OSCAR EMR at Hamilton Public Health Services September 28, 2015

Outline Hamilton’s journey to an EMR OSCAR

Why? Functionality

OSCAR Project Challenges Lessons learned Next steps OSCAR Demo

How did we get here? 2010:

eHealth Inventory Project: internal scan 2011:

External info gathering Requirements gathered & business case developed PHSMT made decision to go with OSCAR

2012: PHS became OSSP Went live in Mental Health and Flu Clinics

2013: Support Mental Health Went live in Flu Clinics Sexual Health requirements and customizations

2014 Went live in Sexual Health Clinics & Phone Line Internal File Audit

2015 Went live IDTB & IDPC Intake Line Went live in HBHC Working on Case Management: IDTB, IDPC, SH, SU, BO Expanding Health Protection Intake Lines: Food Safety, VBD, Safe Water, Health

Hazards Breastfeeding Clinic, Parenting

2010: Internal Environmental Scan

Interviewed 26 program and service managers

Defined current information management practices

Discussed needs/gaps/impact on business

Business Problem E-Inventory Scan uncovered several information management

issues: Sustainability of the databases currently used to manage

client information and support PHS practices. Duplicate documentation efforts by staff (electronically and

hard copy). Difficulty navigating and extracting information from current

applications to guide management decision-making. Direct impact on client services when timely, accurate

information is not available. Reliability of current electronic scheduling software. Security of client information that is stored in unknown

locations and duplicated in “home-grown” databases. PHS uses over 50 out-dated “home-grown” applications for similar purposes.

Security of hard copy records in transit. We are data heavy, information and knowledge poor

…So we couldn’t “do nothing”!

2011: Researched Options Talked to 17 Health Units Researched EMRs Built business case Management team decided on

OSCAR Developed relationship with

McMaster Prioritized program area needs

2012: Implemented OSCAR Open Source Clinical Application and

Resource Developed based on the collective

work, ideas and support of numerous health care providers and developers across the nation, including McMaster University

Includes: Electronic Medical Records, case management, personal health record and other integrated applications

Joined the Oscar Community

Why OSCAR? Cost effective No vendor lock-in Ability to expand use across several

programs and services and contribute to Hamilton PHS Client Electronic Health Record

Sustainable solution Large user community Potential to collaborate across healthcare

sectors Co-location with McMaster clinics

What our users like about OSCAR Allows you to search for clients from

various locations Building a comprehensive record for each

client Minimizes paper Reduces number of forms Improves business processes Complies with documentation, privacy

and security standards Allows us to gather statistics efficiently Provides ability to pull ad hoc reports

OSCAR Functionality

Schedule client appointments Document client interactions Create and assign tasks Customize forms Upload documents (labs, physician

letters etc.) Extract reports Set reminders Communicate about clients Organize resources

Open Source Model OSCAR Service Providers (OSPs) OSCAR Self-Service Provider (OSSPs)

1 week training at McMaster Data stored on our servers Installed and maintained internally Share development work across OSCAR community Ex.

Maternity Centre Project Resources:

0.8 FTE Applications Analyst 0.8 FTE Project Manager Program Super-Users (time varies) 0.8 eHealth Intern (8 month term) 1.0 Temporary Applications Analyst (4 month contract) 0.5 Clinic Coordinator (temporary) 0.2 External OSCAR Developer

Since 2012

Added in 2015

Our Vision: OSCAR & Public Health

Collaborate with other Health Units Share eforms, customized features and

reports, business process re-engineering, training material etc.

All contribute and benefit from “Public Health Oscar”

Communicate with clients via MyOscar Connect across healthcare sector (labs,

primary care, hospitals)

Where are we now? Live (Supporting) In Progress Planned for 2016 Sexual Health Clinics & Intake Line

Reportable Infection Management: • IDTB • IDPC • Sexual Health • Surveillance Unit • Business Operations

School Programs

Mental Health & Street Outreach

Intake Lines: • Food Safety • Safe Water • VBD • Health Hazards

Tobacco Control

IDTB Intake Line Breastfeeding Clinic VBD Case Management

IDPC Intake Line Dental Services

HBHC - Health Connections

Vaccine Preventable Disease

Surveillance Unit Nurse Family Partnership

Reproduction & Child Health

Challenges

Good news travels fast! Internal human resources

Technical Project Management Business Analysis “Super-Users”

Planning + Implementing + Sustaining + Evaluating

With new technology comes new processes and equipment

Resistance to change Wide variation of technical skills

Lessons Learned Explain WHY “Super-Users” need to be relieved of regular duties Executive and management support visible across the

health unit Customize strategically Need people who understand both clinical and

technical It’s an investment It’s not just a tool, it’s changing the way we work Celebrate success!

EMR Value Sexual Health Clinic Receptionist save 90 minutes

per clinic Minimize staff time spent printing, filing, calling,

locking etc. Ex. 15 min per SH client Less cost for mileage because access anywhere

and cold storage (#s to come) Communication between programs/locations

are automated and secure Easy retrieval of client info from any location =

better customer service Minimize security risk of handling paper records

between locations

Next Steps Continue OSCAR implementation Develop Service Level Agreements Provide on-going support Advance reporting Evaluate effectiveness

Oscar Demo

Discussion, Comments, Questions?

Email: Danika.walden@hamilton.ca

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