FEATURE REPORT: WIRELESS AND MOBILE SOLUTIONS – PAGE 16 Publications Mail Agreement #40018238

CANADA’S MAGAZINE FOR MANAGERS AND USERS OF INFORMATION SYSTEMS IN HEALTHCARE VOL. 26, NO. 2 MARCH 2021 INSIDE:

DIAGNOSTIC IMAGING PAGE 14

Lean COVID-19 clinic Montfort Hospital, in Ottawa, re-engineered the workflow in its COVID-19 clinic to better handle the influx of patients. It resulted in a 33 percent drop in human resource requirements. Page 4

Better face-shield Ultrasound technologists at Hamilton Health Sciences realized that standard face-shields were not giving them the protection they needed. They worked with partners to develop better ones. Page 6

Reducing sepsis deaths A dramatic reduction in sepsis mortality has been achieved through the combination of three systems: the electronic patient record, an AI-powered analytics

solution, and a real-time alerting PHOTO: NICK MENZIES PHOTOGRAPHY system that quickly notifies Telus Health, in partnership with the UHN and the Parkdale Queen West Community Health Centre, has launched a mobile van that pro- caregivers. vides medical services to the homeless and underserved community in Toronto’s west end. It is also providing pop-up COVID-19 testing, Page 20 and hopes to help with the COVID vaccination effort. Pictured at left is Raymond Macaraeg, Nurse Practitioner. SEE STORY BELOW. Telus and UHN deliver services to the marginalized

BY DAVE WEBB fax. Originally designed to deliver primary quirements call for things that individuals care, the program pivoted to meet the needs who are homeless don’t have,” Robertson elus’s Health for Good program of patients in the COVID-19 pandemic, said said. “If the response calls for isolation, that has launched the latest of its spe- Nimtaz Kanji, Calgary-based director of suggests people have places to isolate in.” cially equipped vans to provide Telus Social Purpose Programs. And in the shelter system, pre-COVID, medical services to the homeless Angela Robertson of the Parkdale Queen the environment was very congregate, with andT underserved, this time to the population West Community Health Centre (CHC) as- many people in the same physical space, said of Toronto’s west end. The project relies not serted that marginalized people are particu- Robertson. Some homeless persons, in order only on the hardware and software – the larly susceptible to the spread of COVID-19, to keep themselves safe, have created en- vans and technology – but on the care deliv- campments, and the city has opened up ered by trained and socially sensitive med- Even adequate hand-washing some hotel rooms across the city to create ical professionals. spaces for physical distancing. For the Toronto project, those profession- and basic hygiene can become a Even proper hand-washing and hygiene als are working at the University Health Net- challenge for the homeless. becomes a challenge for the homeless. work’s Social Medicine program and the “COVID calls for individuals to practice Parkdale Queen West Community Health as they don’t have access to the basic precau- constant hand-washing. Oftentimes, individ- Centre. The city’s Parkdale community, in tions that prevent its spread. uals who are homeless use public washroom the west end, has a high concentration of The clinic is located near a Pizza Pizza facilities that may be in restaurants or coffee homeless and marginalized people. franchise; homeless people shelter under its shops, and many of those spaces are now First launched in 2014, Telus’s Health for overhang on the weekends, she said. Some closed. So there are limitations to accessing Good program has delivered mobile clinics have encampments under nearby bridges. those facilities. It’s not like they’re in a com- to 13 Canadian cities, from Victoria to Hali- “The public health guidelines and re- CONTINUED ON PAGE 2 Telus teams with UHN to deliver services to the homeless and underserved

CONTINUED FROM PAGE 1 101,” and the need for social distancing makes this impossible. munity where there are public hand-wash- Secondly, COVID has affected the sup- ing facilities for people who are homeless.” ply chain of street drugs. As a result, they’re The mobile health clinic allows the being mixed increasingly with “toxic” im- CHC to take “pop-up testing” into com- purities like Fentanyl that can be deadly. munities where there is high positivity and The van itself is a Mercedes Sprinter, where additional COVID testing is needed. modified by architectural firm éKM archi- The CHC can take testing into congregate tecture et aménagement and builder Zone sites and congregate housing to provide Technologie, both based in Montréal. Ac- more testing, Robertson said. cording to Car and Driver magazine, the “The other piece that we will use the Sprinter line – with 21 cargo models and 10 van to do is, when the vaccine supply gets passenger versions – is “considered by many back online, and when the health system to be the king of cargo and passenger vans.” gets to doing community vaccinations … Kanji said the platform was chosen for we hope that we can be part of that effort.” its reputation for reliability and robustness. COVID has contributed to a spike in While the configuration is customized cases of Toronto’s other pandemic: opioid for each mobile clinic, it generally consists overdoses. Some community members are of two sections: A practitioner’s worksta- Raymond Macaraeg, nurse practitioner, and Angela Robertson, executive director, PQW CHC. reluctant to seek care because of the stigma tion and a more spacious and private ex- attached to substance abuse; and COVID amination room, so patients can receive dent of provider solutions wrote in an e- medical record (EMR) from TELUS Health has a one-two punch for users. treatment with privacy and dignity, Kanji mail interview. The Parkdale Queen West and TELUS LTE Wi-Fi network technology. The first rule of substance abuse is, said. The Parkdale clinic is 92 square feet. mobile clinic is designed for primary med- Practitioners will be able to collect and don’t use alone; always be with someone “While the layouts vary across regions, ical services, including wound care, mobile store patient data, examine a patient’s re- who can respond to a potential overdose, they typically include an examination table COVID-19 testing and vaccination efforts, sults over time, and provide better conti- ideally someone who can administer and health practitioners’ workstation, in- harm reduction services, mental healthcare nuity of care to those marginalized citizens Nalaxone to reverse the effects of the over- cluding equipment necessary to provide and counseling. who often would have had undocumented dose, Robertson said. “It’s substance abuse primary healthcare,” the Telus vice-presi- The clinic equipped with an electronic medical histories. The EMR system is Telus Health’s PS Suite (formerly Practice Solutions). It is an easy-to-use, customizable solution for gen- eral and specialty practices that captures, organizes, and displays patient information in a user-friendly way. The solution allows for the electronic management of patient charts and scheduling, receipt of labs and hospital reports directly into the EMR, and personalization of workflows with cus- tomizable templates, toolbars, and en- counter assistants. But like others tested for COVID, it’s a 24-48 hour wait for results. Pop-up or not, how does the mobile team get results to patients who have no fixed address? The CHC set up a centre for testing in a tent at the Waterfront Community Centre. Swabs are sent to the lab. “We are responsi- ble for connecting back with community members and their results,” Robertson said. “This is the value of having Parkdale With PrescribeIT®, collaboration between pharmacists and prescribers just got easier. Queen West being in front of the testing, PrescribeIT® is a secure e-prescribing service that seamlessly integrates into because many of the community members who are homeless we know through our electronic medical records and pharmacy management systems, enabling clinical other services, and there is some trust in communication. Imagine: no more fax or phone tag. folks either coming to us to make arrange- ments to collect their results, or we know where they are.” This is a key element of the program, A new era for prescribing. said Kanji – leveraging community trust. For more, visit PrescribeIT.ca In Vancouver downtown east side, for ex- ample, where there is a high concentration of marginalized members of the indige- nous community, nurse practitioners are accompanied by native elders in a partner- ship with the Kilala Lelum Health Centre.

Publisher & Editor Contributing Editors Art Director CANADA’S MAGAZINE FOR MANAGERS AND USERS Jerry Zeidenberg Dr. Sunny Malhotra Walter Caniparoli OF INFORMATION TECHNOLOGY IN HEALTHCARE [email protected] Twitter: @drsunnymalhotra [email protected] Volume 26, Number 2 March 2021 Office Manager Dianne Daniel Art Assistant [email protected] Address all correspondence to Canadian Healthcare Technology, 1118 Centre Street, Suite 204, Thornhill ON L4J 7R9 Canada. Telephone: (905) 709-2330. Neil Zeidenberg Joanne Jubas Fax: (905) 709-2258. Internet: www.canhealth.com. E-mail: [email protected]. Canadian Healthcare Technology will publish eight issues in 2021. Feature [email protected] Dianne Craig [email protected] schedule and advertising kits available upon request. Canadian Healthcare Technology is sent free of charge to physicians and managers in hospitals, clinics [email protected] and nursing homes. All others: $67.80 per year ($60 + $7.80 HST). Registration number 899059430 RT. ©2021 by Canadian Healthcare Technology. The Dave Webb content of Canadian Healthcare Technology is subject to copyright. Reproduction in whole or in part without prior written permission is strictly prohibited. [email protected] Send all requests for permission to Jerry Zeidenberg, Publisher. Publications Mail Agreement No. 40018238. Return undeliverable Canadian addresses to Canadian Healthcare Technology, 1118 Centre Street, Suite 204, Thornhill ON L4J 7R9. E-mail: [email protected]. ISSN 1486-7133.

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ca.medical.canon NEWS AND TRENDS Using Lean, working smarter, to reduce wait times for COVID-19 tests

BY STÉPHANIE LAPLANTE, ing efficiency and consequently output, as MARIE CLAUDE POIRIER well as improving patient satisfaction. AND LISE VAILLANCOURT Reflections led us towards a totally dif- ferent workflow, composed of a two- n response to the global pandemic, tiered appointment system, which also Hôpital Montfort, a 289-bed fran- met the new requirements of the govern- cophone teaching hospital in Ot- ment of Ontario, of eliminating the tawa, was mandated by the Cham- “walk-in type” model. plain Health Region Incident Com- By using appointments, we were able to Imand to set up a COVID-19 care clinic to decrease variation in demand, allowing a service the east end of the city. steadier flow throughout the day. At the time the request came through, Consequently, to optimize human, the clinic had to be ready for operation technical, and financial resources, we part- within the following week, as a surge of ill nered with another Ottawa hospital to im- patients was anticipated. Different in its plement an online booking system where mandate, as compared to a testing-only patients were able to reserve an appoint- centre, this care clinic allowed medical care The Montfort Hospital, in Ottawa, re-engineered the workflow of its COVID-19 clinic to improve processes. ment up to 48 hours in advance. on site. (i.e. X-rays, bloodwork, ECGs). Through customization of the The initial workflow was inspired by the At this point, although we aimed to see within only a few hours after opening SAVIENCE solution, patients would self- same one used in the main-site’s emer- as many patients as possible, some time. We were then starting to refuse pa- triage by choosing between either a gency room, with slight adjustments. Elec- processes involved duplication of the doc- tients up to five hours before the clinic’s COVID-19 “test-only” appointment or re- tronic registration and documentation umentation. Examples included data col- scheduled closing time, as we would not be ceiving a medical evaluation, combined were possible through an extension of our lection from the patient, as well as labora- able to meet the demand. with a COVID-19 screening test, if their hospital IT network and HIS. tory requisitions that were documented Daily wait times easily went up to symptoms required so. Within five days of determining the lo- both on paper and electronically to meet nearly 5-6 hours during this period. This Within this new model, our registration cation of our “walk-in type” COVID-19 Ontario Public Health’s as well as regional situation of course led to population dis- and electronic clinical documentation Care Clinic, a nearby decommissioned laboratories requirements. satisfaction and an overworked staff. processes and tools were also revamped. school that was now used for storage, we The use of workstations on wheels al- At this point, we found ourselves in a Improvements focused on streamlining were ready to accept our first patients, on a lowing electronic clinical documentation position where we had to rethink the data collection and data entry into only first-come first-serve basis. outside the patient room; this con- clinic’s processes to become more efficient one instance of documentation. Within the initial workflow, the pa- tributed to reducing the use of personal and increase patient satisfaction back to its Improved workflow: The improved tient’s journey started by undergoing a protective equipment to better protect original level. workflow permitted an adjustment to the triage process, paired with clinical data very limited stocks. By working with this Since our hospital has been using the skill mix of healthcare workers required to collection tools, built in the MEDITECH model, our clinic was still able to see up to Lean methodology for continuous im- operate the clinic. Expanse EHR. 470 patients per day with good popula- provement since 2008, the team referred to Where our first model was physician- After going through the registration tion satisfaction. their Lean knowledge to address the situa- driven, our second model allowed our process, patients were directed to a waiting It was only towards the end of summer tion. A few Lean principles were used to physicians to attend to the sicker pa- room until they could meet with one of 2020, as the clinic became well estab- create our new flow: “decrease variation”, tients. A new type of healthcare worker, our clinical teams to undergo a medical lished, that we experienced a surge in pa- which is one of the key principles, “better called a test administrator, was intro- evaluation and/or COVID-19 testing. tient demand, which resulted in very long use of talent” and “simplify the process”. duced in the skill mix for the patients These teams were composed of a physician waiting lines. This new model aimed to minimize the choosing a “test-only” appointment. and a registered practical nurse (RPN). Full capacity was sometimes reached time spent by our patients on-site, increas- CONTINUED ON PAGE 8

