description: In December 2003, the National Patient Safety Agency in England published a report entitled “Realizing the Potential of GP Computer Systems to Improve Patient Safety.” The project team that generated the report was led by Professor Anthony Avery, Head of the Division of Primary Care, School of Community Health Sciences, at the University of Nottingham. The project team also included researchers from the University of Manchester and the University of Edinburgh. read more »

·         The Knowledge Audit As A Launch Pad For Knowledge Management In Hospitals: A Case Report From Sunnybrook And Women’s Health Sciences Centre

Published: Monday June 14th 11PM

Link: http://www.longwoods.com/content/16207

Description: A recent issue of HealthcarePapers addressed the topic of evidence-based healthcare, or more specifically, its implementation in organizational practice. The lead article by Browman, Snider and Ellis 2003 identified a key gap that impeded the integration of clinical evidence in healthcare practice – specifically, the cultural ” inhabited by hospital managers, the keepers of the financial keys, and clinicians, the primary custodians of quality care. Other articles in the same issue suggested variations on the metaphor of negotiation and the practice of storytelling proposed to improve evidence uptake. Whatever the specific flavour of sharing adopted, contributors to the issue recognized a core problem in which knowledge management, in a general sense, has a central role. They recognized that innovation was required to resolve the problem. Though the possibilities of negotiation are in a sense unbounded, in essence what was proposed was a movement towards a culture read more »

·         Ehealthrecord.info

Published: Monday June 14th 11PM

Link: http://www.longwoods.com/content/20454

Description: HL7 Approves New Standards Standards development organization Health Level Seven has approved three new draft electronic messaging standards for trial use. Early adopters of the draft standards will submit feedback to Ann Arbor, MI-based HL7, which will make needed modifications. If HL7 voting members approve the modifications, they will be submitted to the American National Standards Institute for final approval as full HL7 standards. The new draft standards are: Version 3 Standard: Patient Administration, Release 1 – The standard supports core administrative functions including, among others, patient registrations, discharges and transfers. An initial analysis identified nearly 460 possible messaging events. Release 1 supports 53 of the most common events such as “add a new patient” or “revise demographic information about a person.” Subsequent releases will support other messaging events and early adopters of each release will provide input on work for the future read more »

·         Publisher’s Page

Published: Monday June 14th 11PM

Link: http://www.longwoods.com/content/16230

Description: No abstract available for this article. read more »

·         Donna Strating

Published: Monday June 14th 11PM

Link: http://www.longwoods.com/content/16216

Description: Donna Strating is the Chief Information Office CIO for Capital Health, Edmonton. Donna has worked in the IT field for over 20 years in the private and public sector, within both the United States and Canada. In her current position, she is responsible for overseeing Capital Health’s Information System strategic priorities, goals and initiatives. read more »

·         The Hit Report From Klas: Cpoe Usage 2004: The Realities Of Computerized Physician Order Entry In 2004

Published: Monday June 14th 11PM

Link: http://www.longwoods.com/content/16209

Description: A 2004 CPOE report is the second such report from KLAS initial report February 2003 regarding CPOE usage, its vendors and systems. Today, interest in CPOE remains strong, and deployment of CPOE by healthcare providers is increasing as evidenced by the results of the 2004 study. The report is intended to provide a snapshot of current CPOE usage and capabilities, through the eyes of users and vendors, as the market grows and its vendors and products mature. read more »

·         Critical Success Factors Relating To Healthcare’s Adoption Of New Technology: A Guide To Increasing The Likelihood Of Successful Implementation

Published: Sunday March 14th 11PM

Link: http://www.longwoods.com/content/16194

Description: Over the last decade, significant attention has been paid in both academic and professional literature to the healthcare information technology conundrum, which can easily be summarized in the following question: Why have we not seen more successful implementation of information technology in healthcare While many theories and suggestions have been proposed, there can be no argument that none have been truly effective in explaining or helping to resolve this widespread problem. As a result, the healthcare field is becoming experienced in building not-so-effective systems. read more »

·         Ehealthrecord.info

Published: Sunday March 14th 11PM

Link: http://www.longwoods.com/content/20452

Description: The eHealthrecord.info is designed to provide the latest news, best practices, policy and ideas about electronic healthcare. The subject is salient to advancing the quality of care; our objective is to provide you with clarity and to keep you current. Think of it as a supplement to the journal ElectronicHealthcare. It will be updated every two weeks. To view the full database, please visit <a href=”http://www.longwoods.com/eHealthrecord/EHRindex.html” target=”_blank>http://www.longwoods.com/eHealthrecord/ EHRindex.html</a>. Subscribe to the eHealthrecord.info for free at <a href=”http://www.longwoods.com/mailinglist/index.html” target=”_blank>http://www.longwoods.com/mailinglist/index.html</a>. read more »

·         Profile: Dr. Robert M. Filler

Published: Sunday March 14th 11PM

Link: http://www.longwoods.com/content/16215

Description: Dr. Filler is a founding member of the Canadian Society of Telehealth and served as president from 2000 to 2002. He currently sits as a board member and plays an integral role in advocating for new public policy for telehealth.Dr. Filler completed an unprecedented 18-year term as the surgeon-in-chief at the Hospital for Sick Children HSC , during which time he also served as head of the Division of General Surgery for 20 years and chairman of the Medical Advisory Committee for six years. read more »

·         Publisher’s Page

Published: Sunday March 14th 11PM

Link: http://www.longwoods.com/content/16227

Description: No abstract available for this article. read more »

·         The Hit Report From Klas: Pacs 2003; Focus: Picture Archive And Communication Systems Pacs Market Performance

Published: Sunday March 14th 11PM

Link: http://www.longwoods.com/content/16196

Description: This extract, from a November 2003 PACS study, is the third such study from KLAS regarding PACS vendors and systems, and provides a snapshot of today’s market performance in the acute care setting. Note: In 2003, KLAS separated the PACS market into two segments: 1 PACS Acute Care Settings – the focus of the 2003 study and 2 PACS Ambulatory and Imaging Centres insufficient data to date . read more »

·         The Editor’s Focus: Motivating Change: Ushering In A New World Of Clinical Practice

Published: Thursday August 14th 11PM

Link: http://www.longwoods.com/content/16155

Description: After completing rounds with their residents, two prominent professors of medicine were overheard lamenting the deteriorating values of the profession.”It’s terrible that all these new graduates seem only to focus on making truckloads of money and being treated like gods,” said one.”It really is a shame,” replied the other. “I remember the good old days when all we expected was to be treated like gods “In this issue of ElectronicHealthcare, we feature several articles that address the challenge of motivating physicians to adopt electronic record systems. I chose the humorous anecdote above to highlight the difficulties inherent in introducing a major change in clinical practice. Financial considerations and issues relating to the professional independence of clinical professionals are certainly key factors to be addressed as part of any change-management strategy. But, as the articles in this issue highlight, there are a multitude of other factors that hav read more »

