There is an opportunity to create larger changes and to advance and reshape the healthcare system through proper healthcare systems integration and care coordination. This will make managing an individual’s health more accessible, affordable and convenient.
Digital health has real-time, real-life applications for everyday people across the country. From Alberta to Newfoundland, from a pregnant woman diagnosed with diabetes to an elderly man making end-of-life care decisions, technology can be an enabler to significantly improve the delivery of healthcare in Canada.
Here are six real-life patient stories from coast-to-coast (with some names changed to protect privacy) where Orion Health solutions have supported patients through potential health crises, chronic conditions and unexpected health emergencies, by offering the tools to integrate and coordinate information among a patient’s entire circle of care.
How the clinical portal helped avoid disastrous consequences (Alberta)
When Mark, 40, experienced shortness of breath while on a ski trip away from home, he went to the local emergency room where tests indicated a possible clot in one of his lungs.
When he was admitted to his home city hospital for further evaluation and treatment, the tests confirmed the clot, and Mark was prescribed blood thinners. Mark was then transferred, at his request, to another hospital in his home town.
Through the Orion Health Clinical Portal, Mark’s primary care physician in his home town saw an addendum that the initial radiologist had made to his CT report. This report showed a clot, but also a suspicious mass in his lung, which could have caused the clot. With this new information, the primary care physician could treat the blood clot, and fully work up and treat the mass. But, had the addendum not been accessible through the clinical health portal, the mass could have been missed. This could have had disastrous consequences had it not been benign.
Mark’s story indicates the importance of having complete patient information from the entire care journey – regardless of location, specialist, or level of engagement. When medical professionals have full knowledge of the case at hand, they can make lifesaving decisions.
eHealth viewer helps wildfire evacuees eliminate uncertainty (Saskatchewan)
Barb, a family nurse practitioner in Regina, was working to treat evacuees from wildfires in Northern Saskatchewan. Barb noticed the patients presented a wide variety of health issues. And, without information about when they could return home or when the ordeal would end, it was difficult to advise on their treatment plans.
Barb didn’t know what materials would be needed when she arrived onsite, but she decided to bring her laptop just in case. Through her laptop she could access the E-Health viewer, which granted access to patient information and allowed to her access files on who was running out of meds, who didn’t know their dosages, and which patients needed narcotics. Barb even had a prenatal patient who had an ultrasound but did not know the results. Through eHealth viewer, they were able to find those results and see that the patient needed to have a repeat ultrasound arranged. The mobility and convenience of the system was a relief for Barb, who would otherwise not have a way to quickly access health information.
“Thank goodness for the E-health viewer,” she said.
Coordinated care addresses communications gaps for end of life care (Ontario)
This patient story comes from Dr. Jocelyn Charles who is a Medical Director at Sunnybrook Health Sciences Centre. She recalls an elderly patient, Sam, who was high functioning, but living alone with several co-morbidities and declining health. Sam understood that he might pass away soon, but did not share his final wishes with his family members because he found the subject difficult to broach.
However, Dr. Charles was able to capture the patient’s wishes in his care coordination plan, using Orion Health’s Coordinated Care Tool (CCT), Specifically, he wished to die at home, and not in an acute hospital Intensive Care Unit.
Sam later suffered a stroke and was unable to provide direction, but since his preferences were registered in his care coordination plan, he was taken home, where he passed away peacefully. The family was very pleased that his wishes for terminal care were known and followed by the care team.
This fully integrated model of care coordination can evolve how healthcare providers interact with patients, colleagues and families during the trying end-of-life time. Sam’s story shows that with tools such as CCT, patients can receive personalized care, bridge any communications gaps with members of the healthcare team, and provide one care plan for all caregivers to follow.
Remote Patient Monitoring makes gestational diabetes manageable (Quebec)
While Remote Patient Monitoring (RPM) is frequently linked to elderly patients, Orion Health’s solution is applicable for individuals of all ages with chronic conditions.
Consider the below case of a woman with gestational diabetes – which occurs for over nine per cent of pregnant women, according to a 2014 analysis by the Centers for Disease Control and Prevention (CDC).
Heather’s gestational diabetes caught her off guard. When she went into the clinic, she was overwhelmed with information and burdened by the constant monitoring of her blood sugar that was required. This was especially daunting because she was pregnant when she received her diagnosis.
To manage her diabetes, she began to use telehomecare, which let her take a more active role in her care. She could input blood sugar levels remotely, the computer could react to her input levels, and provide recommendations. For example, it would prompt her to add units in the event of high results.
Because Heather entered her information on telehealth, she didn’t have to go to hospital weekly for check-ups, she saved money on expenses, and she could conveniently track her blood sugar remotely on her cell phone or computer.
Despite her initial scare and concerns, Heather delivered a healthy baby girl. This story demonstrates how RPM can ease adaptation to one’s condition by reducing the time, effort and money it takes to manage it.
Shared electronic health records can help save lives (Newfoundland and Labrador)
One day, a woman collapsed unexpectedly in her local supermarket. Nobody knew what to do initially. Fortunately, a pharmacist was onsite, and had access to Healthe NL, the provincial shared Electronic Health Record (EHR). This system uses a clinical data repository provided by Orion Health.
The pharmacist was able to log in to Healthe NL and view the patient’s complete shared electronic medication record and broader medical history. This allowed them to understand and begin treatment, before the ambulance even arrived.
This patient story demonstrates how with HealthE NL, medical professionals can gain real-time access to actionable data. By coordinating and integrating a patient’s entire medical record, medical professionals get on-demand information that will ultimately help them make life-saving decisions.
The importance of proper reporting (New Brunswick)
The New Brunswick Heart Centre (NBHC,) is the provincial referral centre for tertiary cardiac care in the province. NBHC relies on referring sites, which have been notoriously slow in updating the Centre on test results in the past. In some circumstances the Centre cannot make a decision pertaining to the patient’s eligibility for transfer until those results are available (especially INR, Hemoglobin and Creatinine results). Recently, the Centre has been able to perform those pre-test checks themselves, by accessing and obtaining results in the Provincial Electronic Health Record. Such direct access to this information has improved patient flow.
Before the Provincial Electronic Health Record, it was not uncommon for NBHC to contend with incomplete information when admitting a patient. For example, when coordinating transfers of a patient they were often told that bloodwork had been ordered for that patient only to find out that no such work-order had been processed, once the patient arrived at NBHC. The impact of this incomplete or often completely incorrect patient information was that once the patient arrived he or she would not be eligible for the procedure ordered because the necessary preliminary steps had not been taken. This would add a delay to the queue of procedures, incurring cost, time waste, inefficiency, and general ineptitude.
The information available via the Provincial Electronic Health Record enables the NBHC to mitigate such occurrences as they are able to check the status and capability of the Centre in conducting a test before coordinating the transfer. When flags are noted, they appropriately delay the transfer and when indicated, recommend additional investigations, treatments in the referring site.