Testing Virtual Care for Recovering Post-Op Patients

FEATURE REPORT: DIRECTORY OF HEALTHCARE I.T. SUPPLIERS – PAGE 18 Publications Mail Agreement #40018238 TWENTY-FIVE Y EARS

CANADA’S MAGAZINE FOR MANAGERS AND USERS OF INFORMATION SYSTEMS IN HEALTHCARE VOL. 25, NO. 5 JUNE/JULY 2020 INSIDE:

DIAGNOSTIC IMAGING PAGE 14

Solutions for public health Dissatisfied with the data management system available in Ontario, and under pressure to track the course of COVID-19 more effectively, public health agencies in Toronto and Ottawa have launched new platforms. Page 4

Tele-wound coalition Care providers and companies specializing in the treatment of wounds for patients in the community have banded together to provide enhanced services. Page 8

Notre Dame and healthcare The fire that destroyed the famed Notre Dame cathedral in Paris a year ago offers lessons for disaster planning in healthcare. Hospital managers can learn a great deal about how to improve

their own procedures. SCIENCES HEALTH PHOTO: COURTESY OF HAMILTON Page 10 Testing virtual care for recovering post-op patients Researchers and clinicians in Hamilton, Ont., are leading a pan-Canadian trial of remote monitoring technology for post-operative patients. The multi-site study involves 900 patients, and aims to assess how virtual care can keep patients healthy at home while reducing ER visits and readmissions to hospital. Pictured are project leaders Dr. Michael McGillion and Dr. P.J. Devereaux. SEE STORY ON PAGE 4.

Sunnybrook and OMA devise an interactive platform

BY JERRY ZEIDENBERG tients, so they’re not flipping from one sys- have one source of patient information, tem to another for the data they need. where the patient’s data has been consoli- ORONTO – Sunnybrook Health Sci- “Doctors are spending too much time dated, he said. The idea is to have MyChart ences Centre and the Ontario Med- opening multiple systems, searching in one serve that purpose, and to continue adding ical Association are collaborating to place for lab information and in another for patients and functionality to the patient extend the functionality of the My- portal. ChartT patient portal, to support patients and “It’s already the largest patient portal in The goal is to turn the MyChart doctors communicating online more easily, the country, so it makes sense,” said Dr. So- saving both time and effort. portal into an interactive system hail. “The next biggest is only one-sixth of MyChart, created by Sunnybrook and linking doctors and patients. its size.” shared with other hospitals across Canada, is And while MyChart has, to date, been the largest patient portal in the country. In encounter or discharge information,” said largely a static warehouse, where patients Ontario, it’s used by 658,000 patients in more Dr. Sohail Gandhi, a family physician and could view their medical records data, enter than 70 of the province’s hospitals and labs. former President of the Ontario Medical As- personal data such as self-monitoring and The goal now is to give doctors access to sociation. “It gets to be ludicrous.” provide access to trusted friends, family those records, with permission of the pa- Instead, it would be so much easier to CONTINUED ON PAGE 2 Sunnybrook and OMA work to make MyChart an interactive platform