·         Clinical Decision Support Systems: A Discussion Of Quality, Safety And Legal Liability Issues

Published: Thursday August 14th 11PM

Link: http://www.longwoods.com/content/16145

Description: Developers of Clinical Decision Support Systems CDSSs have to date been more concerned with the efficacy of systems than with safety. In future, CDSS developers may be legally required to acknowledge a “duty of care” covering design, development and deployment. Experience in other safety-critical industries has led to a range of quality and safety assurance methods whose adoption may be needed before CDSSs can safely become a trusted part of routine patient care. No single method will be sufficient; a range of techniques will be needed and used selectively. This paper is a contribution to discussion of quality, safety and legal liability issues in the medical informatics community. read more »

·         The Publisher’s Page

Published: Thursday August 14th 11PM

Link: http://www.longwoods.com/content/16228

Description: No abstract available for this article. read more »

·         Barriers To Implementation Of Clinical Systems

Published: Thursday August 14th 11PM

Link: http://www.longwoods.com/content/16143

Description: A year ago in this journal, I wrote a commentary about how to move ahead with clinical computer systems in the face of physician resistance to computerization. I recommended that the planners of these programs move past the small but vocal number of physicians who opposed computerization. I felt then, and still do now, that system planners should not expend too much energy trying to convince the doubters and the “computer-phobes” of the benefits inherent in computerization. Development and innovation move at a much faster rate than do physicians’ attitudes to new and somewhat difficult changes in their method of day-to-day practice, even when these changes promise to make their work more efficient and cost-effective. read more »

·         More Lessons To Be Learned About Primary Care Computing From Another Small Nation

Published: Thursday August 14th 11PM

Link: http://www.longwoods.com/content/16154

Description: In previous issues, we have been exposed to what the Danes have been able to accomplish with physician office computing and the electronic medical record EMR . Here is another success story from another small country that has managed to maximize physician use of computers and the use of electronic medical records to improve the health status of its population. read more »

·         Computerized Physician Order Entry And Communication: Reciprocal Impacts

Published: Thursday August 14th 11PM

Link: http://www.longwoods.com/content/16144

Description: Participant observation, focus group and oral history techniques were used to collect data from four distinctly different sites across the United States. Data were examined initially to identify success factors for computerized physician order entry CPOE implementation. These data, reexamined for communication issues, revealed significant impacts on communication channels and relationships unanticipated by the implementers. Effects on physician-nurse interactions, pharmacy roles, and patient communications that vary by time and location were noted. The importance of robust bidirectional information channels between administration and staff was demonstrated to be potentially “mission-critical.” The recommendation for implementers is “Plan to be surprised.” Careful planning and pre-work are important, but no matter how much an institution prepares for the upheaval of CPOE, unforeseen consequences are inevitable. The presence of a prepared and capable implementation read more »

·         National E-claims Standard Initiative Necst – Healthcare Partnerships In Action

Published: Thursday August 14th 11PM

Link: http://www.longwoods.com/content/16146

Description: The National e-Claims Standard NeCST Project was initiated in April 2000 as a collaborative effort between the public and private sectors as well as national provider associations. This pan-Canadian, voluntary electronic standard was created in order to address the complex and expensive claims environment. This project is funded in part by the stakeholders and Canada Health Infoway, an independent corporation working to accelerate the development of compatible electronic health record systems in Canada. read more »

·         Himss Can Be A Truly Canadian Adventure For Canadians

Published: Thursday August 14th 11PM

Link: http://www.longwoods.com/content/16158

Description: “It’s much easier to get into the mind first than to try to convince someone you have a better organization than the one that did get there first.”HIMSS Healthcare Information and Management Systems Society is the healthcare industry’s dominant membership organization, exclusively focused on providing leadership for the optimal use of healthcare information technology and management systems for the betterment of human health. Worldwide, HIMSS represents more than 13,000 individual members and some 150 member corporations that employ more than one million people. HIMSS shapes and directs healthcare public policy and industry practices through its advocacy, educational and professional development initiatives designed to promote information and management systems’ contributions to quality patient care. In Canada we have different organizations with different mandates. HIMSS has history, reputation, programs, networks and more. We need to encourage them and work with them. read more »

·         Five Most Highly Recommended Health Privacy Websites From The University Health Network

Published: Thursday August 14th 11PM

Link: http://www.longwoods.com/content/16229

Description: No abstract available for this article. read more »

·         The Hit Report From Klas: Radiology Information Systems 2003: Market Performance

Published: Thursday August 14th 11PM

Link: http://www.longwoods.com/content/16156

Description: This extract, from a recent Radiology Information Systems RIS study, provides a snapshot of today’s market performance and industry trends through the eyes of both users and vendors. The result incorporates the opinions of 154 providers 42 chief information officers, two chief medical officers, 14 information system directors, 40 information system managers, 52 radiology directors and four ” . The results of this study were published in May 2003 by KLAS. KLAS 2003 . read more »

·         The Editor’s Focus: Amnesic D J Vu: The Feeling That You Have Forgotten This Before.

Published: Wednesday May 14th 11PM

Link: http://www.longwoods.com/content/16152

Description: When I first heard this humorous definition, I couldn’t help but think of our healthcare system as it tries to implement electronic health records. Over and over again, the same tactical and strategic errors have been repeated across the country. Somehow, the health system does not seem to retain lessons learned in an effective way. Certainly we would progress more quickly down the EHR path if we learned more effectively from the mistakes and successes of others. So what is it that keeps us from learning and remembering our collective past experiences read more »

·         The Publisher’s Page

Published: Wednesday May 14th 11PM

Link: http://www.longwoods.com/content/16225

Description: No abstract available for this article. read more »

·         The Evolution Of A Health Information Brokering Service In The Province Of British Columbia

Published: Wednesday May 14th 11PM

Link: http://www.longwoods.com/content/16147

Description: The Provincial Health Services Authority PHSA is implementing a health information brokering service in the province of British Columbia. This brokering service called the Clinical Broker is based upon the experienced gained by the B.C. Cancer Agency BCCA in the creation of its Electronic Health Record EHR for cancer care. The brokering service will initially focus on an operational need for information exchange between healthcare providers. Over time, it will be extended to include more complex healthcare services, such as results query, appointment booking and clinical decision support. read more »

·         Building A Quality Improvement Coalition: A Cancer Information Management Strategy For Ontario

Published: Wednesday May 14th 11PM

Link: http://www.longwoods.com/content/16148

Description: Information management plans should support the organization’s overall business objectives rather than being crafted in isolation from overall organizational strategies. The cancer system is undergoing significant transformation, including integration of service delivery at the regional level and a revamped role for Cancer Care Ontario. The Cancer Information Management plan for Ontario outlines an approach to linking and coordinating various information management systems and projects to support the new directions. Through a coalition of partners working together and by building on the success of earlier initiatives – including the widespread adoption of CPOE within a large part of the cancer system – the plan will improve the quality of care for Ontario cancer patients. read more »