There’s more to it than promoting one-off, virtual care encounters

BY JIMMY YANG privatization and corporatization approach, but if we get it right, physician and patient coordinator are all happening throughout the healthcare tomorrow’s healthcare will provide this supporting a smooth journey and that anadians have embraced virtual system. High functioning systems will seamless patient experience with real- our data moves seamlessly as well. The care during COVID-19. A require a combination of traditional and time information through a mix of most recent data on electronic medical Canada Health Infoway atypical players. Our systems are personal and virtual services. We are record (EMR) connectivity from the (Infoway) survey shows that moving towards more value-based care seeing new partnerships and alliances 2018 Canada Health Infoway surveys Cwithin weeks of the pandemic lockdowns, models, as seen in the UK, Scandinavia between providers, pharmacies, health show limited EMR functionality between virtually conducted consultations surged and the US. technology companies and mobile tech different healthcare sectors, and it’s even to 60 percent of all primary care visits, Getting ahead: Innovators in the 42 leaders, that are helping to build the lower between physicians and patients. tripling the 2019 percentage. current Ontario Health Teams improving bridge to citizens We must also consider how privacy, A Canadian Medical Association poll services for their communities. They will spanning physical consent and personal health information shows that 91 percent of Canadians are attract funding envelopes and be and digital care come together, and require an satisfied with their virtual care experience. rewarded for providing greater value and and experiences. overarching governance framework for Our healthcare systems can convert outcomes tailored to their respective Barriers: With any sharing across verticals – think of it as this generational opportunity and address populations and by addressing their most disruption to the open banking for health. some of our biggest healthcare challenges. pressing pain points. traditional We deserve better: At Accenture, we Virtual care will help sustain our This value-based healthcare evolution healthcare model, are helping to reimagine the future of healthcare systems, address chronic will also map the patient journey beyond this co-dependent healthcare. Through technology, strategy disease, support healthy aging and provide the traditional verticals of primary care, framework comes and design we are providing better better access to healthcare opportunities home and community and long-term with its own outcomes with modernized, innovative, for our rural and remote communities. care. For example, after patient discharge, Jimmy Yang barriers to change. sustainable healthcare systems. We are To fully leverage these possibilities, we a more connected healthcare journey In the existing pleased to be a part of the Infoway need to aim higher than a series of one- would provide seamless medication context, we require funding reform or Alliance, a group of industry leaders off solutions by ensuring that patients instructions, easy access and transition to hybrid funding models, along with who are working to improve the quality and the entire healthcare continuum are rehabilitation and mental health services, shared-risk models to solve for of care for patients using digital health effectively engaged throughout a and personal support to help residents interoperability. technologies. patient’s healthcare journey. navigate their daily activities. If patients want a seamless journey We are in the most co-dependent era Today’s healthcare lacks this robust from left to right or right to left, we Jimmy Yang is Accenture’s Canadian in the history of healthcare with rapid personalized care management must ensure that the pharmacist, nurse, Health Industry Lead

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2Bleeper.2479.PrintAd.202010.Canada.PRINT.indd 1 10/7/20 10:48 PM ‘ 6 about their idea and with theirconsent,about theirideaandwith we spokeThey to thePPE educators atHHS wanted theminany to support way Icould. Colapinto. itwasoutstandingand “I thought technologists,”mized forultrasound saidDr. personal protective equipment(PPE) opti- Hospital. atHamiltonlead forUltrasound General Dr.with Michael Colapinto, radiologist felt unprotected inthatarea.” down,tients are lying lookingupatus; we ourgown,”and thetop of says Allred. “Pa- using leftabiggapbetween thechin, neck, exposed to thepatient. thetechnologist’ssides of face andneckare theexam,reach of theentirety the during on thepatientto acquire images. technologist usesahandheldprobe placed thestretcher,cated besidetheheadof the machine lo- theirultrasound monitor of chair besidethem. the While viewing the technologist seated onanelevated staff. Thepatientlays onastretcher with compared to otherpatient-facinghospital andtheirpatientsarenologists unique the face shieldswe were usingatthetime.” coverageconcerns from aboutthelackof HospitalGeneral (HGH). “We hadsome mented Billone, whoworks atHamilton know wasspreading,” how thevirus com- patients. interactions with during anextended face shieldtoidea of wear 19, Billone and the Allred cameupwith much aboutCOVID- wasstillunknown (HHS). thepandemic, At when of thestart atHamiltontic Imaging Health Sciences I Ultrasound technologists better face-shield with protection devise NEWS ANDTRENDS starting assoonuponadmission,starting to into thehealth-caresupports system, discharged into homelessness. be to would patientswho otherwise providing timelyandaccessible supports hospital admissionsandhomelessness by Address seeksto stop thecycle between scientific director atLawson, No Fixed hospital discharge to homelessness. a potential bestpractice forpreventing strategy, theseprojects are beingtested as hospitalwalls.homelessness from within collaborative approach to preventing announced two projects representing a a multi-sectoral research team L “Lisa and Sarah were“Lisa andSarah lookingto develop Billone and Allred discussedtheiridea “We noticed thattheshieldswe were This meansthat, arm’s whilewithin Interactions tech- between ultrasound wasin April.“This At thetime, we didn’t CANADIAN HEALTHCARE TECHNOLOGY MARCH 2021 It brings housing andfinancial It brings Led by Dr. Forchuk, Cheryl assistant Built ontheNo Fixed Address gists in the Department of Diagnos- of intheDepartment gists Sarah Allred, technolo- ultrasound are LisaBillone thewords and of itbecoming real.”tations of Those t wasjustanidea. We hadnoexpec- Institute and the City of London, Institute of andtheCity Lawson Health Research event forLondoners hosted by ONDON, ONT. BY NICOLESEIXEIRO Projects aimto prevent homelessness after hospital discharge – During avirtual – During put ittogether soquickly.” equipment, sothat’s how we were ableto thematerials and ready hadsomeof project managerattheMMRI. “But we al- works onmetalcutting,” Remilli, observed this before. generally Ourdepartment expected to beinvolved insomethinglike thing we were familiar with, so we never shield forahospitalsettingwasn’t some- leaped attheopportunity. “Making a face sound team’s email, immediately they the MMRI. When read they theUltra- really theprocess.” helpedto kick-start work anddesign,” saidDr. Colapinto. “She MMRI. “Kaylana isexceptional art- with fordiscussionswith ideas into illustrations Allred, joinedtheteam to helptranslate Billone and technologist atHGHwith anhour.yes within It wasremarkable.” anenthusiastictise; gotbackto they uswith exper- to lendtheirengineering be willing search would they Institute (MMRI)to seeif emailed theMcMaster Manufacturing Re- sound, andultrasoundtechnologistsLisaBillone,KaylanaParente, andSarahAllred. Lefttoright:Dr.aging forbetterprotectionagainstCOVID-19. MichaelColapinto,radiologistleadforUltra- shield inpartnershipwiththeMcMasterManufacturingandResearchInstitutePrintexTransparentPack- The UltrasoundteamatHamiltonHealthSciences’GeneralHospitaldevelopedanextendedface of thehomelesspopulation. of found to be the fastest growing segment concerning foryouth, whohave been visits. Thisisparticularly department readmission andemergency rates difficult. often They experience higher challenges thatmake recovery more homelessness inCanadaface many homelessness. of for patientsatrisk provide direct, support on-site (orvirtual) Ontario Works Londonto of intheCity Army’s Housing Bankand Stability Unlimited,Opportunities Salvation Association Elgin-Middlesex, Youth London, CanadianMental Health from of theCity staff collaborating with Joseph’s Health Care Londonare orto avoidsupports apotential eviction. assist infindingappropriate housingand Steve Remilli andBrady Semplework at Kaylana Parente, alsoanultrasound NFA wasinitiallytested strong with Patients discharged from hospitalto atLHSCandSt. Several departments were already providing standard face ourvendorsreached who outto oneof extended face along. shieldmoving “I pandemic. sume projects thatwere delayed dueto the a setprototype, theMMRIteam hadto re- team andMMRIagreed on the ultrasound and ity Value Improvement atHHS. When said Dr. Colapinto. from“It there.” took off HHS were interested insimilarprotection,” that Anesthesia andMedical Reprocessing at PPE Task Force forapproval. “It out turned tothen submitted theHHS theprototype extended face shieldwascomplete. andsafety,fort the of thefinalized design and MMRI, forcom- tweaking thedesign team between theHGHUltrasound forth someback-and- roughly three weeks of days by creating hand. theprototype After followed design by afewmorethe original the MMRI, spentaboutaweek developing Works theprovision of assistwith will maintain orobtain housing. Ontario homelessnessto of at risk individuals Outreach worker support will at hospitalsites. A Coordinated Access Coordinated Access Outreach program London’s of the City evaluate Income (H2I). Thisresearch study will Homelessness –Health, Housing and LHSC’s University and Victoria Hospitals. project wasextended to medicalunitsat andthesecond the the city version of success formentalhealthpatientsacross Herechuk swooped into helpgetthe HerechukBryan Qual- isthedirector of Allred, Billone, Parente, andColapinto Semple, aseniorresearch at engineer PROJECT 1: Collaboration to Address or obtainhousing. of homelessnesstomaintain support individualsatrisk An outreachworker will Middlesex. Children’s Londonand Aid Society by Youth Unlimited Opportunities and care, provided additionalsupport with into acoordinatedsupport system of streamlining housingandfinancial be exploredyouth will by at-risk unique healthandhousingneeds of youth forvulnerable 16-24.strategy The research customize study will theNFA No Fixed Address – Youth (NFA-Y). This Strategy. Housing Corporation’s National Housing funded by theCanadaMortgage and months post-discharge. Thisproject is inhospitalandagainsix be interviewed financial resources to secure housing. Bank may beaccessed forneeded the Salvation Army Housing Stability and income andemployment supports tonhealthsciences.ca/share/ppe-collaboration/ Publicences Relations. https://www.hamil- Hamilton HealthNicole iswith Sci- Seixeiro itto you life.” inbringing support you havethat if anidea, thehospitalwill something like this. “It to know isinspiring never Iwould ever thought beinvolved in day you anddowhat work every do. I couragement isallyou need. “You come to as Billone pointsout, sometimesalittleen- – notdreaming upanewinnovation. But, always theirminds been attheforefront of sound andproviding care to patients has tients, theshieldson.” sowe feelsaferwith COVID-positive alotof work with pa- are easyto useandthey’re reliable. We team loves“The them. say They theshields her co-workers’ reaction to theirnewPPE. since lastNovember. Allred with isthrilled have beenusingtheextended face shields came together sonaturally.” play quickly. together very Everything intheirfieldscan experts how groups of expertise. of on really shonealight “This collaboration areas between various ple of to HHSandthatwasit. totype their design, andbrought thesecond pro- novation, modificationsto slight with itandhesaidyes.with So, we usedthatin- wouldHHS. they beokay Iasked if Bryan put itinto theextended face shieldfor ticed we could take thatinnovation and face shieldsforchildren.designing Ino- toject wasreally me,” important saidTassé. works inanursing home, too, sothispro- volved. “I’m aHamilton guy. My wife Packaging, wasmore thanhappy to getin- PrintexBurlington Transparent campus of sending themthedrawings.” me aday of within developed aprototype explains. onit. jumpedright They “They wouldthey consider producing,” Herechuk thisissomething shields forusandasked if PROJECT 2: Preventing discharge to Over two years, will 106participants Allred andBillone’s passionforultra- technologists acrossUltrasound HHS Remilli saidthe project isagreat exam- “At thetimewe gottherequest, we were Dave Tassé, salesmanageratthelocal http://www.canhealth.com

PHOTO: JOSH CAREY, HAMILTON HEALTH SCIENCES Connected Health

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TRUS TED BY WINNER

     BOLD EPIC INNOVATOR AWARD NEWS AND TRENDS Analytics dashboard monitors COVID-19 patients at hospital and at home

