Towards Patient-Centered Integration: Hôpital Montfort’s Clinical Informatics Plan

1. Towards Patient-Centered Integration: • Hôpital Montfort’s Clinical Informatics Plan

2. An Overview of Clinical Informatics at Hôpital Montfort Carl Balcom RN BScN MBA CHE Clinical Director Emergency, Critical Care, and Clinical Informatics

3. Agenda • Introduction • Background • Current State • Future state • Strategic Plan • Conclusion • Questions

4. Introduction • Hôpital Montfort • Francophone hospital that provides bilingual care • Only health institution that offers clinical training in a Francophone environment in Ontario • Full spectrum general hospital • 300+ inpatient beds (medicine, surgery, ICU, OB/GYN, mental health, rehabilitation, geriatrics) • 12 operating rooms, 20 recovery room bays • High volume emergency room (60,000 visits/year)

6. Introduction Mission “Hôpital Montfort is a Francophone institution that delivers quality care in both official languages, within an academic setting and works with its partners to improve communities’ health”

7. Introduction Vision The excellence of the institution’s personalized patient care and the quality of its workplace, teaching and research make Montfort the hospital of choice.

8. Introduction • Strategic Directions • Exemplary Care and Clinical Services • Organizational Performance • Workplace of Choice • Academic Identity • Relationships with Communities and Partners

9. Background • History of Hôpital Montfort: • 1940’s: need for a francophone hospital identified • Resistance from local government (anglophone) • Local support raised majority of capital in fundraising • Daughters of Wisdom mortaged all Canadian properties • 1953: Hôpital Montfort opened its doors • 1956: Nursing School opened beside the hospital

10. Background • History of Hôpital Montfort • 1961: First affiliation agreement with University • 1964: Governance transferred to lay committee • 1969: Hospital becomes public corporation • 1970’s : Expansion of clinical services • Intensive care unit, Psychiatry • 1980’s : Expansion of Clinical Services • Ambulatory Care and Day Surgery

11. Background • 1990’s: Physical Expansion • New South Wing, CT scan, Birthing Unit • 1997: Montfort slated for closure • Health Services Restructuring Commission • Large campaign with major community support • “Montfort fermé: jamais!” • 2002 : Court of Appeal – Victory for Montfort • Provincial government chose not to appeal

13. Background • History of Hôpital Montfort • 2005: Major Funding Announcement ($175M) • Physical expansion coupled with rebranding • More than double square footage and capacity • 2010: Construction and Moves Complete • “Le Nouveau Montfort” • 2013: Designation as “Class A” University Hospital

15. Background • Regional Context • Local Health Integration Networks (LHIN) • Decentralized decision-making • Emphasis on inter-agency collaboration and streamlined services; avoid duplication • Champlain Association of Meditech Partners • Partnership of 6 hospitals within the LHIN • Common EMR using the Meditech 6.0 platform • Seamless transitions and standardization of practices • Montfort looked to as a leader

16. Background • Clinical Informatics at Hôpital Montfort • Traditionally managed primarily by IT • Clinical oversight by professional practice • Reorganization • Transversal approach to portfolio distribution • Clinical Informatics became a separate portfolio • Changing philosophy and organizational approach to advancing the EPR

17. Current State • Historical Context • Have a problem or a need? Buy a solution. • Nursing = Meditech Magic NUR • Laboratory = TD Synergy • Diagnostic Imaging = Meditech Client Server • Material Management = Smart Stream • Result? Silo approach and Inefficiency • Systems don’t communicate well • Wasted money and talent

18. Current State People & Processes People & Processes People & Processes Laboratory Medical Imaging Nursing & Allied Pharmacy

19. Current State • Challenges • Availability of information heavily reliant on people and internal processes • Delay in accessing information • Data quality issues • Inefficiencies resulting in delay to end-user • Departmental vs. Corporate Ownership • “This is the lab’s system in place for the lab” vs. “This is the Hospital’s system in place to better patient care”

20. Future State • The Perfect Storm for Change • Visionary Chief Nursing Executive • Advocate of clinical informatics and its direct link to evidence-based practice and high-quality care • New IT director • Focus shift to meeting the needs of the clinicians • Reorganization – Clinical Informatics Department • Separate department within clinical programs division • Joining the CHAMP partnership for Meditech 6.0

21. Future State • Strategic deliverable: • To have an integrated Electronic Medical Record that links the patient, the provider, and the system in a single area. • Transition from “Silos” to a “System”

22. Future State A recap of our current state… People & Processes People & Processes People & Processes Laboratory Pharmacy Medical Imaging Nursing & Allied

23. Future State

24. Future State

25. Future State

26. Strategic Plan “To support high-quality patient care by providing clinicians with the informatics tools that they need to deliver evidence-based care following best practices”

27. Strategic Plan Clinical Informatics

28. Strategic Plan

29. Strategic Plan • Strategic goals • Meet and exceed clinician requirements • Support evidence-based care and clinical best practices • Enable seamless transitions through the continuum of care • System integration to provide a single point of access for end-users and patients

31. Strategic Plan

32. Strategic Plan

33. Conclusion • Hôpital Montfort is well on its way to reaching the goal of becoming a paperless hospital • Strong collaboration between IT and Clinical programs is a key success factor • “Middleware” solutions such as Connexall support system integration and patient-centric solutions • With a strong and engaged team, anything is possible.

34. Questions Mr. Carl Balcom, RN BScN MBA CHE Clinical Director Emergency, Critical Care, and Clinical Informatics Hôpital Montfort 713 ch. Montréal Road Ottawa, Ontario (Canada), K1K 0T2 Email: carlbalcom@montfort.on.ca

35. Thank you