·         Five It Decisions That Should Involve Non-it Executives

Published: Wednesday May 14th 11PM

Link: http://www.longwoods.com/content/16149

Description: For years, senior-level executives have struggled with the challenge of making IT decisions, often feeling that they don’t have enough IT knowledge to manage technology projects in detail. Yet research has shown that organizations whose senior leadership is involved in IT decisions often experience higher return on IT investments and more successful implementation of new technologies. read more »

·         Strategic Operations: The New Method For Marrying Strategic And Operational Silos, Utilizing Expert System Technology To Improve Resource Allocation And Cost-effectiveness

Published: Wednesday May 14th 11PM

Link: http://www.longwoods.com/content/16150

Description: What a hospital board plans to do through strategic retreats is often considerably different from what happens at the operational level. The daily pressures of fighting fires – labour contract changes, increased pressure from overflowing emergency rooms, nursing shortages, increased drug costs and a host of other unexpected changes – mean that operational management is most usually focused on dealing with ever-changing management pressures. Time is very limited by these issues, so strategic plans are difficult to operationalize in this milieu.The authors propose a new approach to assist healthcare management to marry strategic thinking with operational processes. This new method of strategic operations using expert system software overcomes the issues created by traditional operational silos and provides a radical new approach to healthcare management. This new approach is so nimble and responsive that it can even be used in the midst of daily fire-fighting to take into account changes read more »

·         Further Lessons From Denmark About Computer Systems In Physician Offices

Published: Wednesday May 14th 11PM

Link: http://www.longwoods.com/content/16151

Description: In the last issue, we asked: What can a small country of only 5.3 million people teach us about health informatics When it comes to physician office computing and the electronic medical record EMR , it may be worth taking a closer look at what the Danes have accomplished and how they got there. read more »

·         Favourite Websites From The Canadian Society Of Physician Executives

Published: Wednesday May 14th 11PM

Link: http://www.longwoods.com/content/16226

Description: No abstract available for this article. read more »

·         Gary G. Mar On Alberta’s Health It Initiatives

Published: Wednesday May 14th 11PM

Link: http://www.longwoods.com/content/16153

Description: The Hon. Gary G. Mar QC PC , MLA for Calgary Nose Creek, is Alberta’s Minister of Health and Wellness, elected to his third term as Member of the Legislative Assembly in 2001. Since he was first elected in 1993, Mr. Mar has served as Minister of Community Development, Minister of Education and Minister of Environment. Mr. Mar is a member of the Agenda and Priorities Committee and the Standing Policy Committee on Health and Community Living. read more »

·         Book Review: The Strategic Application Of Information Technology In Health Care Organizations, By John P. Glaser

Published: Wednesday May 14th 11PM

Link: http://www.longwoods.com/content/16157

Description: “The battle to prove that IT is vital to business operations is still being fought within the enterprise.”Fewer IT managers believe bosses are able to make strategic use of technology.”2These two statements come from recent surveys exploring the views of executives and IT managers on the value of IT investments for their organizations. I am personally not surprised by these findings. I have been on both sides of the equation during my career and have come to the conclusion that, in large measure, a lack of alignment between the strategic orientations of an organization and the IT investment portfolio has perpetuated the disconnect. read more »

·         The Hit Report From Klas: Cpoe Usage 2002, The Realities Of Computerized Physician Order Entry In 2002

Published: Wednesday May 14th 11PM

Link: http://www.longwoods.com/content/16159

Description: A previous KLAS study found that 75 of acute care organizations were considering either implementing Computerized Physician Order Entry CPOE or augmenting an existing CPOE with wireless. Other recent articles report a rather wide range of observations regarding order entry automation, physician use and CPOE benefits. This heightened interest in CPOE has created a “need to know” more about CPOE: separating fact from fiction and hype from reality, as to the who, what, when, where and why of CPOE. read more »

·         The Editor’s Focus

Published: Friday February 14th 11PM

Link: http://www.longwoods.com/content/16186

Description: No abstract available for this article. read more »

·         The Publisher’s Page

Published: Friday February 14th 11PM

Link: http://www.longwoods.com/content/16223

Description: No abstract available for this article. read more »

·         Rush Physician Order Entry: From Physician Resistors To Physician Champions

Published: Friday February 14th 11PM

Link: http://www.longwoods.com/content/16187

Description: Rush-Presbyterian-St. Luke’s Medical Center is the hub of the Rush System for Health, a comprehensive, cooperative healthcare system serving patients throughout the Chicago area through its own resources and in affiliation with other healthcare institutions. The Medical Center includes the 824-bed Presbyterian-St. Luke’s Hospital including the Rush Children’s Hospital and the 110-bed Johnston R. Bowman Health Center for the care of the elderly and disabled. Rush also operates Oak Park Hospital, a 296-bed community hospital in Chicago’s Near west suburbs. read more »

·         Engaging Physicians In The Use Of Electronic Medical Records

Published: Friday February 14th 11PM

Link: http://www.longwoods.com/content/16188

Description: Although this article could be applied to physicians across all specialties, our focus is on the engagement of Canadian primary care physicians in the use of Electronic Medical Record EMR systems. The objective of our article is to suggest a methodology that can be followed in order to assist in the physician’s adoption of EMR.It would be presumptuous to state that we have all the answers when it comes to an issue as complex as the adoption of EMR by physicians; however, there are broad principles that can provide an organized and logical approach towards the implementation of these systems. read more »

·         Was It Really Only A Scant Few Years Ago That Silicon Valley Was Booming, Dot.coms Were The Next Big Things And Nortel Shares Were Trading At More Than 100

Published: Friday February 14th 11PM

Link: http://www.longwoods.com/content/16189

Description: Alas, there’s nothing like a pinch of reality to pop an over-inflated hype bubble. These days, so many of those whiz-bang dot.coms are dot.goners; Nortel shares are penny stocks; and the busiest folks in Silicon Valley aren’t new age high-tech gurus, but rather a legion of repo men towing BMW and Mercedes sports coupes back to the impound lot.Since the turn of the new millennium, the business casualty list – especially in the IT sector – has become increasingly bloated. A McKinsey Quarterly report released last year determined that out of 492 software companies defined as “struggling,” only 13 were subsequently able to revive themselves. McKinsey noted that executing a turnaround in the software sector is an especially difficult task because at the first signs of trouble forces specific to the industry combine to create a deadly downward spiral. read more »

·         Home Healthcare Electronics: Consumers Are Ready, Willing And Able

Published: Friday February 14th 11PM

Link: http://www.longwoods.com/content/16193

Description: How many older Americans are afraid to use electronic medical devices at home, fearing they will use them incorrectly or, worse, break them, or that the devices will not work properly The answer is, not many. A recent Accenture survey reveals that among respondents over age 65, 83 percent disagree, and 46 percent strongly disagree, that they are afraid to test their own health at home. Only 13 percent fear that a device will not function properly, while only 12 percent think they might break the device. Even fewer – 8 percent – believe they might forget how to use one. read more »