BY NORM TOLLINSKY Recently certified for use by Health Canada, the Biobeat devices measure 14 s reports of overburdened hospitals vital signs, including blood oxygen satura- and mounting COVID-19 deaths tion, respiratory rate, blood pressure and in China and Italy made head- pulse rate. lines around the world, senior A third component of CARE 360 is a leadershipA at Montreal’s Jewish General geolocalization tool that “allows us to have Hospital (JGH) began preparing for the an overview of where there are concentra- inevitable spread of the virus to Canada. tions and clusters of infection (in the Topping their list of priorities was the de- Montreal area),” said Kapetanovic. “The velopment of an epidemiological predic- tool also has the capability to push infor- tion model to make sure they had the re- mation to the public and warn the elderly, quired number of beds, staff, ventilators for example, to socially distance, avoid go- and personal protective equipment (PPE) ing out and to wear protective equipment to cope with admissions. if there is an outbreak in their area.” Being prepared for COVID-19 was es- Decision making related to the pan- pecially important for the JGH once it was demic is made in the JGH’s Command designated by Quebec’s Ministry of Health Centre, where key people from different and Social Services as a lead institution for departments have access to the Maisha treating COVID-19 patients. With the Labs information systems. busiest emergency room in the province The objective, said Dr. Cross, is to and its Pavilion K, which contains a num- Asaf Ashkenazi, Maisha Labs Dr. Justin Cross, JGH’s chief digital health officer “change the culture of decision making” by ber of rooms specially equipped for a pan- putting key people in the same room and demic scenario, the JGH was ideally suited COVID specific tool,” said Ido Rivlin, house data scientists with hands-on capa- provide them with all of the information for its first responder role. Maisha Labs’ chief data scientist. bility, you can adjust your models and see they need about patient flow and bed oc- “At the beginning of the pandemic, During the first wave of the pandemic to what works,” said Asaf Ashkenazi, execu- cupancy to respond rapidly as situations there was a huge issue with PPE and the hit Montreal, the model generated predic- tive board member, Maisha Labs. “That’s come up.” shortages thereof,” recalled Danina tions with up to 98 per cent accuracy seven an advantage that a startup has over an en- The Command Centre is also being Kapetanovic, strategic advisor for entre- days in advance. On May 11th, for example, terprise system. You have to be agile and be used to co-ordinate and manage the vac- preneurship and innovation at OROT, the the hospital had 164 admissions – three less able to adjust to rapid changes.” cine rollout to the long-term care homes in JGH’s research and innovation hub. “We than the 167 the model predicted. Founded in 2011, Maisha Labs initially the Integrated Health and Social Services were dealing with an unknown enemy and “We looked at a few ways to attack this focused on bringing together data scientists, University Network for West-Central were faced with the reality of having to problem using linear models, but it was a engineers, cyber security specialists and law Montreal, which comprises 34 healthcare protect our healthcare workers. Given the problem because we didn’t have enough enforcement to help NGOs and govern- organizations including the JGH. experience of a few countries that were hit data to start making good projections,” said ments in Africa combat the illegal trade in In a post COVID world, Maisha Labs hard ahead of us, it became clear that this Rivlin. “Instead, we used an epidemiologi- persons, wildlife and natural resources. will focus on the AI-based Command and virus had the potential for completely cal model and customized it for Montreal. Following a major fire in Israel in 2010, overrunning our resources.” “To begin with, we gathered data from Ashkenazi was responsible for building a Fortunately, the JGH didn’t have to other countries that had their outbreak ear- predictive analytics model to forecast the During the first wave of scramble to find the data science expertise lier, then used local data once COVID hit.” demand for firefighting services 15 years in COVID-19, the model generated required to build the model. Prior to the The model also factored in population the future, “so we have experience predict- predictions with 98 percent pandemic, the hospital was working with age and density along with assumptions ing large-scale phenomena and from our Israeli-based Maisha Labs to develop an AI- relating to social distancing based on work in Africa, we are skilled in intelligence accuracy, seven days in advance. powered Command and Control Platform school closings, lockdowns and public ad- gathering and data exploitation,” he said. to predict Emergency Room admissions herence to the rules in force. The epidemiological prediction tool is Control product that it was in the midst of and patient flow through the hospital. Tweaking the model proved necessary part of a broader situational awareness so- developing when COVID relegated it to “But when COVID-19 struck, we had to through the summer and late fall when the lution called CARE 360 that provides the back burner. put it on hold and were asked to build a second wave hit Montreal, “but having in- front-line staff at the JGH with a dash- “The Command and Control platform board overview of its COVID-19 patients. predicts ER volumes along with admis- “When we saw stories coming out of sions and discharges,” said Amanda Bab- By introducing two different Italy about the number of patients admit- bit, who heads up the Montreal office for Working smarter types of visits in our second model, ted to hospital, we wanted to put together Maisha Labs. “It’s a tool that allows the CONTINUED FROM PAGE 4 we became more efficient and a dashboard view of all admitted COVID- hospital to see what’s happening in various reduced direct human resources cost 19 patients with key indicators including areas and highlights early warning signs so Patients who came in for a “test- by 33%. vital signs, lab values and length of stay in- they can be addressed proactively.” only” could always change care paths By using technology to our formation that clinicians could reference if “It’s used for operational purposes by if they were identified to be sicker advantage, we were able to decrease they were so overwhelmed that they didn’t our bed flow co-ordinators to try to get an than originally expected. These the time to complete a visit for a “test- have time to do their normal EHR work- advanced idea of how many people are changes allowed patients to receive the only” appointment by approximately flow,” said Dr. Justin Cross, the JGH’s chief likely to be admitted to the ER and how right type of service, in a timely 50%. As an example, patients spent on digital health officer. “That’s another piece many rooms we need to get ready. It also manner, by the right healthcare of the work with Maisha Labs.” helps us make arrangements for transport provider. The solution allows clinicians to zoom to reduce the wait time for patients in the In addition, our efforts decreased By introducing two types in on an individual patient and view vital ER once a doctor has decided that they duplication and associated potential of COVID-19 visits, human sign data from biomedical equipment, need to be admitted,” said Dr. Cross. errors. A notable example was to allow resource costs were reduced freeing them from having to enter a pa- “It has really helped with patient flow. It the printing of a report that tient’s room. predicts anticipated volumes in the ER identically mimicked the paper- by 33 percent. Taking the solution one step further, the several days ahead of time, so it’s really format COVID-19 laboratory JGH has launched a pilot project with helpful for ER staffing.” requisition required by Ontario Public average 24.7 minutes initially for a Maisha Labs to deploy a wearable vital sign Maisha Labs is realistic about the long- Health laboratories, by using the “test-only” visit. Our new model monitoring device from Tel Aviv-based term need for CARE 360 and the epidemi- administrative and clinical data decreased this time to roughly 12 Biobeat that’s cloud enabled and would al- ological prediction model for COVID-19. documented through our HIS. minutes. Consequently, patient low the JGH the option to monitor pa- “More than anything else, we really The report was printed once the satisfaction improved. tients outside the hospital, said Dr. Cross. hope that this tool will not be needed order was completed in the HIS by our Although the staff was reluctant at “For example, if we had patients who long term,” said Ashkenazi. In the mean- frontline worker. This meant we were first, they are now very happy with the were ready to go home, but we wanted to time, “We’re happy to share it with new no longer required to fill out a paper changes and would not go back to our keep an eye on them for a few days, we clients or offer it to anyone who needs it version of the laboratory requisition. original model. could send them home with one of these provided we are able to cover our inte- devices. There’s a patch and there’s a watch.” gration costs.”

8 CANADIAN HEALTHCARE TECHNOLOGY MARCH 2021 http://www.canhealth.com SPONSORED CONTENT VIRTUAL CARE Lakeridge Health quickly pivots to virtual care during the COVID-19 crisis A Microsoft 365-powered bookings app and Teams were used to create over 30 new virtual clinics.

aced with the unpredicted challenge of the COVID-19 crisis, Lakeridge Health, a healthcare provider to hundreds of thousands of Canadians in a large catch- ment area just east of Toronto, quickly enacted its pandemic response plan. FThis included the creation of new solutions capa- ble of offering an 800 percent increase in virtual care, limiting patient and staff exposure to the virus. By creatively adapting multiple Microsoft 365 and Microsoft Power Platform solutions to work in new and innovative ways, the organization has met its goals, simultaneously creating a nearly entirely new electronic medical record (EMR) platform. Lakeridge Health, comprised of five hospitals and 11 clinical outpatient facilities, provides primary healthcare to more than 750,000 people in the Durham region of Ontario. As a crucial and integral part of the region’s medical system, Lakeridge Health played a significant role in the local response to the COVID-19 crisis. so that it could extract patient information and pop- diagnostic requests compared to the organization’s “COVID-19 was something that took the entire ulate a SharePoint site for us.” traditional requisition system. healthcare system by surprise,” said Dr. Ilan Lenga, This SharePoint site quickly became the standard “By tying our SharePoint sites to Power Apps and Chief Information Officer and Chief Medical Infor- patient-tracking solution for Lakeridge Health. Power Automate, we’ve been able to take all the in- mation Officer at Lakeridge Health. “And the realiza- Adding a small amount of analytics to this site, the formation that patients give us and use it to generate tion that it had gained a foothold in Canada required organization effectively triaged patients based on a requisition,” said Lenga. “We can even produce a la- an immediate response.” their reported symptoms. This was especially impor- bel for our swab and produce a requisition for our Thankfully, after the 2002–2004 SARS epidemic tant during the early days of the pandemic when test- laboratory requests right from SharePoint.” proved how rapidly viruses can spread across the ing supplies, swabs, and even personal protective Scalability has also been a crucial part of Lak- globe, Lakeridge Health had formulated an emer- equipment (PPE) faced national shortages. eridge Health’s pandemic response. The early stages gency operations plan. Key leaders were placed in For patients requiring assessment, but not yet in of the COVID-19 crisis saw an 800 percent increase pandemic-response roles, and the organization be- need of testing, Lakeridge Health turned to Microsoft in patient visits compared to an average year. Lak- gan developing plans to draw down regular activities Teams. Using Teams for virtual assessments, medical eridge Health handled many of these visits through in preparation for a projected surge in patients. The personnel could better understand the state of each virtual care and, as demand for these services steadily organization’s communications team worked to patient’s symptoms, keeping those who likely did not increased, leadership saw a dire need for increased rapidly build out new channels capable of managing have the virus safer by allowing them to stay at home. virtual care capacity. interactions between hospital staff, their external As time went on, testing supplies became more In years past, the process of creating a virtual clinic partners, and regional leadership. available, allowing Lakeridge Health to test everyone within an existing department or ambulatory space at Lakeridge Health next identified three major who felt the need to be tested. This created other is- Lakeridge Health took between three and six months. changes that would need to be enacted to meet the Thanks to a combination of cooperation from the challenge of the COVID-19 virus. “We needed to cut health ministry and its newly minted solutions, the or- down face-to-face interactions for the safety of our There are multiple easy-to-understand ganization was able to speed that process dramatically. patients and our employees, we needed to create a tools that make up Microsoft 365, “We used a combination of our Microsoft 365- system that would allow for the rapid deployment of which you can pick up, learn a little powered bookings app and Teams to spin up over 30 multiple new clinics, and we needed to ensure that we new virtual clinics in just weeks,” said Kelly. “We were were providing a safe environment for our patients about, and use as building blocks. creating a new clinic every couple of days.” and staff during in-person care scenarios,” said An- These new clinics also quickly benefited from drew Kelly, Director of IT Strategy and Innovation at sues, however. “If you switch to a universal testing ap- other solutions Lakeridge Health created. “We Lakeridge Health. “We relied heavily on Microsoft proach without a clear-cut appointments schedule, started by testing our new Microsoft 365-based apps 365 to create solutions for each of those needs.” you run the risk of potentially infected people congre- at one clinic, and then a second,” said Kelly. “Thanks Though Lakeridge Health had been using a num- gating in long lines outside your facilities,” said Lenga. to the intuitive nature of these solutions, we’ve since ber of Office 365 components for years, Lenga admits “That’s why we used Power Automate and the calen- gone on to offer them to multiple community sites that very few users would have considered themselves dar in Office 365 to create a new booking system.” and clinics, where we’ve seen our clinical teams take highly proficient prior to the COVID-19 crisis. Similar to the patient triage system, Lakeridge to them very rapidly.” “It’s the expertise that we’ve developed over the Health’s booking system allows patients to provide Lenga agrees, adding that the organization’s over- last few months that took us from Microsoft 365- their data in Forms. Power Automate then identifies arching goal in offering virtual services has always aware to Microsoft 365 experts,” he recalls. “That’s a number of key factors within that data and triages been top-quality care. “We had a lot of clinicians who what’s great about the solution. There are multiple them accordingly, ultimately referencing an Office were hesitant about the virtual care experience,” he easy-to-understand tools that make up Microsoft 365 calendar populated by prearranged appointment said. “This has since transformed into glowing rec- 365, which you can pick up, learn a little about, and slots based on staff availability and scheduling the ommendations. One of the most prevalent things we use as building blocks for almost any kind of infra- patient. hear from our personnel today is confidence in the structure you might require.” Patients are then sent automated appointment idea that virtual care is here to stay – that this isn’t a The first of these building blocks Lakeridge confirmation emails, and the appointment is made stop-gap in a time of crisis, but a transition to a new Health turned to were Microsoft Forms, Power Auto- visible to receptionists via SharePoint Online. standard of care. mate, and SharePoint Online. “At the very beginning, To further track patient interactions, Lakeridge “We have been truly amazed by what we’ve been we knew we needed a solution capable of keeping Health also built nurses and physicians role-specific able to accomplish in a relatively short amount of track of a massive influx of patients,” said Lenga. apps with Microsoft Power Apps. These apps not time, and we’re equally excited to see what we’ll be “Right away, we began creating an intake form in Mi- only help with patient data entry into the system fol- able to accomplish with Microsoft 365 in the days crosoft Forms, which we then fed to Power Automate lowing screenings, but they have also sped laboratory to come.” http://www.canhealth.com MARCH 2021 CANADIAN HEALTHCARE TECHNOLOGY 9 Integrated communications system boosts safety at Interior Health The implementation of Vocera has helped clinicians deliver high-quality care amid the pandemic.

