eHealth is a journey … not a destination!

2013 eHealth Summit

May 1-3, 2013

About Bayshore

• Founded in 1966

• Diversified health services

company

• 100% Canadian owned &

operated

• Operating in all Canadian

provinces and territories

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What is eHealth

• eHealth has also been defined as a collection of

interconnected technologies used to support

healthcare that are client-centred and can be

consumer-driven (Oh et al., 2005)

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Why did Bayshore need eHealth?

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Better care / outcomes

Support efficient operations

Support new business initiatives

Support new business models

& reporting standards

Bayshore’s eHealth journey

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Phase I • Initial experimentation w/

non-intelligent electronic forms (Word, Adobe, etc.)

• No workflow or indexing for fast reference

• Inexpensive to implement and deploy - costly and onerous to maintain

Bayshore’s eHealth journey

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Phase II

• Moved experimentation to front-office solution

• Rudimentary electronic forms

• Basic workflow

• Integrated w/ scheduling & coordination

• Very slow, difficult and too costly to operate

2G

Bayshore’s eHealth journey

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Phase III • Dedicated mobile

documentation system

• Advanced smart electronic forms and flowsheets

• Customized workflow

• 3rd party integration w/ front-office scheduling & coordination software

• Very onerous and costly to operate

3G

Phase III Evaluation

Purpose:

To assess the effectiveness of our implementation process.

To examine the impact of the implementation process on

frontline nurse, clients, and on the organization.

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Moderating and mediating factors

effecting implementation

Organizational Factors

Characteristics of Patients

Environment Factors

Characteristics of Nurses

Characteristics of Technology

Factors effecting sustainability

Improved efficiencies

Satisfaction with the device

Patient satisfaction

Goal attainment

Nurse recruitment and retention

Health care quality

Evaluation: Conceptual Framework

Powell-Cope, Nelson, & Patterson (2008)

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Mediating and Moderating Factors

Characteristics of Technology:

• An increased focus on the

characteristics of the technology is

required.

• Improvements to handheld devices and

software programs are required to

support the needs of a decentralized

home care team.

Executive Data (Qualitative)

Nursing Data (Quantitative & Qualitative)

Satisfaction and Sustainability

Characteristics of the Technology:

• The current hardware and software

does not meet the needs of frontline

nurses and is having a negative

impact on nursing productivity, the

nurse-client relationship, and

recruitment and retention.

• Increased attention to the

characteristics of the nurse and

characteristics of our clients, and

the potential impact of handheld

technology on the delivery of care is

required.

Phase III Evaluation: Outcome

If left on current trajectory, technology

platform would receive poor adoption

across the organization

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Bayshore’s eHealth journey – Phase IV

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EPSILON™Platform (Present Day)

• Integrated front-office solution w/ enhanced mobile documentation system

• Advanced smart electronic forms and flowsheets

• Clinical Pathways and customized clinical workflow by staff-type

• Time & Attendance, Expense Reporting

• Integration with customers (funders) &key data stakeholders (eg. ICES, CCAC)

What is Epsilon™ ?

• w An integrated process and

technology platform for

branch and field operations,

that enables:

1. Collection of clinical and

operational data at the point

of care

2. Delivery of clinical and

operational decision support

at the point of care

3. Administrative efficiencies

and improved

communication

Flexible

Scalable

Inter-operable

Sustain-able

Affordable

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Industry-leading components

• w • Front office, Field & Mobile Application Suite Procura

• UCP Mobile Hardware / Software Platform Blackberry

• Virtualization & Cloud Platform VMWare

• BI platform & laptop OS Microsoft

• Clinical Hardware Platform Lenovo

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Application Suite Components

• w

Intake Inbox

Self-Scheduling

Mobile for Para-

Professionals

mHealth for Clinical

Professionals

Staff Portal

Automated Provider

Reporting

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Intake Inbox

Automated System-to- System Communication

• XML Messaging

• Integrated to customer / funder systems

• Direct data movement into Bayshore’s systems

• Presently operating in Ontario – integrated to CCAC CHRIS pXML schema

• Architected to connect to any other customer / funder across the country

Intake Inbox

Service Offers

Service Referrals

Service Changes

Notifications

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Intake Inbox enables …

Automated Provider Reports

• XML Messaging

• Integrated to customer / funder systems

• Direct data movement from point of care directly to customer / funder systems

• Validated through extensive testing and FULL deployment in Ontario’s NSM CCAC (Planning / scheduling underway in Champlain)

• Architected to connect to other customers / funders across the country

Customer Systems

XML Messaging

Bayshore Systems

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Complete electronic exchange of data

Customer / Funder

Systems

Intake Inbox

Field visit information

APR

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Self-Scheduling

Leveraging system intelligence and automation

• Allows for system to create schedules based on predetermined rules and conditions

• Significantly decreases manual scheduling activity

• Breaks down silos of knowledge and makes it easy to schedule 80% of the time

• Will allow for easier regionalization of scheduling activities, if required

Scheduling Genius

Offer & Availability

Service Requirements (Clinical, HR)

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Mobile Docs for Para-

Professionals

Handheld SmartPhone

Care Plan

Electronic

Documentation

Time & Attendance

eMail Offer / Portal Access

Mobile Docs for Para-Professionals

Native Blackberry / Android Mobile App

• 100% integrated to core scheduling system

• Seamless data flow from field branch back office

• Built for UCP, with our input and workflow in mind

• Stable and reliable

• Blackberry or Android hardware platforms available

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EMR

Client ROS

Schedule

Clinical

Doc.

APR

Care Plan

Clinical Reference

Administrative

Time & Attend.

Availability Portal

Expenses & Mileage

Access Portal

mHealth for Clinical Professionals

Comprehensive clinical point-of-care system

• 100% integrated

• Field staff documentation and clinical support system

• Designed and built with OBPR and Multi-Disciplinary needs in mind

• Ability to create / edit own forms, clinical pathways, assessments and flow sheets

• Able to scale and customize to regional needs

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Enhanced Functionality

• Newer technology platform, better performance

• Ability for staff to receive, review, accept / reject offers of visits / shifts

• Staff availability update

• Web interface to allow for access across platforms and mobile smart phones

Staff Portal

Staff Portal

Schedule

Availability Time &

Attendance

Offers

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Challenges of mHealth – Pace of Change

? Platform

Apps Store & Forward

Integration

Technology is important, but it changes every 6 months!

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Creation

Location

Access

Security

Maintenance

Disposal

Challenges of mHealth - Data

Com

ple

xity

Pre

ssure

S

ecurity

Pre

ssure

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Commitment to eHealth

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Why?

Improve access to home care data & information

Improve the quality of care

Inform health care funding models

Questions

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