·         Two-thirds Of All Online Canadians Have Visited A Health Website, Up From 55 In 2000

Published: Friday February 14th 11PM

Link: http://www.longwoods.com/content/16190

Description: Survey results released in December, 2002 from Ipsos-Reid’s Canadian Inter ctive Reid Report show that more Canadians have looked for online health information than any other online activity. A larger proportion of online Canadians have visited a health Website than those who have sent joke emails 59 , used instant messaging 54 , conducted online banking 49 , comparison shopped 45 or who have purchased something online 43 . In fact, besides the generic categories of sending & receiving email, and using a search engine, using the Internet to visit a health site that offers medical, nutritional, exercise, diet or alternative medicine information, is number one among 40+ activities Canadian Inter ctive Reid Report has measured over the past eight years. It is also an activity with relatively frequent participation levels, as 66 of those who have visited a health site do so on a monthly basis, and a smaller proportion 22 browse weekly. read more »

·         Beware Clinical Decision Support – But You May Already Have To Use It

Published: Friday February 14th 11PM

Link: http://www.longwoods.com/content/16191

Description: Hospitals looking at clinical decision support systems should be aware of the two-edged sword such systems could turn into if they’re not thoughtfully implemented. Both edges are pretty sharp. That’s the conclusion of Eta S. Berner, a professor of healthcare informatics at the University of Alabama at Birmingham and author of a sobering article in the fall Healthcare Information and Management Systems Society Journal. If you haven’t seen it, the gist is that: Hospitals could be liable if their clinicians make decisions based on a decision-support system that has faulty or incomplete rules, and they could be held responsible for those rules even if the vendor programmed them; and Decision-support systems are getting to be just common enough to begin to constitute a standard of care, and hospitals might be liable for not having one if its absence is deemed to have harmed a patient, or if a doctor overrides the system without a good reason. read more »

·         Steve Lieber’s Favourite Websites

Published: Friday February 14th 11PM

Link: http://www.longwoods.com/content/16224

Description: Steve Lieber is President and CEO of the Chicago-based Healthcare Information and Management Systems Society HIMSS , a leading association for healthcare IT professionals. Headquartered in Chicago, HIMSS provides services to more than 13,000 members, including IT healthcare corporations, firms and professionals from around the globe. Through the collaboration of 41 chapters and 20 special interest groups, HIMSS directs and shapes the healthcare industry, encourages emerging technology and promotes public policies that will improve healthcare delivery. read more »

·         Profile: Victor Peel

Published: Friday February 14th 11PM

Link: http://www.longwoods.com/content/16214

Description: With 26 years of experience as a healthcare administrator, 12 of which were spent as a CEO of a teaching hospital and then a health district in the United Kingdom, editorial advisory board member Victor Peel has been in a unique position as both a teacher and one of the early adopters of the broad use of health informatics. He is a Fellow of the University of Surrey in England and of Erasmus University in The Netherlands. Victor believes it was his joint experience as an administrator and as an academic earlier at the University of Manchester that was key to his formative years in health information and technology. He first became interested in health informatics “a long time ago ” by using an early information system to solve a major health service problem. read more »

·         The Hit Report From Klas: Pacs 2002; Focus: Picture Archive And Communication Systems Pacs Market Performance

Published: Friday February 14th 11PM

Link: http://www.longwoods.com/content/16192

Description: This extract, from a recent PACS study, provides a snapshot of today’s market performance and industry trends, through the eyes of both users and vendors, as the market continues to grow and its vendors and products mature. Clients interviewed were from more than 130 sites, and the results incorporate the opinions of over 225 PACS imaging managers, medical directors, radiologists, CIOs, department directors and vendor executives. The full report contains over 350 pages of rankings, commentaries and analysis and was published in November 2002 by KLAS the 2002 PACS report is the second such report from KLAS; initial report June 2001 . read more »

·         The Editor’s Focus: Building On A Legacy

Published: Monday October 14th 11PM

Link: http://www.longwoods.com/content/16178

Description: As we ponder the task of implementing electronic health records for the Canadian population, the challenge of integrating legacy systems quickly takes centre stage. Billions of dollars have been spent over the past couple of decades implementing clinical systems of various descriptions. They use every architecture, operating system, developmental environment and vendor platform imaginable. Add to that the absence of standard nomenclatures in common use for most clinical information and you have the electronic equivalent of the Tower of Babel. read more »

·         The Publisher’s Page

Published: Monday October 14th 11PM

Link: http://www.longwoods.com/content/16221

Description: No abstract available for this article. read more »

·         Putting Canada In The Vanguard Of The Internet Transformation

Published: Monday October 14th 11PM

Link: http://www.longwoods.com/content/16179

Description: In August 1995 at the conclusion of my term as Clifford Clark Visiting Economist, I left behind at the Department of Finance an essay outlining some proposals as to Canada’s policy priorities for the next decade. Included was the following statement: “Perhaps the most compelling phenomenon of our times is the emergence of the information society – based on microchips and communications – but far transcending those technological underpinnings. Shaping Canada’s role in the information society according to our values, and assuring that we stay at the leading edge, are opportunities of sufficient breadth and potential to define a great national project . read more »

·         Health On-line – The Best Will Get Better

Published: Monday October 14th 11PM

Link: http://www.longwoods.com/content/16180

Description: The major medical centres of the United States already have the best brands, the best performance records and the most customers. The Internet could make these institutions even more successful.In 1999, an estimated 17.5 million people – nearly half of all adults using the Internet in the United States – visited World Wide Web sites offering healthcare information. As Internet use becomes more prevalent, it will transform the local, low-return U.S. healthcare industry. We believe that in this transformation the players holding the best hands are the major medical centres of the United States rather than the Internet – pure plays currently dominating the landscape of e-healthcare. read more »

·         Careconnect – A Waypoint For The Electronic Health Record In 2002; Part 1: Conceptual Models

Published: Friday October 4th 11PM

Link: http://www.longwoods.com/content/16181

Description: Discussions concerning the electronic health record EHR are often erudite and theoretical, in part because the EHR is less a destination than a journey Denis Protti, University of Victoria, personal communication . At one level, it is a compendium of health data repositories. This level of complexity may require a “view only” functionality. At another level, the EHR is an element of a complex clinical decision support system that is at the core of processes to improve patient safety and quality of care. At this level, a “view and do” functionality may be required. read more »