BY JERRY ZEIDENBERG large tertiary facility, Povah said there was significant auto-answer, so the patient didn’t have to manually demand from clinicians who wanted streamlined operate the device. Visitors outside could be con- nterior Health, headquartered in Kelowna, communications. nected, even using their own cell phones, and they BC, had just finished rolling out its Vocera The strategy was to increase the number of de- could communicate with their loved ones inside. integrated communications platform re- vices being used by clinicians, such as in the emer- “It bridged the communication gap while we gion-wide when the COVID-19 pandemic gency department. “This greatly improved their abil- weren’t allowing visitors inside,” said Povah. struck with full force in March of 2020. It ity to communicate about the flow of patients in the Dr. Ben Kanter, chief medical information officer was excellent timing, as the technology en- ER,” said Povah. at Vocera, asserted that an integrated communica- Iables staff and clinicians to instantly call each other Another group that hadn’t previously been on- tion system is essential for hospitals to respond by using hands-free badges, even when wearing per- boarded were the respiratory therapists. With quickly to a variety of patient alerts, and to connect sonal protective equipment. The user can say, OK COVID-19 being a respiratory disease, their services staff and clinicians. Vocera, call Dr. John Smith, and he or she will be were crucial. “This deployment was extremely help- Clinicians shouldn’t have to pause to look up a

INTEROPERABILITY quickly connected. ful,” said Povah. number, contact the switchboard, or find out who is Users can even find a person by role. For example, The platform was also useful to security personnel on call in a hospital. An integrated system should be you can ask for the on-call cardiologist, and the sys- and those controlling the entrances and exits of the able to do this work for the clinician or staff member. tem will find the person on its own. hospital. “The purpose here was to assess visitors and “The quicker a message gets through to a nurse or That was a big help when it came to managing pa- determine whether they could come in,” said Povah. other healthcare professional, the more likely there tients and keeping staff free from infection. “When COVID hit, we had to respond quickly,” said Andrew Povah, manager of Mobility Services at Interior Health, who spoke at a webinar on Real- Time Communication Systems in Healthcare, last October. “We let the staff know that communications would be essential.” Interior Health serves a population of 801,000 in British Columbia and comprises numerous hospitals and long-term care centres, many of which utilize Vo- cera. It has an annual operating budget of $2.6 billion. During his webinar presentation, Povah gave spe- cific examples of how the Vocera platform has helped staff and clinicians. He discussed the case of the region’s Princeton General Hospital, a commu- nity facility just outside Penticton, BC. While the centre is well-equipped for acute care and has an emergency department and lab, it didn’t have isola- tion rooms for patients infected with COVID-19. The staff at Princeton General improvised and quickly created an isolation room, but it lacked win- Dr. Ben Kanter, CMIO at Vocera Andrew Povah, manager of Mobility Services at Interior Health. dows, telephony and intercoms. “So, facilitating ef- fective communication in this room was a huge chal- These staff members quickly found that they had a will be a good outcome,” said Dr. Kanter, who also lenge,” said Povah. need to communicate amongst themselves. “Being a spoke at the webinar. Dr. Kanter asserted that “short- Phones or intercoms to communicate with pa- large facility with multiple entrances and exits, staff ening the time to act – for clinical and operational tients could have been installed, but it would have wanted to communicate about personnel levels and processes – is critical to overall healthcare delivery.” taken a fair amount of time. “When you’re cabling resource requirements – and to communicate about He noted that Vocera can be used to integrate the and you’ve got contractors coming in, it’s not a mat- visitors who may have been rejected at one entrance large number of alerting systems used in hospitals – ter of days that you need, it’s weeks,” said Povah. and might be trying to come in through another one.” such as cardiac monitors, telemetry and lab results – He said that since the facility was already using Using the backend programming of the Vocera and when appropriate, to direct them to the right Vocera, the I.T. staff asked why they hadn’t extended system, role-based communications were deployed person, so the situation can be normalized. it into the isolation room. It turned out that clini- and became important. This occurred in logistics If a person is busy or doesn’t respond, the system cians were using highly plasticized, protective gowns, and was helpful in replenishing PPE. can escalate the message to the next available and ap- and this heavy PPE generated noise that made it hard As there were constraints in the supply of PPE, the propriate person. to work with the Vocera badges, especially when used wards were being stocked on an as-needed basis. “To accomplish this, hospitals need technologies underneath the gowns. “That meant when you needed top-ups, you needed that can monitor systems and using rules and logic, A solution was found in wearing the badges out- them very quickly,” said Povah. “That role was very can distribute information to staff based on their side the gowns and using a special protocol for clean- effective in getting the PPE to the right place and the various roles and responsibilities.” ing the devices afterwards. As well, it was found that right time.” Without a system of logical handoffs, he observed, clinicians could continue wearing the badges under Another important role, and perhaps an unex- a nurse could otherwise receive five alarms from five their gowns by retraining the Vocera system to un- pected one, was elevator cleaning. “After a patient different systems in the space of five minutes. “That derstand their muffled voices. transfer, we had to clean the elevator and communi- can be chaotic,” said Dr. Kanter. However, the Vocera As another measure, a badge was installed in the cate that it had been completed to ensure the safety platform can take inputs from up to 150 different room using the auto-answer feature, so that it acted as of our staff and patients,” he said. “Vocera played a systems, aggregate them, and forward them to the a wireless intercom. “It meant we didn’t have to take key role there.” appropriate person. badges in and out of the room anymore,” said Povah. At Noric House, a long-term care centre in Ver- Messages can be sent to any and all devices, from Instead, staff outside the room could converse with non, BC, visits to the facility were limited, and at hospitals with a BYOD strategy, to Vocera’s own clinicians who had entered, as well as with the patient. times were completely prohibited. However, the fa- badges, or standard tablets, phones and desktops. “This was a very successful implementation, and cility used the Vocera system to connect patients to Moreover, using the Vocera devices, communication we took the learnings and used them at our other visitors – outside their windows – by deploying a Vo- can be done hands-free, using voice recognition and sites in British Columbia,” said Povah. cera badge in the room of the patient. As with the activation. “We’ve been doing this for 20 years,” said Meanwhile, at the Kelowna General Hospital, a Princeton General Hospital, the badge was set to Dr. Kanter. “Long before Amazon and Google.”

10 CANADIAN HEALTHCARE TECHNOLOGY MARCH 2021 http://www.canhealth.com

Virtual care has progressed, but more work on integration is needed Advances in interoperability, and scaling it up, would make it even more useful.

VIEWPOINT BY DR. SUNNY MALHOTRA Remote patient monitoring can also be utilized in platform solutions for anticipation of patient loads hospital settings by allowing nurses to monitor and and capacity strains, thus assisting hospital organiza- s 2021 begins, the COVID-19 pandemic re- communicate with inpatients via streaming of real- tions in the preparation for future outbreaks. How- mains rampant, raising the death toll in the time video feeds, thus reducing physical contact and ever, most healthcare organizations fall short of en- United States to well over 400,000 and lowering the risk of transmission. Although many or- suring that all involved understand the data provided counting. Healthcare companies like ganizations can launch new solutions like these, most and can apply it to generate real-world solutions. Pfizer and Moderna have raced against lack the infrastructure to survey many patients at once Predictive analytics can further evolve by offering the odds to produce and obtain au- without compromising the quality of healthcare that real-time evidence and “possible solution” algo- thorizationA for the distribution of their vaccines. rithms to ensure proactive mitigation of risk and However, the approval of these vaccines is only one their prospective outcomes. of the many obstacles that healthcare industries face Integration between new solutions More recently, vaccine deployment has become the moving forward. COVID health technologies, like vir- and traditional workflows would top priority in the war against the pandemic and has tual healthcare, remote patient monitoring, predictive ensure the seamless exchange of proven to be a more challenging task, but business man- analytics, and vaccine deployment have brought about agement technologies offer new solutions to help in effi- solutions to alleviate many healthcare challenges to information for doctors and patients. cient and organized distribution of COVID vaccines. date, but some still fall short of meeting the mark. Companies like Accenture aid healthcare organi- Virtual healthcare has proven to be the most criti- patients receive. These technologies need to become zations by providing vaccine management solutions. cal to the COVID-19 strategy. Taking healthcare on- scalable, and interoperable with clinical workflows, to This includes planning to meet the needs of different line allows patients to have a virtual means of access improve patient care and maximize productivity. levels of care, and to allocate the appropriate funding and communication with their physicians, thereby al- Predictive Analytics has helped us recognize for such distribution. leviating the overcrowding of waiting rooms and facil- health disparities amongst specific commu- Accenture provides a software platform that ities and reducing the chance of spreading the virus. nities within our patient populations. These is designed to securely track vaccination It allows staff members to provide a great deal of solutions gather specific data on popula- journeys from registration and appoint- care in an efficient and effective manner. In many tion subsets and offer insight into stratify- ment scheduling to final administration cases, it is also more convenient for patients. ing risks and implementing tactics to bet- and symptom follow-ups. However, virtual healthcare comes with its limita- ter serve the needs of each community. Robotic process automation services can tions. Integration between these new solutions and Companies like Health Catalyst offer support vaccine supply ordering, inventory existing clinical workflows is needed to ensure the management and demand forecasting. Vac- seamless exchange of information and easy access for Dr. Sunny Malhotra is a US trained sports cine management platforms can also help both providers and patients alike. Integrating these cardiologist working in New York. He is an with increases in surges by deploying vir- features into virtual healthcare will further improve entrepreneur and health technology tual agents to address questions and its usefulness. investor. He is the winner of the automate texts and emails for Another technological solution in the fight against national Governor General’s community engagement, eli- COVID is remote patient monitoring. Employing re- Caring Canadian Award 2015, gibility screening, and health mote patient monitoring allows patients to recover at NY Superdoctors Rising Stars surveys. home while still being under the surveillance of their 2018 and 2019. They can also gather public medical providers and decreasing spreadable risk. Twitter: @drsunnymalhotra CONTINUED ON PAGE 14

How COVID will continue to transform healthcare organizations

BY LANA LEONE supplies needed to keep patients and can create an “electronic whiteboard” workflows. RTLS tags, for example, clinicians safe, such as hand sanitizer that records everything from can be added to wheelchairs so that espite the many challenges and personal protective equipment specimen analysis and X-rays to nurses can locate them quickly to of 2020, healthcare (PPE), were hard to come by. physical therapy. speed patient discharge. Once the organizations have gained In 2021, we are seeing hospitals Hospitals can then monitor patient is wheeled out of the room, considerable insights and increasingly embracing technologies precisely how long each treatment nurses can use their purpose-built Dexperience that will transform such as barcodes, radio frequency takes and mobile devices to notify housekeeping healthcare well into the future. Today, identification (RFID) and real-time identify where that the room is available for cleaning. hospitals are already adopting location systems (RTLS) to gain workflow Research shows that technologies technologies that are helping them unprecedented visibility and control bottlenecks like RTLS can result in up to 50% realize critical cost-savings and of their supply chain and inventory exist. For faster bed turnover times and as productivity benefits. These management systems. These visibility instance, is it much as a three-hour reduction in advancements promise to become enhancements will also help hospitals difficult to patient length of stay. In a 275-bed mainstream after the pandemic is a reduce inventory waste due to find a hospital, cutting just four hours off distant memory. Here are some of the unused and expired supplies. wheelchair to the average hospital stay is the same trends you can expect in 2021. Streamlining patient care: Beds transport a as adding 10 new beds. Focus on the supply chain: Even also became a scarce resource at discharged Making healthcare professionals’ before the pandemic, supply chain many hospitals in 2020. This year, Lana Leone patient? Are jobs easier: Staff burnout became a inefficiencies cost hospitals more more hospitals are exploring new there regular huge issue last year, with hospital than $25.7 billion each year, ways to move patients through the backups in X-ray, laboratory testing, facilities and their clinicians according to an analysis from system faster. Hospitals can use both social services or other areas that struggling to keep up. One way to Guidehouse, the international location technologies and mobile affect patient care? decrease burnout is to make consulting company. The pandemic computers to track and streamline Technology has proven highly clinicians’ roles easier. To further exacerbated those treatment throughout a patient’s stay. effective in improving patient accomplish this, many hospitals are shortcomings. Ventilators and basic Using these technologies, hospitals turnaround times and hospital CONTINUED ON PAGE 22

