The ImagineNation Outcomes Challenge sought to improve health care quality and the patient experience in Canada by accelerating the use and spread of innovative solutions in four key areas:
- Medication Reconciliation
- Clinical Synoptic Reporting
- Patient Access to Health Information
The Outcomes Challenge started on January 1, 2012. Over a 16 month period, more than three million uses of health IT have been logged by 43 participating teams from across Canada.
Categories and Award Recipients
The four Challenge categories are based on priorities as identified by Canadians and clinicians.
Medication Reconciliation Category:
Medication reconciliation reduces the risk of adverse drug events by taking a best possible medication history for every patient and ensuring new prescriptions are reconciled with that list.
First Place (tie): University Health Network, Ontario
Tied for first place is a team from the University Health Network (UHN) for their single web-based platform that is integrated with the electronic discharge summary. The solution is used to document the patient’s best possible medication history and reconcile medications at admission as well as discharge. It also allows users to generate e-prescriptions, medication letters, patient grids and medication wallet cards for patients. The team at UHN has been able to increase admission reconciliation rates to more than 80 per cent across their three hospitals – a rate that is maintained today with ongoing in-service refresher sessions with the inter-professional team.
First Place (tie): Toronto East General Hospital, Ontario
Also tied for first place, Toronto East General Hospital (TEGH) created an electronic medication reconciliation module that allows pharmacists at TEGH to electronically document a best possible medication history (BPMH), document discrepancies and recommendations, and order any clinically reasonable pre-admission medications through an advanced medical directive. At discharge, the system can also be used to generate electronic prescriptions and reconcile those medications into the BPMH. The team says that the biggest benefit of TEGH’s medication reconciliation process is its impact on preventing medication errors at patient transition points, thereby enhancing patient care, safety, and overall hospital performance.
Third Place: Mount Sinai Hospital, Ontario
The third place team from Mount Sinai Hospital created a medication reconciliation solution that has helped users more than double the number of patients whose medications are reconciled at discharge within a very short period of time. The solution works by offering printed patient instructions that clearly outline and subdivide “home” medications that were changed or discontinued, those that stayed the same and the new medications that were added in hospital.
Clinical Synoptic Reporting Category:
Synoptic reporting is used to record key clinical information in a systematic way based on the latest evidence about best practices.
First Place: Sunnybrook Health Sciences Centre, Ontario
First place award recipient Sunnybrook Health Sciences Centre developed a standardized synoptic reporting tool with drop-down list options containing mandatory fields. It helps ensure that all the pertinent information is captured. The team says that the completeness, consistency and clarity of the new reporting structure have been beneficial to clinicians and patients alike.
Second Place (tie): University Health Network, Ontario
University Health Network (UHN) is tied for second place in this category. The UHN team began looking to improve communication between the hospital and community physicians when patients were discharged but eventually evolved into a broader solution for capturing data so that it can be reused clinically, enabling clinical decision support and health system reporting. By providing clinicians with a common platform to document information for different procedures, the UHN team has seen a number of positive impacts. They report that not only have the synoptic reporting tools improved access to information and communication between care providers, they have also provided a real-time learning tool for residents, data reporting and research initiatives, and improved quality and timeliness of physician documentation for hospital reporting and chart completion.
Second Place (tie): North York General Hospital, Ontario
Also tied for second place is North York General Hospital for adopting an electronic standardized synoptic reporting template to ensure that care teams have the most complete and accurate clinical information as quickly as possible when caring for patients with cancer. The hospital’s solution uses customized checklists based on Cancer Care Ontario and the College of American Pathologists’ cancer checklist standards that help ensure all required data are captured. The team says that the solution not only saves time for the pathologists completing the reports, but also enables clinicians to find the information they need to provide patients with the best possible care more easily.
Patient Access to Health Information Category:
Access to health information empowers patients to view their own health information, such as lab test results or immunization history, electronically.
First Place: Excelleris, British Columbia
In first place, Excelleris’ solution provides patients in British Columbia with access to their laboratory test results and supports patient home monitoring to enable better management of chronic conditions.
Second Place: West Carleton Family Health Team, Ontario
The second place award recipient is the West Carleton Family Health Team. They launched an online patient health portal, where any of their 16,500 patients can securely view information that is stored in their electronic medical record, such as lab results and immunization information. The portal also provides patients with tools to help them play a more active role in managing their own health.
Third Place: Wise Elephant Family Health Team, Ontario
The third place award recipient in this category is the Wise Elephant Family Health Team. They developed a patient portal that provides access to their patients’ personal health information whenever and wherever they need it. The portal is updated automatically using data directly from the patient’s electronic medical record. With immediate access to information such as lab results, medication lists and upcoming preventative screenings, the team reports that the portal helps patients ensure all their caregivers have the information they need to provide them with the best possible care.
e-Scheduling enables patients to book appointments online and at their convenience using a mobile device.
First Place: Group of 14 clinics, British Columbia
The first place award recipients are a group of regulated health care professionals such as registered massage therapists, chiropractors, and their office staff in 14 clinics in British Columbia. Their e-scheduling application allows clients to book, change and cancel their appointments online. The teams say that this also allows administrative staff to have more face-time with patients, while spending less time answering the telephone or juggling appointments.
Second Place: Group of 49 clinics, Quebec
The second place e-scheduling solution was developed to help find innovative solutions to challenges commonly encountered by patients who need to book last-minute appointments with physicians, and by health care practitioners and administrative professionals dealing with last-minute cancellations. The result is an automated system that the clinics report improves productivity for clinicians and their support staff and increases access to care for patients.
Third Place: Canadian Blood Services
The third place e-scheduling application by the Canadian Blood Services allows donors to quickly create a profile; search for appointments by location or date; and book, change or cancel them online.