·         Investing In Information Technology: Where Do Canadian Hospitals Stand

Published: Monday October 14th 11PM

Link: http://www.longwoods.com/content/16182

Description: Investments in information technology IT can have a significant impact on an organization’s performance. Well-managed IT investments that are carefully selected and focused on meeting defined needs can propel an organization forward, improving performance while reducing costs. Likewise, poor investments, those that are inadequately justified or whose costs, risks and benefits are poorly managed, can hinder and even restrict an organization’s performance. read more »

·         The Ehr In Denmark: You Don’t Have To Be Big To Be In Front

Published: Monday October 14th 11PM

Link: http://www.longwoods.com/content/16183

Description: What can a robust, hard-working, seafaring nation of only 5.3 million people that is smaller in size than Nova Scotia teach us about health informatics Perhaps more than we realize. In terms of the use of information technology IT in hospitals i.e., the electronic patient record , Denmark is not remarkable. However, when it comes to primary computing, Denmark rivals the United Kingdom. read more »

·         Remote Icu Monitoring Yields Dramatic Benefits

Published: Monday October 14th 11PM

Link: http://www.longwoods.com/content/16184

Description: A system that allows for remote around-the-clock monitoring of ICU patients by intensivists has yielded dramatic clinical and financial benefits at beta site Sentara Healthcare, Norfolk, Va. read more »

·         Nils Clausen’s Favourite Websites

Published: Monday October 14th 11PM

Link: http://www.longwoods.com/content/16222

Description: Nils Clausen is Country Manager for Global Healthcare Exchange, an Internet-based trading exchange for the healthcare system. Its Canadian members now include more than 30 suppliers who account for over half of the 4 billion market for patient care products in Canada and over 60 hospital sites. read more »

·         Profiles

Published: Monday October 14th 11PM

Link: http://www.longwoods.com/content/16213

Description: No abstract available for this article. read more »

·         The Hit Report From Klas: Emergency Department Systems Study; Focus: Eight Ed Vendor Products Compared. Study Provides Valuable Insight Into The Success Of Ed Systems.

Published: Monday October 14th 11PM

Link: http://www.longwoods.com/content/16185

Description: Emergency Department ED Systems appear to be a system whose “time has come.” Aided by recent advancements in technology and application software, ED automation is demonstrating solid benefits with proven Return on Investment ROI , as reported by system users. Vendors whose products qualified for the study reported here were those offering an ED product that supported patient tracking, discharge planning, clinician documentation and charting physician and nurse , clinical integration for orders and results, and billing and coding with sufficient sites in production from which to survey. This article is an excerpt from the full study published May 2002 by KLAS. read more »

·         The Editor’s Focus: The Pathology Of It Investments

Published: Tuesday May 14th 11PM

Link: http://www.longwoods.com/content/16169

Description: No abstract available for this article. read more »

·         The Publisher’s Page

Published: Tuesday May 14th 11PM

Link: http://www.longwoods.com/content/16799

Description: No abstract available for this article. read more »

·         An Aging Population: Challenges To The Electronic Health Record Development And Health Informatics Community

Published: Tuesday May 14th 11PM

Link: http://www.longwoods.com/content/16170

Description: Baycrest Centre is one of the largest Academic Health Centres in Canada serving the aging population. As such, it has very complex information management IM requirements. Recently, a research project was carried out to determine the extent to which electronic health record EHR technologies are available and implemented within long-term care LTC organizations of comparable dimensions. Data collection included Internet searches and telephone interviews with targeted technology vendors and facilities. Results showed that although there are many superficial similarities between LTC and acute care, care delivery models and processes are so different, and the IM and EHR needs so unique, as to require different technology solutions and information management approaches. However, progress in development of relevant LTC solutions has been slow – 70 of vendors have chosen not to participate in LTC applications development. LTC facilities also expressed frustration with the fact that imple read more »

·         Bringing Data To The Continuous Quality Improvement Cqi Process; The Pppeso Perinatal Database: From Low Tech To High Tech

Published: Tuesday May 14th 11PM

Link: http://www.longwoods.com/content/16171

Description: Obstetrical services are one of the high-volume services in hospitals in Canada. As such, it is essential that hospital managers have access to timely, high-quality perinatal information on the characteristics of the women using their services, the use of interventions, and health outcomes. Ideally, this information is used as an integral part of a formal continuous quality improvement CQI process.Individual hospitals, mainly teaching hospitals, have developed their own clinical databases to provide perinatal information for research and management purposes. The Eastern Ontario region took a different approach. Under the direction of the Perinatal Partnership Program of Eastern and Southeastern Ontario PPPESO , the hospitals collaborated on the development of a common database. read more »

·         The Ehr And Patient Safety: A Paradigm Shift For Healthcare Decision-makers

Published: Tuesday May 14th 11PM

Link: http://www.longwoods.com/content/16174

Description: No abstract available for this article. read more »

·         Physician Order Entry: The Wave That Never Breaks

Published: Tuesday May 14th 11PM

Link: http://www.longwoods.com/content/16172

Description: I grew up listening and watching waves break along the shores of Nova Scotia. But it was not until I actually ventured out into the cold Atlantic water that I realized the power and forces of change that were working below the surface. As a physician, the same can be said about my decade long experience with physician order entry POE . There have been moments when I have wondered if the wave will ever break, hoping for the time when this powerful tool would become ubiquitous in clinical practice. There have been moments when I have seen the forces of POE change medical practice for the better, helping ensure safer, faster and more efficient delivery of care. And there have been moments when I have seen the wave crash violently, causing chaos, frustration and harm. Yet I remain absolutely convinced that without POE, pursuit of the electronic patient record EPR is simply a bad idea, a poor use of technology and a tool of limited value, with a questionable return on investment. read more »

·         Physician Order Entry Systems Should Be Integrated

Published: Tuesday May 14th 11PM

Link: http://www.longwoods.com/content/16173

Description: Thanks to influences such as the Institute of Medicine IOM and the Leapfrog Group there is now a high priority on implementing physician order entry POE systems. Given the substantial cost and complexity associated with implementing POE as part of a computer-based patient record system CPR , some care delivery organizations CDOs are considering implementing a POE as a stand-alone approach e.g., an addition to a pharmacy system . read more »

·         The Components Of Automated Healthcare Order Management

Published: Tuesday May 14th 11PM

Link: http://www.longwoods.com/content/16175

Description: The physician ordering process initiates activities representing 80 of the care delivery costs of healthcare. Because order management is a complex capability, it is important to clearly define its various components. This will permit care delivery organizations CDOs to better evaluate vendor capabilities and thus obtain products that better meet their needs. read more »

·         When Computers Learn To Talk: A Web Services Primer; What Are Web Services Why Should You Care

Published: Tuesday May 14th 11PM

Link: http://www.longwoods.com/content/16176

Description: Anyone made leery by the unfulfilled promises of the dot-com era may feel skeptical, or at least confused, about Web services, the latest wave of innovation on the Internet. Sky-high expectations and reams of hype are too often the death knell for emerging technologies. Will this one be any different read more »