12 CANADIAN HEALTHCARE TECHNOLOGY MARCH 2021 http://www.canhealth.com VIEWPOINT Three ways the healthcare sector has been transformed by COVID-19

BY PETER JONES we’re seeing with Nuance Communica- lutions and conduct virtual visits, the need ber Security, the pandemic has only exac- tion’s Ambient Intelligence, or interacting for vigilant cybersecurity is paramount. erbated the problem with cybercriminals hile the COVID-19 crisis has with a bot during a virtual visit to pull up Increasingly, Canada’s healthcare sys- looking to exploit the crisis by targeting created immeasurable chal- the latest diagnostic imaging. tem is facing sophisticated cyber threats healthcare organizations supporting the lenges for the healthcare sys- Balancing innovation with security, from bad actors trying to access patient in- national response to COVID-19. tem, it has also demon- privacy and compliance is critical: As more formation and other data. Unfortunately, Recognizing this growing threat, Mi- Wstrated that there is no shortage of innova- healthcare organizations adopt digital so- according to the Canadian Centre for Cy- CONTINUED ON PAGE 22 tors in the industry who were ready to meet the moment. Reflecting on all that happened in 2020, three important take- aways stand out: virtual care is here to stay; balancing innovation with security, privacy and compliance is critical; and finally, in- novation will continue to shape Canada’s healthcare system. Virtual care is here to stay: We have seen extraordinary advancements across our healthcare system as providers acceler- ated their adoption of virtual care. The pandemic has made in-person doctor vis- its challenging, but it has been especially hard for patients with mobility issues, a compromised im- 16TH ANNUAL mune system or liv- ing in areas with a shortage of clini- cians or healthcare facilities. The introduction of billing codes that MIIT 2021 enable doctors to charge for virtual visits have created Peter Jones new opportunities – and there are signs this is here to stay, with Alberta making these codes permanent. We are working with providers to use the VIRTUAL MEETING complete meetings platform in Microsoft Teams, combined with the new Bookings Register online at miit.ca app in Teams, to schedule, manage and conduct virtual visits with patients. In addi- tion to virtual visits, these tools empower health teams to collaborate more effectively and share knowledge in a single secure place, with advanced messaging features. When the pandemic hit, Lakeridge Health, a healthcare provider to hundreds of thousands of people in Ontario, quickly adopted new solutions that provided the capability of offering an 800 percent in- crease in virtual care. The organization used a combination of Microsoft 365 and Microsoft Power Platform solutions, in- cluding Teams, to create over 30 new vir- tual clinics in just weeks. The benefits of virtual care have been well-received by patients and healthcare providers alike – it has become clear that this isn’t a stop-gap in a time of crisis, but a transition to a new standard of care. While many digital solutions were adopted out of necessity, this is a powerful example that shows how the changes put in place today will help medical profes- sionals deliver personalized care to Cana- dians in new, innovative ways in the post- COVID world. The next evolution of virtual care will MIIT 2021 will feature presenters from leading Canadian and U.S. centre around the experience – from institutions speaking on a range of timely topics, including hot topics booking the appointment to automated follow–ups after the visit, the patient is like AI and machine learning, and a panel discussion on DI-R. fully engaged and can easily include fam- ily members. Practitioners are starting to use Speech AI for clinical charting and documenta- Follow @ MIIT_Canada on Twitter for updates and details tion that will automatically integrate with a patient’s Electronic Health Record, as http://www.canhealth.com MARCH 2021 CANADIAN HEALTHCARE TECHNOLOGY 13 DIAGNOSTIC IMAGING COVID speeds up demand for technology in hospitals and community

ORONTO – Burnout is be- tem, with people urgently asking for care. variety of systems and information silos Medicine and Public Health in the United coming a major side-effect The stresses have come to the surface.” used in hospitals and healthcare networks. States, and after being tested in many set- of the pandemic, as physi- Mr. On said that artificial intelligence is For its part, Siemens will be launching a tings, has fanned out to centres across the cians, nurses and technolo- another solution to the problem of over- new platform in Canada called Syngo Car- country, including VA hospitals and the gists succumb to exhaustion. load and burnout. “AI is a huge topic, and bon. It is expected to be rolled out in June. Cedars-Sinai Medical Centre, in Los Ange- Observers have noted, how- we’re investing heavily into it,” he asserted. The Syngo Carbon platform will inte- les, California. ever,T that solutions are available that aren’t “We’re building it into our products to in- grate all types of imaging modalities, so that The program treats patients with pneu- yet being used – especially in Canada – that crease efficiencies and, on another front, to they’re readily available to all clinicians. “It monia, heart failure and COPD in their own could effectively allow healthcare profes- tailor the diagnoses and therapies being will integrate all kinds of images, from DI, homes, in collaboration with home care sionals to work smarter, not harder. used so that they better suit the patients. cardiology, pathology, even wound care,” nurses, and it also uses a video link between In the area of diagnostic imaging, for ex- “In this way, we can improve therapeu- caregivers and patients and their families. ample, workload balancing systems could tic outcomes.” Patients are examined at least once a day by be more extensively used. These “smart” A new system from the company, called a doctor using a remote technology. systems can divide a worklist among radiol- AI Pathway Companion, brings together In more advanced implementations, ogists so that individual physicians are not data on the patient and his or her disease. patients can receive diagnostic studies overloaded. They can also direct the appro- It’s a form of precision medicine designed such as electrocardiograms, echocardio- priate exams to specialists – such as radiol- to support clinicians and their patients in grams, and X-rays at home. They can also ogists with expertise in reading neuro im- diagnosis and therapeutic decision-mak- receive oxygen therapy, intravenous fluids, ages or mammography. And they can rush ing. It enables users to aggregate, correlate, intravenous antibiotics and other medi- urgent cases to the top of the queue. and visualize data in context to the patient cines, respiratory therapy, pharmacy ser- For its part, Siemens Healthineers has a and disease. vices and skilled nursing. solution called Medicalis Workflow Or- There’s another dimension to using in- Niles Geminiuc Sevket On The Johns Hopkins Hospital at Home chestrator that does all of this and is ven- telligent systems in this way, said Mr. On. studies found cost savings of about 30 per- dor agnostic. “One of the most understated benefits is said Mr. Geminiuc. “And it will be vendor cent compared to traditional inpatient “We can divide up to the workload, that it brings the same level of care to loca- agnostic. That’s a game-changer.” care, with better clinical outcomes. There even sending it to radiologists at different tions across the country. You can bring the Now that many hospitals are being over- were fewer iatrogenic complications asso- hospitals based on their credentials” said high level of care that you’d experience in loaded with COVID-19 patients, while still ciated with hospital stays, such as delirium, Niles Geminiuc, director of Digital Health Toronto or top sites around the world to trying to provide care to patients with polypharmacy and functional decline. and Business Development at Siemens anywhere in Canada.” other medical issues, there is an urgent For its part, Mr. Geminiuc said Siemens Healthineers. “The solution sits on top of Mr. On noted that already, AI in cardi- need to reduce visits to hospital, if possible. Healthineers currently has a system called the hospital PACS, and lets the radiologists ology is being used by some cardiologists For this reason, the “Hospital at Home” myCare Companion, which is used for re- read exams from any of the hospitals in the and radiologists to provide amazingly fast concept is gaining traction worldwide. It is mote management of patients with network. Having the right radiologist read reconstructions of the organ. “What used already being used in the United States and chronic diseases. The solution has initially the right exam for the patient at the right to take an hour of the doctor’s time can Australia, and a pilot project has been been used at the German Heart and Dia- time is crucial in improving outcomes”. now be done in three or four minutes. launched in British Columbia. Other areas betes Centre for the care of patients with Prior to COVID, there were stresses and We’re giving an hour back to the cardiolo- of Canada are watching it with interest, as chronic heart failure. inefficiencies in the healthcare system, but gist or radiologist. It means they can con- it essentially transfers some types of care Mr. On asserted that COVID-19 has they weren’t as visible,” said Sevket On, centrate on more urgent work.” from traditional hospitals to the homes of transformed the healthcare system. It is vice president and zone general manager Mr. On also observed that imaging pro- patients. leading to the reorganization of hospitals of Siemens Healthineers in Canada. “Now, fessionals want to look at a variety of im- A successful hospital at home program and to efforts to make them more efficient there are many more demands on the sys- ages and reports but are hindered by the was devised by Johns Hopkins Schools of than ever. There’s a need to improve proce- dures for inpatients, and a growing move- ment to provide care outside of hospitals – in the homes of patients – when possible. In both cases, he said, computerized systems are leading to new solutions. “COVID has expedited the urgency of dig- Our mobile solutions italization,” said Mr. On. work around the clock. More work on Just like you do. integration is needed

Disinfectant-ready and engineered for 24/7 use, CONTINUED FROM PAGE 12 Zebra’s best-in-class mobile devices, scanners and health and third-party data to create vac- printers give you the control and performance you cine distribution plans to define high-pri- need to deliver exceptional patient care. ority populations and monitor population engagement, dosage regimen adherence, At Zebra, we’re focused on empowering your and distribution logistics by using artificial clinical and non-clinical teams with the information intelligence services and capabilities. and resources needed to make more informed Furthermore, it is important that these solutions can integrate with existing solu- decisions, no matter where they are located. tions like electronic health records to en- able vaccine inventory, provider agree- CONTACT ZEBRA TO LEARN MORE. ments, administration data, and patient 877-208-7756 health information. By improving technologies like virtual www.zebra.com/healthcare healthcare, remote patient monitoring, and predictive analytic solutions for the COVID-19 pandemic, we can further en- hance patient care and well-being. By com- bining new solutions like Accenture in vac- cine deployment management and existing solutions, the possibility of combating and overcoming the demand of the COVID pandemic becomes more attainable.

14 CANADIAN HEALTHCARE TECHNOLOGY MARCH 2021 http://www.canhealth.com Our vision at Orion Health is to revolutionize global healthcare so that every individual receives the perfect care for them.

