SPECIAL REPORT

with Sina Jahankhani

Coastal Forest Care CentreCoastal Forest Care CentreCoastal Forest Care CentreCoastal Forest Care Centre

WELCOME TO

NEW PATIENTS WELCOME!

Changing the CFCC

Growing number of patients

Desire to reach remote patients in Southern BC

Desire to improve patient care and communication between clinicians

The need for access to specialists outside the clinic

1. DATA MANAGEMENT1. DATA MANAGEMENT

Transitioning from a paper-based system to an electronic one

Organized, accurate, and up-to-date

The EHR

Electronic Health Record (Canada Health Infoway)

6 Components

The EHR:

Reduce errors of handwriting

Increase distribution

Organized storage of data

Reduced wait times

Improved patient care

the benefits

The EHR:

EDR

Improved primary diagnosis

Record of patient dental history (eg. X-rays)

for the dentist

The EHR:

Integration and compilation of data

Prevention of drug adverse effects

Financial records and prospective research

for other clinicians

The EHR:

The transfer from paper to computer

Security and technological maintenance

Training of clinicians

Accepted standards

the issues

Standards

Controlled data input

Universal terminology

Standards:

Rhymes with “oink”!

Logical Observation Names and Codes

Linked to other standards (eg. SNOMED)

Understanding electronic clinical data

Efficient exchange of information

LOINC

Standards:

Reduce language barriers

Confidence in understanding distributed info

Promote patient understanding and research

Reduce errors

Improved automatic referencing to nomenclature

the benefits

Standards:

Training the users (time and $$)

Difficulty deciding on a standard terminology

the issues

2. Clinical Decision 2. Clinical Decision SupportSupport

Lack of decision support tools

Prone to errors of omission and comission

Integration of computers for efficiency and memory support

CDSS: Knowledge systems that interpret data to assist health professionals

CDSS:

Allow offloading of memory

Updated with new medical research

Provide suggestions, reminders, and alerts

the benefits

CDSS:

Thorough primary diagnosis

Provides suggestions for additional lab tests, etc.

Gives reminders based on patient history, medications, and allergies

Offers recommendations for diet/exercise regimens

for the nutritionist

CDSS:

Improve patient-practitioner relationship

Increase efficiency with routine tasks

Allows administrative organization of clinical facilities and costs

Provides guidance on important decisions

for other clinicians

CDSS

CDSS assist trained health professionals; they do not make decisions for them!

2 types of CDSS

Clinicians’ preferred type of CDSS

But there are risks involved!

CDSS:

Disruption of workflow due to improper integration

Interference with decisions of trained health professionals

Poor user interface design (eg. fonts, colours, etc)

the issues

CDSS:

Human-computer interface needs to be: useful, usable, and likeable

Minimize interface flaws and increase flexibility of human-computer interface

Designing integrable software: time, effort, $$

design and usability

3. Databases and 3. Databases and technologytechnology

Health Informatics and Social Workers:

Storage and backup of data

Confidentiality and ethics

Advanced encryption standards

Relative levels of access

Databases

Databases:

PHR

Allow patients to be active in the care of their own health

for the patients

Telehealth

Remote nursing

Teleconferencing

Desktop sharing

Telehealth:

Nurses

Physicians and nutritionists

Caregivers at home

for other caregivers

Telehealth:

Unauthorized access

Comfort with technology

Implementation

Patients and unfamiliar terminology

the issues

Telehealth:

Remote-area patients

Patient-centered care

in, around, and across clinics

We hope to see you soon!We hope to see you soon!We hope to see you soon!We hope to see you soon!

THANKS FOR VISITING OUR CLINIC

(BUT MAYBE NOT REALLY)