How OntarioMD Measures Our Success

Since 2004, OntarioMD has supported more than 16,000 Ontario primary care clinicians with the adoption and efficient use of electronic medical records (EMRs) and other digital health technology. From having the lowest rate of adoption among Canadian provinces just eight years ago, the EMR usage rate for Ontario physicians is now one of the highest among all provinces. OntarioMD’s strong industry knowledge, relationships and understanding of the health care goals of both clinician practices and the province are keys to our success.

We assist clinicians directly with their digital health needs by certifying EMRs, connecting clinician practices to provincial digital health services, developing solutions to connect these services to EMRs, and help practices adapt their workflows through hands-on change management support from OntarioMD Peer Leaders and our EMR Practice Enhancement Program, as well as at various OntarioMD events.

The digital health space is evolving rapidly as health care needs change, and potential solutions are regularly introduced. However, not all digital health services are effective solutions for clinician needs or for health care system challenges. With this in mind, we constantly test and measure the success of our innovations and support programs with end users. We also collaborate with system partners on assessment and evaluation activities, with the end goal of continuing to build an integrated, effective, patient-centred system aided by technology. The following are just a few examples of how we measure success.

Health Report Manager (HRM)

Health Report Manager (HRM) enables clinicians using an OntarioMD-certified EMR to securely receive patient reports electronically from participating sending facilities including hospitals and specialty clinics. Clinicians connected to HRM automatically get text-based medical reports such as discharge summaries and transcribed diagnostic imaging reports sent to patients’ charts within the EMR. More than 9,000 physicians receive reports through HRM from over 160 hospital sites and more than 200 specialty clinics locations – and the numbers of connected clinicians and sending facilities goes up each month.

In 2017, we asked Deloitte to conduct a survey-based benefits evaluation of HRM that was supplemented by an OntarioMD-led study where practice advisors studied workflow variations and conducted timing assessments. Findings from Deloitte and OntarioMD found that HRM saves an average of 33 minutes per clinician per day by not having to manually handle paper reports. HRM also reduces hospital expenses on printing and postage, as well as labour related to reports that would otherwise need to be faxed to clinicians. The Deloitte report estimated that HRM avoids an average of $15 million a year in costs to the Ontario health care system.

EMR Practice Enhancement Program (EPEP)

EPEP was launched in 2016 to help clinicians and their staff unlock the full potential of their EMR and realize benefits for their practice and patients. Using a hands-on, evidence-based approach, the EPEP team has helped over 500 clinicians and their staff improve EMR data quality and practice workflows and tap into their EMR to proactively monitor and treat patients.

EPEP works with evidence-based tools developed by OntarioMD: the EMR Maturity Model (EMM) and EMR Progress Assessment tool (EPA). These tools assess maturity on a six-point scale (0-5) across three functional areas: Practice Management, Information Management, and Diagnosis and Treatment Support. During EPEP engagements, advisors conduct baseline assessments of a clinician’s EMR maturity and EMR data quality in several priority measures, such as smoking status, cancer screening adherence, and immunizations. They then reassess at regular intervals during and after an EPEP engagement. Our results of these assessments have revealed that data quality measures show improvement after six months. More importantly, most improvements are sustained or even further improved upon at 12 months.

EMR Quality Dashboard

OntarioMD has recognized the need for busy clinicians to quickly and easily visualize their entire patient roster based on their EMR-based patient data. Working with TELUS Health, OSCAR EMR and various industry partners, we developed an EMR Quality Dashboard. The proof of concept initiative is currently in phase 2 with approximately 500 participating clinicians. The Dashboard:

  • provides clinicians with real-time access to EMR data in a user-friendly visual manner, using widely-recognized primary care indicators from Health Quality Ontario, the Canadian Institute for Health Information and the Association of Family Health Teams of Ontario;
  • provides the ability to drill down to patient-level data for each indicator, enabling clinicians to take immediate proactive steps to improve patient care;
  • helps clinicians standardize their data entry to improve the quality of patient data in their EMR;
  • allows clinicians to trend and compare their indicator metrics with other physicians using the Dashboard;
  • would scale provincially to all Ontario physicians using an OntarioMD-certified EMR, and
  • is easily expanded as practice needs and clinical indicators evolve.