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CANADIAN HEALTHCARE TECHNOLOGY MARCH 2021 FEATURE REPORT F Health community clinicalteams work closely with tween hospitalandcommunity care. Lakeridge ontheirown. gen saturations not realize are low harmfully they experiencing oxy- the other–especiallyforCOVID may patients who to Emergencyononehandandearly intervention on take longerandmay escalate to to hospital. atrip a medicationreminder, forexample –whileothers take timeto resolve ashort apatient simplyneeds –if ther assessment, eitherby phoneorvideo. Somealerts andpatientsare contacted asneededforfur- priority sis, from watch theirdesktop foralerts dashboards. nurses, specific patientgroups onadailyba- assigned app to record while community theirsymptoms tem forhypoxia. Twice aday are they prompted by the their oxygen sys- levels asanearlywarning saturation tients, are pulseoximeters provided with to measure COVID and, program monitoring pa- inthecaseof connect themto appthatwill the load thesmartphone ceive text oremailonhow via instructions to down- Emergency, to keep themhomeandsafe,” saidSlevin. we coulddo what the to keep thosepatientsoutof we neededto targetCOVID patientsandwe neededto additional patientgroups currently beingrolled out. patientswith cal thoracic, andgynecologic orthopedic hassincethe platform expanded to includepost-surgi- COVID-19confirmed were caseof targeted firstand uses the Vivify to platform monitor patientsathome. andLakeridge Health that Services Support munity EastLHINHometion between Central andCom- Health wardtario isacollabora- funding, thevirtual COVID inCanadaandmadepossiblethrough On- that modelinto otherprograms.” pital. It became even more from pressing to spinoff hos- theEmergencyandoutof to stay outof trying show ingold,” itsweight saidSlevin. “Everyone was hospitalward program.launch avirtual to quickly pivoted theirhospitalpartners with Health. When thepandemiccamealong, they Telemedicine Network (OTN), Ontario of now part using the Vivify Pathways through Ontario platform forchronicmonitoring diseasepatientssince 2016 munity,” saidSlevin. novative patientcare managing inthecom- ways of situations thatbrought usalltogether …to findin- ple, andprocesses technology belastingones. will dict isin: theconnections beingforgedbetween peo- theCOVID-19 andthever- crisis of a clearwinner issobig,transition thehospitalisnever goingback. Dr. say the surgery IlanLenga overheard of hischief virtual care’svirtual convenience, andquality safety The “magic,” said Slevin, isthecollaboration be- trips Benefits includeareduction inunnecessary theincoming datainorder triages of The platform After ward, beingreferred to thevirtual patientsre- “In wave COVID, oneof itwasreally apparent that Region residentsDurham have who aprobable or thefirstwave of of Launched attheheight “We never anticipated thatremote care would EastLHINhasprovided remoteThe Central care “COVID thosekumbaya hasreally beenoneof Patient-centred care, virtual itseems, isemerging Smartphones haveSmartphones ushered inarevolution incare, to bemore enablingpatients easilymonitored. Health chief medical information officer medicalinformation Health chief moment. In Ajax, Ont., Lakeridge (LHIN) inOntario, itwasa “kumbaya” Local Health Network Integration East ical care attheCentral programs clin- or Cathy Slevin, seniormanagerof BY DIANNEDANIEL Clinicians and patients recognize Clinicians andpatients based virtual urgentcare clinic,based virtual which includesavir- loved are dueto oneswho unableto COVID. visit face-to-face connections between patients andtheir care settings. It to isalsousingtheplatform facilitate hospital sites andthecommunity, includinglong-term consultationsable cliniciansto between provide virtual model,clinics to usingMicrosoft avirtual Teams to en- nothing like to necessity galvanize everyone.” management melted away rapidly,” hesaid. “There’s to change upandthebarriers people usedto bring thanbefore.higher theconcerns“Suddenly allof COVID,during utilizationnow times eight with vices “accelerated dramatically” atLakeridge Health quality,” hesaid. care thatalsohappensto have virtual vide wepens to don’t bedelivered virtually; wantto pro- objective. We wantto care provide thathap- quality hospital embarked onthree years ago. the careward, strategy abroader virtual oneprong of insettingupthevirtual wasvital ence andcapacity experi- whose EastLHINafantasticpartner Central officerinformation atLakeridge Health, callsthe tolook forandwhen refer backto hospital. towhat monitor, what’s considered normal, to what the screening tools foreach patientgroup, including nurses through dedicated Q&Asessionsto develop More recently itlaunched a Microsoft Teams- The hospitalmoved andspecialty itsambulatory According to Dr. Lenga, ser- virtual “Our hasalways mantra isourfirst beenquality Dr. IlanLenga, medical anephrologist andchief cer clinicsinMontreal. It hassince expanded to in- power cancer patientsreceiving care can- atregional the lution of Year asaproject in 2019–started to em- andencounters.formation andabletoare managetheirhealthcare willing in- phones, managetravel justasthey orfinances, they to “doing forthemselves” things ontheirsmart- year. And becausepeopleare becoming accustomed this Canadians estimated to beusingsmartphones acrosshigh thecountry, roughly 32million with inhealthcare. to adoptitasanew mentality right app,patient portal Dr. Tarek Hijal, says thetimingis Montreal, theOpal oncologist andco-lead radiation of settingby choice.virtual Lenga. At thesametime, patientsare coming to the requiredwhen isexpected andunderstood, saidDr. to escalatethe ability apatientto areal world setting physician isbrought upto speed. handoff, headded, sothattheattending Emergency to beseeninperson, ensures theplatform a “warm” waitingroom in-between. apatientneeds virtual If visit, returning toproviders the inthesamevirtual phone andspeaker –allows patientsto seemultiple phone, tabletorcomputer webcam, with micro- time foryour table,” explained Dr. Lenga. would getbuzzed it’s attheCheesecake when Factory when you’re third onthelistto beseen, justlike you fourhours.tients are seenwithin “We’ll pingyou Dapasoft. After submittingintake online, forms pa- incollaborationtual waitingroom with designed Dr. Lebouché, Bertrand remotely monitors their data oxygen levels. saturation Theresearch team, ledby ing Opalto record their dailysymptoms, including 2021, January 25patientswereend of recruited, us- enrolling 50active thegoalof cases.pilot with By the come into contact with. son andtechnologist are theonlytwo people they dedicated entrance. In mostcases, per- thesecurity before thecancer entering an alert clinicthrough a are now de facto waitingrooms, andpatientswait for help cancer patientssafelyreceive treatments. Cars atreating orwhen team sendsamessage. tient chart arrives intheirpa- newinformation userswhen alerts labresultsto andanotificationfeature view that family membersormedicalprofessionals, theability access to clinical notes other thatcanbeshared with isdeleted fromall information apatient’s phone. hospital database servers residinghospital databaseservers securely behind The Opal patient portal app –namedeHealthThe Opalpatientportal So- Dr. is penetration Hijal saidthatsmartphone At McGill University Health Centre (MUHC), in because careClinical confidence ishigh invirtual clinic–which isaccessed byThe virtual smart- Opal is also in the midst of aCOVID monitoring Opal isalsointhemidstof When COVID hit, to theappquicklytransitioned Opal includesacalendarto manageappointments, tered hospitalpatientscanuseit. Dataisfedfrom hospital firewalls and encrypted twice before twice be- hospital firewalls andencrypted Anybody theapp, candownload butonlyregis- (EMR) used. sites, theelectronic medicalrecord regardless of patients with accesspatients with to sixdifferent hospital ing sentto amobiledevice. Once asessionends, foundation, scalingto andiscurrently provide search grants andfundingfromsearch thehospital grants A free through re- service, Opalissupported clinics andhomemonitoring, aswell. plansto advanceclinics with to cardiology bowelclude HIVandinflammatory disease http://www.canhealth.com

ILLUSTRATION: LINDA WEISS WIRELESS AND MOBILE SOLUTIONS and intervenes with a virtual consult when app in its early days, said it helped to re- he recalled, noting that the oncologist was cancer patients when they decided to take a patient’s condition is worsening. move the frustration he felt as his late wife, very supportive of the research. “It was a more personal approach to her journey. Dr. Hijal believes virtual care is the new Sherry, battled stage four colon cancer. He very much a team atmosphere.” Coming to the end of her third line of mentality in healthcare and expects at used it to track events between treatments Pathak’s vision is to bring a discussion- therapy, the cancer had metastasized in some point it will be an operating budget so that they could be “crystal clear” about based model to personal healthcare, em- both her brain and spine. Using the app to line item. “This is how people do things. what was going on when talking to her powering patients by connecting them to connect with people who had the same ge- More and more people want to know nurses and medical oncologist, and to ac- others just like them. His motivation is the netic cancer profile, they were able to take what’s happening with their care,” he said. cess information about clinical trials. memory of his wife, who extended her ini- steps to prove she qualified for a Health When his wife was diagnosed with stage “When we did meet with our oncolo- tial prognosis from months to five years, Canada-approved drug that wouldn’t have four lung cancer in 2016, ZoeInsights co- gist, I could ask, ‘What about this drug?’” becoming an outlier among stage four been offered to her otherwise. founder and CEO Shaneel Pathak knew he wanted to do things differently when it came to managing her healthcare. Recog- nizing a gap in the system, the Alberta- based entrepreneur embarked on a mis- sion to connect patients to their health data in new ways, empowering them to be at the centre of their patient journeys. The result is ZoeInsights, an app named after the couple’s pet dog, and was launched with the help of co-founder Cory One-stop Kapser. It works by giving patients a place to record their health history and experi- ences, and to connect with others who are facing the same challenges. “Every time we had a visit to the ER, a shopping. doctor, a physiotherapist, whoever, my mind was thinking there must be a better way because we often had to repeat our Canadian Healthcare Technology offers story,” said Pathak. “We often had to really the country’s leading healthcare I.T. advocate for us and navigate the system, and we didn’t know what questions to ask.” publications. Are you getting all the news? ZoeInsights not only provides a plat- form for capturing patient reported out- comes such as symptoms, triggers or re- sponse to treatment, but also uses AWS Textract, to allow users to upload existing paper information into a virtual binder simply by snapping a photo. The result is a structured, searchable Canadian Healthcare Technology magazine collection of healthcare information that is easy to correlate and graph, making it eas- Canadian Healthcare Technology breaks the news about important ier to uncover insights and patterns. Users projects, programs and technologies, and provides hospital executives and also have access to health libraries and senior managers with an excellent source of information for improving clinical trials related to their condition, the delivery of healthcare. It’s sent to over 5,200 readers in print format and can manage and track their medica- tions and supplements, as well as create and to 6,800 opt-in subscribers as a digital edition. health routines. After being backed by the Alberta Can- cer Foundation, the company formally launched in June 2020 as a Software-as-a- Service powered by Amazon Web Services eMessenger newsletter (AWS) and currently has a global reach, Canadian Healthcare Technology’s e-Messenger contains breaking news helping patients to manage new, complex about important deals, installations and developments. Four blasts are or chronic conditions. A limited version of the app is available at no cost, while the sent each month, via e-mail, to over 7,000 senior managers and executives premium version that includes caregiver in hospitals, clinics and health regions. access and advanced optical character recognition searching is $5 per month.

oeInsights is also supporting two national clinical trials, one evaluat- Zing the benefit of exercise to cancer survivors and a second examining pain White Papers management among the 500 Canadians Canadian Healthcare Technology’s White Papers are sent out once a living with Fabry, an extremely rare ge- netic disorder characterized by an enzyme month, via e-mail, to over 5,000 senior managers and executives in deficiency. Canadian hospitals and health regions. The monthly blast contains Fabry patient Julia Alton, who also summaries and links to White Papers issued by various organizations, serves as executive director of the Cana- providing cutting-edge information about topics of interest to dian Fabry Association, said “knowledge is healthcare decision-makers. power” when living with a rare disease. The Thunder Bay, Ont., resident started using ZoeInsights in August 2020 and con- siders it her safety net. “I have all of my data with me if I’m carrying my phone. It’s like the security of a medical bracelet,” said Alton, whose hus- band uses the caregiver feature as well. www.canhealth.com Calgary resident and ZoeInsights user For advertising or editorial inquiries, contact Jerry Zeidenberg, Publisher, [email protected] Don Wood, who helped to beta test the http://www.canhealth.com MARCH 2021 CANADIAN HEALTHCARE TECHNOLOGY 17 WIRELESS AND MOBILE SOLUTIONS BD-Canada donates point-of-care antigen tests to Safehaven Project

ISSISSAUGA, ONT. – BD (Bec- ton, Dickinson and Com- pany), a leading global med- ical technology company, Mannounced that its Canadian division has donated rapid, point-of-care, SARS-CoV- 2 antigen tests for use on the BD Veritor Plus System. The donation to Safehaven Project for Community Living in Ontario, which provides residential and respite care to individuals with developmental disabili- ties and complex needs, includes 1,000 rapid antigen tests for COVID-19 and three BD Veritor Plus Analyzers, along- side BD Veritor InfoScan modules that allow for additional data, like a patient identifier, to be collected and linked to test results. The BD Veritor Plus System, which has a slightly larger footprint than a mobile phone, offers an easy-to-use workflow that makes it an ideal solution for point-of-care settings. It achieves test results in approxi- mately 15 minutes and displays easy-to- read digital results for COVID-19, remov- ing result ambiguity. Ontario Premier Doug Ford, centre, made a trip to the Safehaven Project for Community Living, to discuss the continuing rollout of point-of-care testing. The test uses a mid-nasal swab to collect patient samples, which is less invasive for tests are crucial because they can turn COVID-19 response. We are pleased to be tests that can facilitate the early imple- the patient than nasopharyngeal sample around results in minutes instead of days making this significant contribution to mentation of infection prevention and collection. and they also make reporting to public Safehaven and our hope is that the rapid control measures, in order to reduce the The BD Veritor Plus Analyzer also saves health easier, meaning the incredible staff tests will help keep their community safe spread of the virus that can potentially test results on a secured internal drive, at places like Safehaven can focus on the by enabling staff to quickly implement save lives and reduce poor outcomes for avoiding the need for manual transcrip- people, rather than the paperwork.” public health measures and focus on pro- vulnerable individuals in congregate set- tion of results and helps with traceability BD Canada has shipped over 1.1 mil- viding care.” tings,” said Susan Bisaillon, RN, M Sc., of test results. lion SARS-CoV2 rapid antigen tests for The BD Veritor System for Rapid De- CEO, Safehaven. The recording of data could save valu- use on the BD Veritor Plus System to On- tection of SARS-CoV-2 assay has been au- “The BD Veritor test provides a surveil- able time and resources for facilities like tario, with more on the way. thorized by Health Canada under Interim lance tool to help Safehaven monitor Safehaven and ensures reliable results can “BD is committed to supporting the Order. The SARS-CoV-2 antigen assay has COVID-19 in our sites and maintain accu- be provided for public health tracking Canadian and Ontario healthcare efforts been authorized only for the detection of rate data without spending too much time purposes. to help combat COVID-19,” said Greg proteins from SARS-CoV-2, not for any on administrative paperwork. Using a less “Rapid tests are a massive game changer Miziolek, president of BD-Canada. “We other viruses or pathogens. invasive sample collection method will in our work to stop the spread of know that congregate living facilities are in “Rapid testing will enable organiza- also be preferable for individuals with COVID19 and keep Ontarians safe and great need of rapid testing solutions and tions like Safehaven to respond in a complex medical needs that are cared for healthy,” said Premier Doug Ford. “These result reporting is an important part of the timely manner to positive COVID-19 in Safehaven’s facilities.”

