Health Records at HHS

1
Health Records at HHS
General Business MeetingHamilton Chamber of
Commerce14th May 2007

• David ArmstrongHamilton Health SciencesMedical
  Staff Association

2
Health Care in Hamilton

• Provided at multiple sites
• 2 Hospital systems HHS, SJHH
• Inpatient general vs.city-wide sub-specialty
• Ambulatory care
• Emergency Department
• Investigation Lab, DI, Endoscopy,
• Therapy Surgery, Pharmacy, etc
• Family physicians Solo, Groups
• CCAC / Home Care / Nutrition

3
Health Records RequirementsImmediate patient
care

• Promptly available
• Complete and up-to-date
• Universal accessibility (available on-line)
• To read records
• To provide records
• Single portal
• Logical, consistent structure interface
• Readily searchable (skimmable)
• Feasible
• Integrated with current practice for note
  taking and distribution

4
Key Tenets of Health Records

• They should
• Be patient-centred
• Integrate inpatient and outpatient charts
• Inclusive of most, if not all, HHS activities

5
Health Records Challenges

• Patchwork of records systems
• Paper-based charts office external
  information labs, referrals, etc
• Meditech ( old EMR at MUMC)
• Sovera
• PACS
• EndoPro
• Clinical Connect
• St. Josephs Hospital systems
• Community systems

6
Health Records Challenges

• Patchwork of input mechanisms
• Handwritten
• (Private) office transcription
• Analogue / Digital dictation
• Hospital transcription
• Analogue / Digital
• Computer menu-driven

7
Health Records Current Issues

• Sovera
• A page image, digital microfiche that is
  difficult to search
• Integration with clinical practice is cumbersome
  eg pediatric growth charts ECGs
• Addition of information is cumbersome eg
  off-schedule visits information

8
Health Records Current Issues

• Meditech
• Fast not highly intuitive but very familiar
• Does not incorporate community St. Josephs
  results
• Some HHS tests not included
• Ambulatory care ( office) visit data are often
  not incorporated
• Cant show images

9
Health Records Overview

• Medical Staff Prime aim is exemplary patient
  care
• HHS Patient Safety a Strategic Priority for
  2006-2007
• Health records deficiencies are a major obstacle
  to Patient Care and Patient Safety

10
HHS MSA Health Records

• Many members of the medical staff have identified
  concerns re health records
• Issues concerns usually occur and are handled
  as isolated events
• Reporting fatigue / Frustration

11
HHS MSA Health Records

• Progress requires
• Standard reporting mechanism
• Report collation
• Identification of key targets
• HHS MSA Proposal
• Collect collate reports
• Identify key issues
• Work with HHS to improve Health Record-dependent
  patient care

12
HHS MSA Health Records

• Identify MSA lead
• Paper-based reporting system
• Key areas
• Send to MSA Office
• Web- / E-mail based system
• Key areas
• Concerns collated and reviewed