Phase 1 of the proof of concept involved approximately 100 physicians. We conducted a benefits evaluation at the end of that phase, which found that over 75% of participating physicians recognized the Dashboard’s value in identifying target patients and generating actionable patient lists. In addition, 80% said the change management support they received from OntarioMD while using the Dashboard was effective in addressing their questions and concerns and optimizing their use of the technology. Following the end of phase 2 in December 2018, we will conduct a more in-depth analysis of participating clinicians to further demonstrate the clinical impact of Dashboard on participating practices.

In each of these cases, our focus on measuring the success of our initiatives has helped us refine and expand our offerings, and integrate them with OntarioMD’s robust change management and support services. Find out more about HRM, EPEP, Dashboard and our other programs and services at www.ontariomd.ca or by contacting us at support@ontariomd.com.

Maintaining the healthcare system is hard work: My decision to the deep dive into Canada’s most complicated system

Contributed by Janet Song

OntarioMD is excited to partner with the Quality Improvement Practical Experience Program (QIPEP) at Queen’s University. Our two organizations share a passion for quality improvement in health care and a commitment to developing future health care leaders.

QIPEP aligns with OntarioMD’s EMR Practice Enhancement Program (EPEP) in seeking to enhance the quality improvement competencies of EMR users and students who will shape the future of health care increasingly enabled by digital health services.

In this blog post, Janet Song shares her perspective on how quality improvement will help practices, the impact of digital health, and more.


Why did you decide to join QIPEP?

My interest in Ontario’s healthcare system began with my frustration as a patient. It was a month of being ill in my second year of university where I was travelling from clinic to clinic, in a desperate search for a diagnosis. It was through hours in different waiting rooms, multiple retellings of the same medical history, and dealing with the inability to eat solid food, when a doctor finally decided to do a specific blood test for H.Pylori, when I finally discovered my illness.

Throughout this month-long journey, I became tired of complaining about everything wrong about my experience, and instead, I found the motivation find a way to improve the quality of our health care system.

It was through following the Queen’s Institute for Healthcare Improvement’s Facebook page where I found the opportunity to receive hands-on experience to do research in healthcare quality and improvement at a healthcare institution.

As a fourth-year commerce student who is interested in experience in healthcare management, I am extremely excited that experience will enable me to do work that can directly support the improvement of hospital operations to better improve the lives of patients. My project is in the cardiology unit at KHSC which involves working with hospital workers in assessing sources of delay for cardiac order entries for doctors to order care actions for nurses on their patients.

Why do you think Quality Improvement is important to your future practice?

Quality Improvement (QI) is important for my future practice because of my interest in utilizing my management degree to socially impacting the lives of those, and healthcare management is definitely a place where I can positively make a difference in someone else’s life.

I want to learn how to manage certain components of this complicated system, and it begins with starting in a small component of the healthcare sector and learning how to improve the quality of it. It is through the process of the Planning, Doing, Studying, and Acting (PDSA) model in my work. This process will sharpen my research, planning and implementation capacities to not only practice healthcare management in the future but also better manage a complicated system to positively impact the lives of others in other fields as well.

Additionally, as an Ontarian, I deeply care about the future of this fragile system, and I want to be part of improving the system.

In 2017, Ontario was recorded as having the shortest waiting times on average in the country at 15.4 weeks, which is under Canada’s average of 21.5 weeks.

However, digging deeper into this information, the Government of Ontario continues to balance $312 billion ($122,919 per Ontarian) where the cost of healthcare is almost 40%, pushing out resources for other social services to maintain this expense and also paying for interest— which half of the education expenses.

The major question lies, how sustainable is our healthcare system? How much longer can an insurmountable amount of debt be maintained in Ontario?