Roche’s SARS-CoV-2 rapid antigen test approved under interim order

AVAL, QUE. – Roche SARS-CoV-2 virus by identifying the the comprehensive Roche diagnostic An antigen test detects proteins which Diagnostics, a division of virus nucleocapsid protein while portfolio to help healthcare systems are structural or functional components Hoffmann-La Roche Limited, large quantities are present in the combat COVID-19 through testing in of a pathogen and are thus very specific announced that its SARS- respiratory tract,” said Michele the laboratory and at the point of care. to that pathogen. In this case, the test CoV-2 Rapid Antigen Test has D’Elia, director, Medical Affairs at Roche’s SARS-CoV-2 Rapid Antigen would provide a qualitative “yes/no” receivedL approval under Health Canada’s Roche Diagnostics. “The test is Test is a rapid chromatographic answer on the presence of the pathogen Interim Order. This can help healthcare optimized to detect infections in immunoassay intended for the in the patient sample. professionals identify a SARS-CoV-2 individuals with an onset of clinical qualitative detection of a specific antigen If the target antigen is present in infection with results typically ready in symptoms of 5 days or less.” sufficient concentrations in the sample, 15 minutes. Building on Roche’s consistent and it will bind to specific antibodies and “Roche’s SARS-CoV-2 Rapid reliable supply chain since the beginning The test identifies the virus generate a positive result, indicating an Antigen Test allows taking the test to of the pandemic, and with hundreds of nucleocapsid protein while active infection. the patient while enabling fast decision millions of tests distributed worldwide large quantities are present In general, antigen tests have a high making and rapid isolation, thus in partnership with SD Biosensor Inc., specificity, though are not as sensitive reducing the risk of further spreading the company will now start distributing in the respiratory tract. as PCR tests that amplify the target the virus,” said François Drolet, in Canada. Tens of millions of Roche viral DNA or RNA sequence in order to director, Public Affairs at Roche SARS-CoV-2 Rapid Antigen Tests have of SARS-CoV-2 present in human generate a quantifiable signal to Diagnostics. “Our SARS-CoV-2 Rapid been dedicated to the country, the nasopharynx. indicate the presence of the virus in a Antigen Test is an additional tool in the company said. The test is performed by healthcare sample. toolbox which offers opportunities to COVID-19 testing solutions that professionals using a nasopharyngeal Therefore, to make up for the refine the COVID-19 testing strategies provide healthcare professionals and swab collected from a patient. The potential decrease in sensitivity of an while the country looks at safely patients with a quick answer regarding results are intended to aid in the early antigen test, negative results should be reopening the economy and keeping their infection status are critical to diagnosis of SARS-CoV-2 infection in considered together with additional Canadians safe.” contain the community-spread of the individuals suspected of COVID-19 patient factors, such as COVID-19 “The SARS-CoV-2 Rapid Antigen COVID-19 virus. Roche’s SARS-CoV-2 within the first 5 days of the onset of exposure history, clinical symptoms and Test detects the presence of the Rapid Antigen Test is a new addition to symptoms. additional test results.

18 CANADIAN HEALTHCARE TECHNOLOGY MARCH 2021 http://www.canhealth.com EARLY BIRD SAVINGS UNTIL MARCH 30! KEYNOTE Mark Black

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BY DR. PENNY COOPER the care team immediately on their Vocera Badge or smartphone, without any manual ugusta Health is a community intervention. Sepsis alerts are automati- hospital nestled in Virginia’s cally sent to the right care team to initiate beautiful Shenandoah Valley care quickly when early signs of infection focused on improving the are identified. health and well-being of our System interoperability has been key to community.A The statewide sepsis mortality ensuring the right data with situational in- rate in Virginia is 12.7%, while at Augusta formation gets to the right clinicians at the Health it is 4.76%. right time. Upon receiving an alert, the as- We have been able to achieve a signifi- signed staff member immediately screens cantly lower sepsis mortality rate by em- the patient for sepsis. If sepsis is identified, ploying the power of artificial intelligence they begin early intervention. (AI) and communication technology. So In the United States, more than 1.7 mil- far, we have saved over 350 lives that could lion people develop sepsis each year, and have been lost to sepsis. approximately 270,000 of them die. To de- Mortality from sepsis increases by as crease mortality rates and increase the much as 8% for every hour that treatment likelihood of reversing the damaging out- is delayed. Our nurses are highly trained comes of sepsis, early detection is critical. and are skilled at detecting early symptoms Hundreds of lives that could have been of sepsis based on standard indicators. lost to sepsis have been saved because of They are also very busy. our Early Sepsis Alert System; since April Aware of how many patients our nurses 90, respiratory rate greater than 20, and an communication device, which might be a 2016, we have been able to save 355 lives. care for and the many tasks nurses juggle at abnormal white blood cell count. hands-free Vocera Badge or a smartphone The work done by our teams at Augusta once, our leadership team wanted to pro- In addition, we monitored mean arterial running a Vocera app. Health to reduce mortality rates from sepsis vide our nurses with additional support. pressure and shock index. Our Sepsis Team The automated process involves inter- has been a collaborative effort. Health Qual- Among the resources provided was a pro- and Taskforce then began a retrospective operability among three systems: ity Innovators (HQI) named our hospital gram to identify symptoms of sepsis sooner. study of the data to determine which vari- • Our electronic medical record, the Health Quality Innovator for Virginia in We formed a Sepsis Team and Taskforce ables had the highest correlation to Sepsis. MEDITECH the category of Data-driven Care in 2018. in 2016 to take advantage of AI and com- We used the results of that study as a • Our predictive analytics tool, which U.S. News & World Report recognized munication capabilities and give our benchmark for developing an automated scours critical data in a patient’s record Augusta Health as a Best Hospital in the nurses an extra set of eyes to automatically process that analyzes and compiles real- • The Vocera clinical workflow and Shenandoah Valley for 2019-20. review patient data and alert them as soon time data from medical systems each hour communication system We are very proud of these honors and as a patient shows signs of being septic. and assigns each patient a score. If the We considered other sepsis alert tools are happy to have the opportunity to share Our goal was to detect and treat sepsis as score is above a specific threshold, a sepsis that flagged potential sepsis cases within pa- our work with other facilities around the early as possible and save lives. alert is sent automatically to team mem- tients’ EMRs. However, those tools provide state so more lives can be saved. We began by using the four traditional bers caring for that patient. clinicians with sepsis alert flags only when criteria to identify sepsis – a temperature Team members receive the alert with they open the patient’s medical record. Dr. Penny Cooper, DHSc, is a data scientist greater than 38°C, heart rate greater than contextual information on their mobile By contrast, the system we built alerts at Augusta Health.

Providing real-time patient data enables Early Warning Signs detection

BY SHELLY BOND with technologies and clinical workflows.” • ECG and waveforms delivered in Ascom’s partnership with Humber Key to Humber River Hospital’s real-time directly to the clinician’s River Hospital provided the foundation to hen Humber River success in navigating many complex Ascom mobile device; jointly build a sustainable technology Hospital in Toronto deployments was the creation of its own • Nurse call integration provides real- ecosystem that provides early warning opened its doors in 2015, customized technology ecosystem. By time communication between caregivers alerts for serious disease, as well as real- the facility was widely leveraging its partnership with Ascom, and patients for improved clinical time integration. Moreover, the organiza- Wrecognized as North America’s first fully Humber River is providing real-time efficiency and a more positive patient tion continues to blaze new paths. digital acute-care hospital. Built from the patient data that enables Early Warning experience; “Working with Ascom enables Humber ground up to replace several aging Signs detection. These real-time • Humber Command Centre: Ascom to innovate,” said Fernandes. “One such campuses, the leadership had a vision notifications are sent directly to Ascom integrates with the innovation is the new Fetal Alert and the community support to realize it mobile devices, enabling clinicians to Command Centre Notification solution. This first of its kind – an enviable position in healthcare. receive real-time alerts and alarms, to publish Unite workflow is expected to generate positive Prior to the pandemic, its leaders thereby facilitating time savings when staff assignment patient outcomes by integrating end-to- regularly showcased their infrastructure minutes are critical for life-saving information and end with Ascom’s Myco mobile devices.” innovations to colleagues from around interventions. These include: active code Ascom is also committed to raising the globe who were keen to roll out • Code events: Ascom integration with events; and the quality of healthcare by partnering similar innovations in their facilities. nurse call provides real-time notification • RTLS integration: with leading-edge hospitals like Humber But fast forward to today’s to caregivers of all hospital-wide code Ascom nurse call River. For its part, Ascom can provide environment, and fortunately Humber’s notifications (blue, pink, red and white) intelligent the tools, technologies and support investment in futuristic technologies and via their personal handset, reducing integration with needed to create advanced streamlined workflows proved crucial in disruptive overhead paging significantly; Shelly Bond Elpas RTLS communication and alerting ecosystems. helping to pivot and adapt to the severe • Sepsis Advance Warning monitoring: automatically For Humber River Hospital, the early stresses of the COVID-19 pandemic. solution retrieves sepsis information on turns on dome lights outside of the planning and investment in mobile solu- “At the time, we imagined in maybe a a configurable polling interval by an patient room as a caregiver enters, tions have been well worth it: At a time few years we’d be eclipsed by other Http request and communicates a sepsis enabling co-workers to know at a glance when healthcare frontline workers are of- facilities deploying similar leading-edge event alert in real-time that is then that a patient is being attended to. ten exhausted, and hospitals are at near ca- solutions to advance patient health,” said delivered to an assigned caregiver in “Our patient-centric model f gives us pacity, solutions that improve patient care Kevin Fernandes, chief technology officer Ascom Unite Assign; the line of sight to improve our and simultaneously enhance staff satisfac- at Humber River. “But in reality, that • Fetal Alert monitoring: delivers alerts operational efficiency,” said Fernandes. tion and retention are extremely valuable. hasn’t happened, and we’ve remained on directly to the clinician’s Ascom mobile “We can intervene quickly when there the frontline serving our patients, device in a solution that is currently are signs of sepsis and critical early Shelly Bond is Ascom Vice President & community and empowering our staff unique and first of its kind worldwide; warning alert notifications.” Sales Development - Canada

20 CANADIAN HEALTHCARE TECHNOLOGY MARCH 2021 http://www.canhealth.com WIRELESS AND MOBILE SOLUTIONS Remote patient monitoring is showing an improvement in outcomes