·         Denis Caro’s Favourite Websites

Published: Tuesday May 14th 11PM

Link: http://www.longwoods.com/content/16219

Description: Denis Caro is a Professor at the University of Ottawa where he specializes in the areas of management information systems, healthcare management and emergency management systems. His specific research interests include strategic information support in emergency management systems. All you surferholics will want to know that he is co-author of a text entitled “Strategic Management of Technostress in an Information Society.” We’ll leave it to you to search the web, search the web, search the web for it. read more »

·         Board Profiles

Published: Tuesday May 14th 11PM

Link: http://www.longwoods.com/content/16212

Description: No abstract available for this article. read more »

·         Dipen Kalaria’s Favourite Websites

Published: Tuesday May 14th 11PM

Link: http://www.longwoods.com/content/16220

Description: Dipen Kalaria is Director, Internet Pharmacy Services at Pharmacy.ca. Every day he uses the Internet for research and pharmacy e-commerce. For him the Internet is a tool for connecting with a broad range of clients including patients, physicians and clinical trials administrators. He offers these favourite websites. read more »

·         The Hit Report From Klas: Hit Performance: Physician Order Entry Perception Study; Focus: Leading Physician Order Entry – Clinical Information System Vendors

Published: Tuesday May 14th 11PM

Link: http://www.longwoods.com/content/16177

Description: This extract from a recent study offers unique insight into the perception of HIT executives relative to the leading Physician Order Entry – Clinical Information System CPR based vendors, in the healthcare industry, and was published November 2001 by KLAS. A specific 17-question “Market Perception” survey was developed. Interviews were conducted to understand the perception of the participants about today’s software capabilities comparing the possible vendors. The purpose of the study was to find out the most likely vendors to be included by healthcare and IT professionals in today’s selection process versus a year ago, and why. read more »

·         Denis Caro’s Favourite Websites

Published: Monday May 14th 11PM

Link: http://www.longwoods.com/content/20636

Description: Denis Caro is a Professor at the University of Ottawa where he specializes in the areas of management information systems, healthcare management and emergency management systems. His specific research interests include strategic information support in emergency management systems. All you surferholics will want to know that he is co-author of a text entitled “Strategic Management of Technostress in an Information Society.” We’ll leave it to you to search the web, search the web, search the web for it. If you do get frustrated try writing him at <a href=”mailto:drcaro uottawa.ca” target=”_blank>drcaro uottawa.ca</a>. read more »

·         Dipen Kalaria’s Favourite Websites

Published: Monday May 14th 11PM

Link: http://www.longwoods.com/content/20634

Description: Dipen Kalaria is Director, Internet Pharmacy Services at <a href=”http://Pharmacy.ca” target=”_blank>Pharmacy.ca</a>. Every day he uses the Internet for research and pharmacy e-commerce. For him the Internet is a tool for connecting with a broad range of clients including patients, physicians and clinical trials administrators. He offers these favourite websites. read more »

·         Hit Performance: Action Is The Word

Published: Monday May 14th 11PM

Link: http://www.longwoods.com/content/20635

Description: We at KLAS truly marvel as we report on the experiences HIT clients have had with their selected vendors. Vendors who succeed truly are action oriented. Many years ago, a young man from India refused to do nothing and sprung into action. His actions helped to awaken, and then liberate a nation. One of his many quotes is appropriate here as we speak of actionoriented performance: “It’s the action, not the fruit of the action, that’s important. You have to do the right thing. It may not be in your power, may not be in your time, that there’ll be any fruit. But that doesn’t mean you stop doing the right thing. You may never know what results come from your action. But if you do nothing, there will be no result.” -Gandhi read more »

·         The Editor’s Focus: Of Risks And Rewards

Published: Friday December 14th 11PM

Link: http://www.longwoods.com/content/16160

Description: There was a statistics student who, when driving his car, would always accelerate hard before coming to any intersection, whiz straight through, then slow down again once he got to the other side. One day he had a passenger who, understandably, was unnerved by his driving style and asked him why he was in such a hurry when passing through intersections. The statistics student replied, “Well, statistically speaking, you are far more likely to have an accident in an intersection, so I make sure that I spend as little time there as possible.”Over the past decade, the number of people participating in the stock market has increased dramatically. On average, stock markets deliver higher returns than do fixed interest investments. This has driven an increasing number of investors to put more of their assets in the equities market. read more »

·         Letter To The Editor

Published: Friday December 14th 11PM

Link: http://www.longwoods.com/content/16210

Description: I have been using an electronic medical record for the past four years. Prior to selecting that I had been chair of the Computer Software Salon, a.k.a. CyberDoc Cafe, at the Ontario College meetings. I had an opportunity to see several systems over the years. I had started in 1985 with an IBM XT based system which I kept for 18 months for billing and a few other functions. It rarely performed as expected. In October of 1986 I had an opportunity to try the Macintosh Plus computer with the MacMedical program on it. It was so simple and yet so sophisticated compared to what I had. It has continued to be much much more user friendly while accomplishing what I want. The same is true of the EMR program, MacMedical Records. read more »

·         Prescriptions For Investment In Health Information: Managing Risk For Maximum Benefit

Published: Friday December 14th 11PM

Link: http://www.longwoods.com/content/16161

Description: As we plan to increase our spending on health information technology in Canada, this article cautions that we must manage risk carefully and get the most out of our investments. The author outlines 13 principles for investments in information infrastructure that were derived from observations of successes and failures in health and other industries.These principles are: be certain funding is adequate; communicate project objectives in clinical or business terms; actively manage stakeholder expectations; where possible, fund results, not technology; learn from the successes and failures of others; plan for failure; put users in the driver’s seat; invest in success; build teams with experience; maintain strong communication links with stakeholders; include process design in every project; keep projects short; and avoid creating political footballs.Canada is on the verge of escalating its investments in health information systems. Spending by hospitals, health regions, governments and the read more »

·         Hospitals Communicating With Family Doctors; London Health Sciences Centre Keeps Patient Care In Sight With Lens

Published: Friday December 14th 11PM

Link: http://www.longwoods.com/content/16162

Description: How many times have you heard that your hospital doesn’t adequately communicate patient information to the Family Physician community That a patient can be seen, diagnosed, have surgery, and return home before their Family Physician knows about it At the London Health Sciences Centre, we had tried for years to improve communication to our Family Physicians. We had a large number of volunteers who focused on tele-phoning individual physician offices with information about patient visits. We faxed emergency room records to physicians. And we mailed out discharge summaries. But eventually, human error would intervene and some critical piece of communication would fall through the cracks. read more »

·         Newfoundland And Labrador Centre For Health Information – Network Update