What do you think of digital health? Where do you think it’s going?

The greatest demand comes from the area of the greatest need; the increasing senior population.

Ontario has a senior population that is aged 65 and over is projected to almost double from 2.4 million, or 16.7 percent of the population, in 2017 to 4.6 million, or 24.8 percent, by 2041. This population is living longer lives, the model of the emphasis of healthcare services in hospitals, the highest healthcare expense, transformed into a home care model.

How can Canada prepare for this great demand?

It begins with redefining care to support these seniors through homecare and digitizing the experience to efficiently distribute resources, minimize costs, and still deliver quality care. Consumer digital health tools increasingly will focus on chronic disease management.

Incredible organizations are taking great steps towards improving this complicated system such as SE Futures, the innovation arm of the home care provider Saint Elizabeth. They focus on priorities such as new senior living communities, patient experiences in-home (home self-screening), homecare experience, caregiver experience (chatbot support), and more.

 

How EPEP Helps You Reach Your Practice Goals

OntarioMD’s EMR Practice Enhancement Program (EPEP) helps you realize even more value for your patients and your practice by tapping into more of the benefits of your EMR. EPEP staff will work with you and your staff to achieve your unique practice goals, at a time that’s convenient for you. We will analyze your EMR workflow and data quality, and identify quick wins that achieve tangible results or save your valuable time. EPEP emphasizes hands-on support as you move beyond basic data capture to use your EMR for enhanced patient care and improved practice efficiency. 

Watch the latest EPEP Success Story to find out how EPEP helped one practice focus on population health through better prevention and screening management. For more information on EPEP, visit https://www.ontariomd.ca/products-and-services/emr-practice-enhancement-program

Small Changes Can Have a Big Impact With EPEP

 

Contributed by Marsha Foster, OntarioMD Practice Enhancement Consultant

Does this sound familiar?  Your clinic has had an electronic medical record (EMR) for some time now. Things seem to be running OK… but maybe you expected everything to be a little easier by now.  Some questions linger in the back of your mind: Is my data truly sound? Could I use my EMR to better understand my diabetic population? Is there an easier way to keep tabs on my preventive care?

OntarioMD’s EMR Practice Enhancement Program (EPEP) is aimed at helping physicians answer these types of questions to optimize their EMR data and functionality. EPEP is a service available to all Ontario primary care providers and community specialists using a certified EMR. A typical EPEP engagement will start with a meeting between you and your Practice Enhancement Consultant (PEC), held at your office at a time that’s convenient for you. Together, you’ll discuss your areas of interest and practice priorities. Your PEC may also ask you to demonstrate some of your favourite ways to document information in your EMR. Your PEC will then perform an in-depth analysis of your EMR data.

After all this initial work is done, your PEC will present their findings and recommend steps you can take to streamline your workflow and use your EMR to achieve your practice objectives. The choice is always yours as to how closely you follow your PEC’s recommendations.

An EPEP success story

The services of a PEC were requested by a family health organization in the Greater Toronto Area that was concerned about the inaccurate data they saw in their EMR around preventive care and cancer screening. They knew their team of five physicians was providing good care, but this was not being reflected in their ministry reports. Instead of documenting their work in an easily trackable manner, they relied on detailed documents sent from the ministry, and spent many hours manually updating patient charts.

The PEC’s data analysis uncovered an issue with the clinic’s roster status process. This process gap was the cause of the poor preventive care reports being produced.

The PEC demonstrated a best practice that could be used to correct the roster status within the EMR. The clinicians and staff agreed to implement the changes suggested by the PEC, and the data gap was closed within a short amount of time. The roster clean-up dramatically improved the clinic’s preventive care reports, and eliminated the hours needed for manual updates. That was time the clinic could start dedicating to other activities and services.

This is just one story of how small changes can have big impact! To meet with a PEC and see how EPEP can improve your practice efficiency, please contact epep@ontariomd.com.