BY ROBERT KAUL tently and properly monitored and can vides a more holistic view of the patient, Since April 2020, many doctors are therefore safely remain in their home. making it easier for doctors to understand having a simpler time billing for virtual t goes almost without saying that Physicians and clinical staff also appre- their condition and to intervene before the models of care, with reimbursement codes the COVID-19 pandemic has ciate RPM. Clinicians are much better patient experiences an exacerbation or from public and private insurance changed people’s lives, altering ex- equipped to understand and manage their dangerous health episode. providers that are frequently being up- pectations and introducing a new patients’ health, thanks to a constant The constant stream of health data en- dated to match the evolving virtual care reality for all of us. The way people stream of accurate, reliable vital sign data ables clinicians to keep an eye on their landscape. In Canada, emergency funding Iexpect to receive everything, including from in-home RPM devices. patients in “near real time”, but typically allocated to virtual care at the beginning healthcare, has shifted. A patient’s health can change drastically the caregiver staff is only alerted when a of the pandemic is being made perma- The uptake of virtual care has been ex- between clinic visits and it can be difficult patient needs their attention. They can nent, and many provincial health authori- traordinary, with some providers seeing for a practitioner to piece together what therefore take care of more patients, ties are deploying some form of virtual increases in virtual visits of over 4,000% occurred and to understand the true im- while simultaneously providing a higher care, RPM or both to Canadian patients. compared to 2019. This increased accep- pact on their patient’s health. RPM pro- level of care. CONTINUED ON PAGE 22 tance has led to further adoption of re- mote patient monitoring, which intro- duces positive outcomes for both patients and practitioners. Of course, the most obvious benefit of COVID-19 biobank is a first for Island Health remote patient monitoring (RPM) during the ongoing pandemic is that it enables BY SHAWNA CADIEUX Mass Spectrometry and Molecular & Health’s clinical workflow with the aim many high-risk patients to get the care Cellular Proteomics. One published of improving patient care. they need, without visiting a clinic, physi- ICTORIA – Cutting-edge research project involved the creation of a new “The equipment in the new lab is not cian office or hospital emergency room. to create new diagnostic tools, test for the diagnosis, monitoring and only being used for research purposes, Staying out of these environments enables Vtests and treatments for a wide treatment of iron metabolism disorders. it’s also being made available for Island vulnerable individuals to lower their risk range of diseases, as well as the creation The test is currently awaiting clinical Health clinical laboratory staff to use as of contracting COVID-19, while still get- of a new COVID-19 biobank to gather validation and implementation. needed,” said Catriona Gano, Island ting the care they need. Providers are also data and biological specimens from Dr. Chen is also participating in Health Director, Laboratory Services. less exposed to potentially infected pa- COVID-19 patients across the region, is on-going international research “For example, because the equipment tients. However, this is only one of the taking place at Victoria General collaborations with Taiwan Medical and software is so advanced, our staff many positive impacts of RPM. Hospital (VGH). University, National University of can produce toxicology results in much Studies have shown that patients who A collaboration between Island Singapore, and Radboud University less time. This has greatly improved the are using remote monitoring devices and Health, University of Victoria, and Medical Center in The Netherlands. quality, effectiveness and efficiency of services tend to be more engaged in their University of British Columbia has “I’m delighted for the opportunity to our testing processes while significantly treatment. Patients who become part of resulted in Island Health allocating conduct this important research, reducing our workloads.” the health data gathering process tend to laboratory space at VGH for the These improvements to patient take more of an interest and active role in research to take place, while UBC and diagnoses and outcomes are expected to their care. UVic have provided $1.5 million in In addition to conducting make lasting impacts, such as Many RPM users have reported that equipment grants. research, the new lab has reductions in emergency department they’ve gained a better understanding of The COVID-19 biobank, a first for been integrated into Island visits, fewer and shorter hospital stays, what their vital sign data means how their Island Health in collaboration with the and enhanced quality of life and well- condition may be changing. As a result, BC Cancer Agency and other health Health’s clinical workflow. being for patients. some patients are even able to better self- authorities, was made possible through Dr. Bruce Wright, Regional Dean, manage their conditions, reducing the funding from the Victoria Hospitals supported by our partners, using world UBC Island Medical Program and Head, possibility of exacerbations due to certain Foundation and the UBC Faculty of class pieces of diagnostic equipment UVic Division of Medical Sciences, was chronic conditions, like chronic obstruc- Medicine, with additional support and called mass spectrometers. Mass instrumental in securing the funding for tive pulmonary disease (COPD). expertise from Island Health’s Research spectrometers are extremely important the lab research project. The intention is Patients on RPM also have been ob- Department. tools in bioscience research, and they to eventually create a Centre for served to adhere to their care plans more Dr. Michael Chen is the leading are helping us to develop diagnostic Translational Omics laboratory at VGH, closely, as they know that their practitioner medical researcher who oversees the tests that have not previously been with representatives from Island Health, will be able to monitor their progress. This new research lab and the COVID-19 available in British Columbia. This UBC and UVic currently working is called the “Hawthorne effect” or “the al- biobank. Since the lab’s inception, Dr. could include tests related to COVID- together toward that goal. teration of behavior by subjects due to Chen has authored or co-authored eight 19,” said Dr. Chen. “Research is integral to solving some their awareness of being observed.” publications in peer reviewed journals In addition to research, the new lab of healthcare’s most pressing issues and Patients who use remote monitoring including Rapid Communications in has also been integrated into Island collaboration between organizations is devices and apps are often more likely to key,” said Dr. Wright. “It’s exciting to see better understand their conditions, be- how Dr. Chen’s laboratory is already coming more health literate as they be- producing the kind of research that come active and proactive participants in healthcare providers need to provide the their own healthcare. best care possible to their patients.” Typical RPM services offer an online The COVID-19 biobank will allow portal or dashboard where vital sign and researchers to focus on tests to better other data is stored and displayed. These detect the virus, and identify features tools enable caregivers to access each pa- relevant to diagnosis and personalized tient’s health data, survey answers, trends, treatment. The samples collected from clinical notes, and even pictures of wounds. across the Island will also help For example, family members who live researchers understand the away from aging parents can remain up- complications of COVID-19 over the dated on their loved one’s condition, giv- long term. With patient consent, these ing them peace of mind and a clearer pic- specimens will be stored and used in ture of their changing health status. This quality improvement and research extra support system can be very beneficial projects. The specimens are also to patients and can help to increase adher- available for use by healthcare ence to physician instructions. researchers in other parts of British On the topic of “older relatives”, RPM is Columbia and Canada. also known to help individuals “age in place”, rather than needing to enter into a Shawna Cadieux is with Island Health long-term care facility. This is possible be- Dr. Michael Chen, medical researcher, and Catriona Gano, Island Health Director, Lab Services. Communications. cause older RPM users are being consis- http://www.canhealth.com MARCH 2021 CANADIAN HEALTHCARE TECHNOLOGY 21 grated cloud capabilities that make it Providence Health Care and computer vi- big thinking. Our team at Microsoft is Three ways faster and easier to provide more effi- sion researchers at the University of British working with biomedical researchers to CONTINUED FROM PAGE 13 cient care, while ensuring end-to-end se- Columbia to develop an AI powered solu- use AI to accelerate the implementation of curity, compliance and interoperability tion that uses cameras to monitor the ef- cancer treatments that target patients’ spe- crosoft has stepped in to offer Account- of health data. fectiveness of social distancing policies and cific genomic profiles, a type of precision Guard for Healthcare at no cost for And with many healthcare providers guidelines at the St. Paul’s Hospital cam- medicine that in some cases is more effec- healthcare providers on the front line of still working remotely, it’s critical that en- pus in Vancouver, while protecting the pri- tive than traditional chemotherapy and care combatting COVID-19. The service is riched data is able to flow securely vacy of patients and staff. has fewer side effects. designed to help these critical organiza- through every point of care to help con- Although the cameras enable real-time Senior scientists at the Princess Mar- tions protect themselves from cybersecu- tinuously improve the patient experience compliance, they do not collect personally garet Cancer Centre developed powerful rity threats. and health outcomes while maintaining machine learning platforms and algo- Cybersecurity will continue to be a patient privacy. rithms to drive cancer research and treat- threat, even when COVID-19 is in our Innovation will continue to shape COVID-19 has set-off a wave ment at the University Health Network. rear-view mirror, but we can’t let it get in Canada’s healthcare system: Canadian in- of innovation in digital health Platforms such as CReSCENT, Pharma- the way of innovation. Our team works novators have the potential to transform that will transform Canadian coDB, SYNERGx and cBioPortal are using closely with healthcare customers to es- the future of our healthcare system, but Azure to access to large amounts of data tablish a platform that is secure and first we must give them the space and op- healthcare and research. and are using AI to process that data and compliant by design. Microsoft Cloud portunity to succeed. We are working bring precision medicine to life. for Healthcare offers trusted and inte- alongside chief innovation officers and identifiable information. This initiative Looking ahead at 2021, if we want to chief medical information officers, physi- marked a milestone for Microsoft and of- tackle the big challenges facing the health- cians and other healthcare providers who fers valuable learnings for other healthcare care industry, we must take on a growth are dedicated to making the system better environments regarding the deployment mindset that embraces a willingness to be Remote monitoring is by leveraging digital tools and solutions to and adoption of AI and IoT technology in first. I’m inspired by the innovators we are improving outcomes enhance patient engagement and improve their operations. working with and I can’t wait to see how care, empower collaboration across Some of the best changes happen when their solutions transform healthcare. CONTINUED FROM PAGE 21 providers and optimize clinical and opera- we let innovation occur and empower the tional insights. industry to find new ways to deliver better Peter Jones is Industry Lead, Healthcare, at It’s a myth that older patients are un- Recently, our team collaborated with healthcare outcomes. Big challenges take Microsoft Canada. comfortable with, or afraid to embrace virtual care and remote patient monitor- ing. Several studies have shown that mod- ern RPM devices pre-paired with a simple Tool predicts which mini-strokes could lead to major strokes tablet computer are so easy to use that even seniors with little exposure to gad- A MADE-IN-OTTAWA TOOL can help emer- symptoms usually last minutes to hours, needs care most urgently. On the flip side, gets can successfully take their vital signs gency physicians predict which patients and do not cause permanent damage. it also helps us gives patients at low risk remotely. As long as the RPM program be- with mini-strokes are at greatest risk of If a TIA is not treated, there is up to a 1 some peace of mind.” ing deployed has a “patient-centric” de- having a major stroke within the week, ac- in 10 chance of having a subsequent The Canadian TIA Score uses 13 pieces sign and a track record of success, then cording to a study published in The BMJ. stroke. The risk is greatest in the first week. of information collected in the emergency users of any age can be cared for from “Mini-strokes can be a warning that a department to categorize patients as being home with RPM. larger stroke is coming,” said Dr. Jeffrey at low (less than 0.5 percent), medium (2.3 Overall, the COVID-19 pandemic has Perry, emergency physician and senior sci- If a TIA is not treated, there is percent), or high (6 percent) risk of having made us look at virtually everything in our entist at The Ottawa Hospital and profes- up to a 1 in 10 chance of having a stroke within the week. professional and personal lives differently, sor at the University of Ottawa. “Thank- a subsequent stroke. The risk is “For high-risk patients we do absolutely and healthcare delivery is no exception. fully, we’re very good at preventing subse- everything we can while they are in the ED, The silver lining in the massive, ongoing quent strokes if patients come to the emer- greatest in the first week. including diagnostic imaging, starting treat- shift to virtual care we’re experiencing is gency department promptly.” ment and bringing in a neurologist,” said Dr. that new models have emerged, including A mini-stroke, or transient ischemic at- “TIA or mini-strokes are quite com- Perry. “For medium-risk patients, we do RPM and virtual care, which enable a tack (TIA), is a temporary blockage of the mon – we see one to two patients a day at similar things but refer them to a stroke pre- number of positive outcomes for both pa- brain’s blood supply. The symptoms are The Ottawa Hospital emergency depart- vention clinic, where they can see a neurolo- tients and practitioners. similar to stroke – drooping face, weakness ments,” said Dr. Perry. “We developed the gist in a day or two. Low-risk patients can in the arm or leg, loss of vision, and Canadian TIA Score to help us better iden- safely start their treatment as a neurology Robert Kaul is President and CEO of Cloud DX. slurred or jumbled speech. Unlike a stroke, tify who is at greatest risk of stroke and outpatient or with their family doctor.” The tool was validated in 13 Canadian emergency departments over five years. Of in 2020 as COVID continued to spread. in 2020, some hospitals used technology the 7,607 patients enrolled who had TIA or COVID transforms But the need for sanitization in to create “virtual doctors” by mounting a minor stroke, 17 percent (1,293) were CONTINUED FROM PAGE 12 healthcare organizations has always rugged mobile tablets on IV poles that categorized as low risk, 71 percent (5,400) been critical, given that healthcare- allowed specialists to interact with were categorized as medium risk and 13 again turning to technology to facilitate acquired infections affect an estimated patients via video. percent (989) were categorized as high risk. better clinician communications and 1.7 million US patients each year, Many hospitals found that this Overall, 108 patients (1.4 percent) in the improve workflows. according to the Centers for Disease virtual solution resulted in faster care study had a subsequent stroke within the Purpose-built mobile devices that Control and Prevention. for patients because specialists could week, while 83 (1.1 percent) had surgery to allow nurses and doctors to However, in 2020, some hospitals handle multiple consults without improve blood flow in their neck to prevent communicate better and streamline found that their non-rugged devices wasting time traveling between rooms a stroke. This low rate of stroke is testament workflows effectively reduce stress for could not withstand repeated cleaning or hospitals. In 2021, more hospitals to the preventative care provided in the ED. providers while also improving patient will rely heavily on virtual patient The study showed the Canadian TIA care. At the same time, handheld consultations for more efficient patient Score accurately categorized patients into mobile computers help mitigate alarm In 2021, we will see more care while also keeping both patients the three risk groups and performed signifi- fatigue by sending alerts directly to the hospitals adopt mobile and clinicians safe. cantly better than the existing ABCD2 score. right caregiver. devices that are purpose-built Looking forward: There is no doubt That score only categorizes TIA patients as Nurses can use those same mobile that the pandemic will have a lasting being at low or high risk of a stroke, which is devices to enter vitals directly into a to withstand harsh cleanings. impact on healthcare. The good news is not always helpful to physicians. patient’s electronic health record (EHR) that the lessons learned will have a “The Canadian TIA Score can now be while at the bedside, thus reducing the and sanitizing because they were not positive impact on the way healthcare safely used in emergency departments, amount of time they spend on charting built with healthcare-grade plastics. In facilities manage their inventory and where it can help physicians make the best and reducing errors. 2021, we will see more hospitals adopt workflows going forward. care decisions for patients with mini- Doctors and nurses armed with mo- mobile computers, printers and strokes,” said Dr. Perry. bile devices can be notified immediately handheld scanners that are purpose- Lana Leone is senior marketing manager TIA is a medical emergency. Anyone when a patient gets test results – and built to withstand repeated wipe downs for Healthcare Solutions, Zebra who experiences symptoms should call can quickly communicate how those re- with approved cleaning agents to reduce Technologies. To learn more about 911 or have someone drive them to an sults might affect patient treatment. the spread of infection. healthcare technology solutions that emergency department if their symptoms Stemming the spread of infections: Telehealth will continue to grow: provide patient-centric care, please see have fully resolved. “Sanitize everything!” became a mantra When telehealth became more accepted www.zebra.com The Canadian TIA Score is available online and through The Ottawa Rules app.

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