Published: Friday December 14th 11PM

Link: http://www.longwoods.com/content/16163

Description: The Newfoundland and Labrador Centre for Health Information was established to make the province’s Health System Information Task Force’s vision of a quality person-centred health information system a reality. Since 1996, the centre has been working with partners to develop a comprehensive Health Information Network. The centre has obtained government support to build the unique personal identifier/client registry, and is presently finalizing a proposal to government to fund a project for the Newfoundland and Labrador Pharmacy Network. Work also continues at Newfoundland and Labrador Centre for Health Information towards the development and dissemination of quality health information. read more »

·         The Case For Collaboration In Health Infostructure Developments; Can We Deliver On The Promise It Holds

Published: Friday December 14th 11PM

Link: http://www.longwoods.com/content/16164

Description: At the outset of its health reforms in 1992, Saskatchewan identified health information and technology as a key enabler for health-system change. Collaboration with the new health districts led to a provincial health IT architecture and development of an arms-length agency, the Saskatchewan Health Information Network SHIN to operationalize this vision. Drawing from experience in Saskatchewan, this article explores both the benefits and challenges of collaboration at a time when planning and investment through a new pan-Canadian approach to health infostructure holds out so much promise and opportunity for health informatics in our country. read more »

·         Health Informatics Education In Canada – What’s Ahead

Published: Friday December 14th 11PM

Link: http://www.longwoods.com/content/16165

Description: With the growing recognition that there is a severe shortage of qualified health informatics experts who can understand, manage and use information and communication technologies in health settings, there is an urgent need to advance health informatics education and training in Canada. Given this rising demand, it makes sense to pool together the limited resources available to create a health informatics learning community. A consortium of educational institutions, health organizations, professional associations, government ministries and the private sector could build up a critical mass of qualified health informatics experts, develop online health informatics content and create flexible programs that could be easily accessible from multiple institutions for learners with different learning needs across the country. This article looks at what’s ahead with health informatics education opportunities in Canada over the next few years. read more »

·         Information Systems Solutions To Medical Errors

Published: Friday December 14th 11PM

Link: http://www.longwoods.com/content/16166

Description: The Institute of Medicine released a report in late 1999 titled To Err is Human: Building a Safer Health System. This report puts the number of preventable deaths in America from medical errors at 44,000 to 98,000 a year, and estimates the cost of preventable errors at 17-29 billion. While the research behind this report is not new, these figures shocked the nation, and have already led to a number of proposed regulatory changes. In addition this report has touched a nerve in boardrooms and living rooms across the country, and is likely to eventually result in other, more fundamental changes in the way consumers and purchasers evaluate and select healthcare providers. This paper: Summarizes what the IOM report says about the nature, frequency, and causes of medical errors;Links the report’s recommendations and their information systems implications;Proposes an integrated approach to help providers design information systems solutions that can reduce the rate of medical errors. read more »

·         The Electronic Health Record Journey Into Uncharted Territory: Early Messages From The English Scouts

Published: Friday December 14th 11PM

Link: http://www.longwoods.com/content/16167

Description: England’s Electronic Record Development and Implementation Programme has the overall aim of piloting electronic health record systems and concepts. This involves exploring issues associated with developing and implementing an electronic health record and using information drawn from various electronic patient record systems. As England’s South Staffordshire demonstrator site illustrates, determining content for an electronic health record is a very complex process. There are also issues of consent, access and completeness – to name a few – that also need to be addressed. The electronic health record is a long and arduous journey; this article examines the many challenges that England faces. read more »

·         Industry News

Published: Friday December 14th 11PM

Link: http://www.longwoods.com/content/16208

Description: No abstract available for this article. read more »

·         Anne Lawrence’s Favourite Websites

Published: Friday December 14th 11PM

Link: http://www.longwoods.com/content/16217

Description: Anne Lawrence is the National Health and Education Manager at Compaq Canada Corp. Anne focuses on business development and marketing for both these sectors across the country. With a husband involved in healthcare and raising five girls, Anne has a genuine interest in improving the delivery of healthcare in Canada. But it looks like she still has time for fun on the Web. read more »

·         Board Profiles

Published: Friday December 14th 11PM

Link: http://www.longwoods.com/content/16211

Description: Like industry bookends, Editorial Board members Denis Protti and Catherine Claiter share a fascination for health informatics, separated only by some 30 years of regular paycheques. With Denis in the industry since 1967 and Catherine joining in 1999, they represent the brains, enthusiasm and dedication also evident in their peers. But off work, they do anything but stay on the shelf. Both are avid travellers; Denis fitting in a round or three of golf with every breath he takes, and Catherine breathing the heady air of her beloved forests and mountains. read more »

·         Books At A Glance

Published: Friday December 14th 11PM

Link: http://www.longwoods.com/content/16797

Description: Clausewitz on Strategy Inspiration and Insight from a Master StrategistEdited by Tiha von Ghyczy, Bolko von Oetinger, and Christopher BassfordWhat can a nineteenth-century Prussian general teach a twenty-first century executive or entrepreneur about business strategy A great deal, in fact, given the similarity in the strategic challenges they face: alliances are made, broken, and reconstituted at dizzying speed; when unprecedented events occur, experience does not indicate a course of action; and rules, principles, and how-to prescriptions no longer apply. These, says Carl von Clausewitz, are the times in which the true strategist thrives. read more »

·         Articles At A Glance

Published: Friday December 14th 11PM

Link: http://www.longwoods.com/content/16798

Description: No abstract available for this article. read more »

·         Jennifer Zelmer’s Favourite Websites

Published: Friday December 14th 11PM

Link: http://www.longwoods.com/content/16218

Description: As Director, Health Reports and Analysis, Jennifer Zelmer and her team at the Canadian Institute for Health Information develop health indicators that provide the public, caregivers and health authorities alike with the real stuff. She leads CIHI’s partnership with researchers, AND with the media including Maclean’s Magazine and their annual Health Report. Jennifer is one of a long list of “Protti Proteges.” read more »

·         The Hit Report From Klas: The Filmless Revolution; Focus: Picture Archive And Communication Systems Pacs

Published: Friday December 14th 11PM

Link: http://www.longwoods.com/content/16168

Description: This extract, from a recent PACS study, offers unique insight into the performance, underlying technology, product depth and breath and “real world” issues facing eight of the leading PACS vendors and their clients as rated at more than 130 of their client sites and from over 300 CIOs, department directors and vendor executives. The full report contains over 250 pages of rankings, commentaries and analysis and was published June 2001 by KLAS. read more »

·         The Editor’s Focus: It’s Leaving Here Just Fine

Published: Monday May 14th 11PM

Link: http://www.longwoods.com/content/16197

Description: No abstract available for this article. read more »

·         Contributors

Published: Monday May 14th 11PM

Link: http://www.longwoods.com/content/20628

Description: MICHAEL GUERRIERE, our editor-in-chief, is the Chairman and CEO of HealthLink Clinical Data Network Inc. Prior to that he was a senior executive in a variety of teaching hospitals, most recently as the Executive Vice President and Chief Operating Officer of The University Health Network Toronto General, Toronto Western and Princess Margaret Hospitals . read more »

