New technology sees NYGH getting ahead

Hospital's eCare project garners national attention

North York General Hospital has been recognized for two pieces of technology that make it one of the country’s most innovative hospitals.

North York General won the Innovation in the Adoption of Health Information Award and the Project Team Innovation and Care Delivery Award along with Cerner Corporation at the 7th annual Canadian Health Information Awards Gala.

The hospital was honoured for the second phase of its eCare project consisting of a digital database that offers advice to doctors and a barcode system created to ensure accuracy in prescriptions.

North York General’s Director of Medical Informatics, Dr. Jeremy Theal, said the project kicked off in 2007 with the ultimate aim of creating better frontline care through technology.

“This project was unique because frontline clinicians from the hospital were involved right from the beginning,” Theal said. “It was a project really by clinicians for clinicians.”

The Computerized Physician Order Entry is essentially a process to enter electronic medical records into a database to assist physicians.

This allows the database to provide evidence-based suggestions and recommendations to the doctor, such as what appropriate antibiotic is needed for a condition.

“It’s not cookbook medicine, it’s not the same for everybody,” Theal explained. “There are still choices you have to make within the order sets, but it helps the doctors make better decisions because the evidence in the order sets is readily updated.”

North York General is the first hospital in Canada to implement this type of system. It allows much faster integration of discoveries from medical journals into frontline care.

“We’re able to now make changes in our practice patterns within just one or two months after important information is published in literature,” Theal said. “Compared to the traditional statistic, which says it takes 17 years from the time when it’s first published in literature to when it’s regularly practised at the bedside.”

The second piece of phase two is the Closed Loop Medication Administration, which is a barcode system for prescriptions.

“When the doctor enters those orders for medications, the medications are all individually barcoded, and then when the nurse goes to give medication to the patient, they have a little handheld scanning device that scans the barcode on the medication and the patient,” Theal said. “And if those don’t match with the doctor’s orders, maybe it’s the wrong patient or the wrong dose.”

The new barcode system has been a resounding success; in the first nine months of its implementation, North York General averted over 1,300 potential errors.

Theal said the system ensures a much higher level of accuracy in prescribing medications.

“The way we could measure those types of errors prior to this was not very good, because we didn’t have an automated system,” he said. “This is a way to be much more proactive in preventing errors.”

Healthcare Information and Management Systems Society Analytics designated North York General a stage six hospital due to its real-time, evidence-based decision support system.

“In other words a system is actually popping up alerts to help the doc based on what the system knows about the patient,” Theal said.

This makes North York General one of only three stage six hospitals in Canada, the others being South Okanagan General Hospital in Oliver, British Columbia, and St. Michael’s Hospital in West Toronto.

“We’re really leading in Canada … Most hospitals in Canada right now are stage three or lower,” Theal said. “In the order of three percent or less of hospitals in Canada are stage four or higher.”

He said one of the reasons many Canadian hospitals have been slow to adopt information technology, compared to their American counterparts is they do not have the same funding available to them, and the implementation is expensive.

The eCare project was funded with money from the hospital’s operating budget.

“Our hospital leadership felt that implementing this type of system would actually help improve patient care and maybe even save costs,” Theal said. “On that basis they felt it was a good investment.”

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Posted: Jan 13 2012 6:17 pm
Filed in: Health & Wellness
Edition: Toronto