Moving to Electronic Systems

1. Moving to Electronic Systems Implementing Iatrics PDI for Medication Reconciliation Veronica Breadner RN Marie Descent BSc.Phm., RPh.

2. Our Hospitals • Halton Healthcare Services (HHS) is comprised of 3 acute care community hospitals - Oakville-Trafalgar Memorial, Milton District and Georgetown Hospital • 420 beds (314 acute/67 CCC/39 Rehab) • 34,401 surgical procedures • 20,519 admissions • 157,793 Ambulatory visits • 3,519 Deliveries • 128,873 ED visits • 3000 staff • 325 physicians

3. Paper vs Electronic • Standardized process across organization • Patient D/C Instructions • Electronic documentation • Promote enhanced utilization of electronic record system • Enhancement of Med history in EMR across continuum of care • Increased efficiency of data collection methods and auditing ability • Med history easily updated • Improved legibility • Utilize existing pharmacy dictionary

4. Criteria for Software Evaluation • Screen Appearance • Ease of use and access • Implementation time • Ongoing support & consultation • Training materials • Cost • Extent of experience • Standardized drug names • D/C Prescription • Standardized discharge instructions

5. Why Iatrics • Met more of evaluation criteria than other two vendors • Physicians could use the tool in place of CPOE • Generates order sets and DC Rx • Partnered with Micromedex – we were already familiar with. • Utilizes Meditech programming – HCIS platform – simplify report writing and dictionary build • Design screens familiar to staff • Lower cost alternative • Opportunity for Discharge Instructions

6. Preparing the Team

7. Planning

10. Resources

11. Training and Support • eLearning • Hands on training • MedRec Champion training • Go-Live support for 2 weeks/unit • Ongoing pager support • Huddles • MedRec Resource Binder • Biweekly Newsletter/Updates

14. Implementation • Pilot Areas: • Pre-Admission Clinic • Surgical unit • Renal Medicine Unit • Software Installs handled by Tech team • Testing • Go-Live with Admission, then month later Transfer and 2 weeks after that Discharge • Form issues – completed by vendor • Team available days/evenings for end-user support • PDSA Improvement Cycles

15. Evaluation

16. Statistics

17. Forms • Admission • Pre-Admission • Transfer • Discharge Rx • Patient Discharge Instructions • Patient Discharge Instructions for LTC • Patient Recorded Home Medications

18. Lessons Learned • Corporate support and communication • Use of Champions is key • Early engagement of pilot units • Increased communication with Physician groups • Differentiate between personal preferences and global needs • Impact on other departments • Contracts with Unit Managers • Never under-estimate impact of change process on affected units/departments

19. Future roll-out • Project plan to roll out to remaining OTMH inpatient units by December 2010 • Big Bang rollouts at Georgetown and Milton sites • Consider concurrent rollout in identified Outpatient units

20. Future Challenges • Maintain momentum • Raise profile corporately

21. Questions?

22. Thank You • vbreadner@haltonhealthcare.on.ca • mdescent@haltonhealthcare.on.ca