·         Gatekeepers Of Great Ideas

Published: Monday May 14th 11PM

Link: http://www.longwoods.com/content/20633

Description: The journal of ElectronicHealthcare.com continues the tradition of Hospital Quarterly and HealthcarePapers. Readers will appreciate the directives of an international editorial advisory board and two exceptional editors – Michael Guerriere and Catherine Claiter. We are proud to list them in our masthead. They have assembled important ideas. Great ideas. Individually the board and editors are committed to bringing readers exceptional value in return for investing their time and attention. read more »

·         Developing Canada’s Health Information Infrastructure

Published: Monday May 14th 11PM

Link: http://www.longwoods.com/content/16198

Description: Health Canada’s vision for Canada’s healthcare system is based on e-health improving the quality, accessibility and effectiveness of healthcare. It features a pan-Canadian electronic health record, a range of integrated provider solutions and trusted health information for all Canadians. The federal government is well positioned to provide the focus and leadership for changes to the heath system, and can act as a broker that brings together the provinces and territories around a common agenda for information and communications technologies. read more »

·         A Provincial Strategy In The Development Of Canada’s Health Infostructure

Published: Monday May 14th 11PM

Link: http://www.longwoods.com/content/16204

Description: Alberta Wellnet, a provincial health information sharing and exchange initiative, is one key element in Alberta’s provincial response to a national strategy for integrated health infostructures. It recognizes that integrated systems for health services delivery depend heavily on integrated health infostructures. This article describes the environment leading to the creation and context of alberta wellnet, and analyzes its operation, activities and successes to date as a contribution towards an integrated health information system for Alberta and, ultimately, Canada. read more »

·         The Development Of Canada’s National Health Information Infrastructure: A Prescription For Change Within The Hospital-based Context

Published: Monday May 14th 11PM

Link: http://www.longwoods.com/content/16199

Description: As it currently exists, Canada’s healthcare system, is not sustainable; there is no shortage of evidence to support this. A national health information infrastructure is the new bricks and mortar needed to transform the healthcare system, and hospitals must play a critical role in the development of this infrastructure. Their size, influence and concentration of expertise and resources demand it. Yet, despite efforts of hospitals to date, their work has been unable to yield substantive results. This article outlines the problems with our current system, the evidence and the current nature of change, details the reasons for the suboptimal results, and outlines new strategies that will strengthen the agenda. read more »

·         However Can We Convince Our Colleagues

Published: Monday May 14th 11PM

Link: http://www.longwoods.com/content/16200

Description: While many physicians continue to resist computer technology, and the ramifications of the electronic medical record in the evolving system of healthcare delivery are not completely understood, this technology will be a part of healthcare’s future. By electronically collecting, storing and retrieving data, electronic systems will assist physicians in the increasingly difficult task of diagnosing and prescribing for patients with complicated diseases. The electronic medical record is not something physicians will have the option to reject in the future; it will bring such tremendous advances in efficiency at diagnosis and therapy that to reject it would be akin to rejecting modern radiology. read more »

·         Development Of An Integrated Information System For Ontario’s Community Care Access Centres

Published: Monday May 14th 11PM

Link: http://www.longwoods.com/content/16205

Description: Throughout Ontario, an integrated information system is now being developed to assist community care access centres to use technology to manage and operate their business, thus providing better care and more efficient services to their clients. This project, funded by the Ministry of Health and Long-Term Care and managed by the governance council of Community Care Connects, involves designing and implementing an integrated management system. It will be operated on a common technology platform targeted to the internal and external information requirements of community care access centres . A major objective of the council throughout the development of this system is to keep the central focus on the client.This article outlines the phases of the project already completed, those currently underway and the next steps planned, as well as the expected results and the lessons learned. read more »

·         Just Don’t Call It E-health: A Program For Business To Consumer Internet Information Companies In The Development Of Canada’s National Health Information Infrastructure

Published: Monday May 14th 11PM

Link: http://www.longwoods.com/content/16201

Description: While private Internet health information companies have numerous assets that could assist the development of a unified health information infrastructure in Canada, they face many obstacles in their efforts to become a part of this infrastructure. First among them is insuring the credibility of information and winning over the medical profession. Developing partnerships and collaborations between credible medical groups and private Internet companies is the best model to overcome these challenges and make these Internet companies an effective part of a national health information infrastructure. read more »

·         Accelerating The E-health Connectivity Imperative: Implementing Short-term Value Against Long-term Goals When Building Private-sector Relationships

Published: Monday May 14th 11PM

Link: http://www.longwoods.com/content/16202

Description: The role of the private sector in the e-health equation, whether it be a pure business transaction e-commerce , information transaction e-health or a patient care transaction e-care , is to encourage, build and foster connectivity. The key to building successful connectivity projects that link groups together electronically is to demonstrate value to all parties. Framing this is an over-arching understanding by all participants in the system of the necessity to implement projects with short-term value, while keeping in mind the long-term goals of sustainability and increased care in the Canadian healthcare system. read more »

·         Question: What Might Canada Learn From The Uk Answer: Commit, Commit, Commit

Published: Monday May 14th 11PM

Link: http://www.longwoods.com/content/16206

Description: England is the world leader in moving the health information agenda forward at a national level. Many healthcare organizations around the world have more advanced information technology applications, but in terms of a national strategy, plan and commitment, the English are second to none. We can learn the most from the English in the areas of planning, funding, primary care, the Internet, standards, and electronic records. read more »

Bob Filler’s Top Five Websites

Published: Monday May 14th 11PM

Link: http://www.longwoods.com/content/20631

Description: … read more »

Barb Alexander’s Favourite Web Sites

Published: Monday May 14th 11PM

Link: http://www.longwoods.com/content/20627

Description: Barb Alexander, Regional Sales Manager, Microsoft Canada, British Columbia was responsible for managing Microsoft’s healthcare business across the country before her CEO catapulted her into a larger role in BC. Healthcare’s loss and BC’s gain. </a> read more »

Valerie Mcdonald’s Top Websites

Published: Monday May 14th 11PM

Link: http://www.longwoods.com/content/20632

Description: … read more »

Research Distilled: Enabling Intelligent Decisions; Focus: Healthcare Information Systems

Published: Monday May 14th 11PM

Link: http://www.longwoods.com/content/16203

Description: KLAS enables intelligent decisions in the healthcare industry by compiling reports on areas of interest in Healthcare Information Technology HIT . One of the most comprehensive HIT reports is focused on Acute-Care Healthcare Information Systems. This article is an extract from that report which focuses on the following vendors: Eclipsys SDK, IDX LastWord, McKessonHBOC Star, Meditech Client/Server, Siemens Invision, and QuadraMed Affinity. read more »

This entry was posted on Tuesday, April 12th, 2011 at 4:39 pm and is filed under Longwoods Online.