CONTINUED FROM PAGE 1 interest from 200 to 300 physicians. “We’ve already heard from 800 of them, that members and physicians, the goal now is to they’re in support,” he said. make it more transactional and interactive. For his part, Dr. Gandhi got the ball One significant step will be to incorpo- rolling on the project while he was Presi- rate videoconferencing into MyChart, so dent of the OMA. He has since stepped that patients can set-up and conduct video down, but remains on the Board, and is chats with their doctors. Payment for still committed to the project. video visits is not yet supported by the On- He also has a good deal of experience tario government, except through the On- with online systems. In the past, he was tario Telemedicine Network, but many be- part of an e-Prescribing pilot in his home lieve it will be coming in the near future. region of Georgian Bay, where 50 physi- Also in the works are communication cians working in a family health team systems, as well as online prescription re- consolidated on one EMR, sharing pa- newals and requests for forms, such as tient records with themselves and local sick notes. pharmacists. For uninsured services, beyond what is As well, he was part of a project that covered by the provincial government, like connected doctors to local nursing homes, various forms, physicians will be able to dramatically enhancing the level of care charge patients online. “It’s a carrot for the for residents. doctors to use the system,” said Dr. The project with Sunnybrook and My- Gandhi. “We’re building secure payment Chart is now under way and Dr. Gandhi Leading the project are OMA past-president Dr. Sohail Gandhi and Sunnybrook’s EVP Sam Marafioti. handling into the system, so it’s easy for expects it to go live this fall. the patient and for the physician.” Sam Marafioti, VP, Capital, and CIO at continues to expand into additional hos- gration going on,” said Marafioti. “We’re de- The idea is already proving popular Sunnybrook, said the initiative with the pitals, it’s also targeting greater integra- veloping a whole community care platform.” with doctors. Dr. Gandhi said that when OMA is a significant one for MyChart, too. tion with front-line physicians and com- He noted that until now, MyChart has his team raised it with the OMA’s mem- “It’s our top priority at MyChart,” said munity care providers. been largely “hospital-centric” and a sys- bers, they hoped to receive expressions of Marafioti, noting that while MyChart “We have a strong community care inte- tem for viewing and sharing records. In this next phase, it will broaden its scope into the healthcare continuum and also become more interactive, allowing ex- changes between patients and care-givers. In this way, MyChart could become the portal for information exchange for the new Ontario Health Teams, which are seeking to integrate various tiers of health providers – from acute and complex care hospitals, to nursing homes and retirement residences, to pharmacies and various medical and health clinics. One of the problems to date, however, has been how to connect the disparate systems used by these care providers. From Marafioti’s perspective, MyChart could become the glue that binds them all together. And for the consumer, MyChart has been working on an app that makes it easier to connect by using mobile devices such as smartphones, and to conduct transac- tions from this ubiquitous platform. On the physician front, MyChart would like to integrate with the EMR systems used by doctors, so the connection would be even more seamless, with data loading back and forth automatically. “We’ve already started doing this with physicians [in clinics] at Sunnybrook who are using Accuro,” said Marafioti. He and Dr. Gandhi would like to continue this work and get more of the EMR vendors on board. By doing so, it would make so much more information quickly and easily available to doctors. “We should really be doing this,” said Marafioti. “It’s one of my hopes that we get it done.”

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 25, Number 5 June/July 2020 Office Manager Dianne Daniel Art Assistant [email protected] Address all correspondence to Canadian Healthcare Technology, 1118 Centre Street, Suite 207, 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 2020. 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. ©2020 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 207, Thornhill ON L4J 7R9. E-mail: [email protected]. ISSN 1486-7133.

2 CANADIAN HEALTHCARE TECHNOLOGY JUNE/JULY 2020 http://www.canhealth.com Embracing proactive health for better outcomes

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cerner.ca @CernerCanada NEWS AND TRENDS Public health in Toronto and Ottawa switch to newer data solutions

BY NORM TOLLINSKY case and contact management team with training that is able to be accomplished in mbitious but complex data collec- a couple of days given the ease-of-use of tion and reporting solutions for the system. Previously, it was harder to communicable disease outbreak bring people on to train them how to use management are fine in theory, iPHIS. Also, we no longer have to use pa- Abut during a pandemic, simpler and user- per to keep track of the details of cases un- friendly systems may be the best solution. til we can get that information into iPHIS That’s the conclusion public health through data entry staff, so it’s definitely units serving Toronto and Ottawa came to improving our efficiency.” when staff using the province’s integrated Seven online iPHIS user guides total- Public Health Information System (iPHIS) ing 396 pages are indicative of the soft- were unable to keep up with skyrocketing ware’s complexity and the challenges cases of COVID-19. around onboarding new staff in the midst On March 30th, after eight of its em- of a pandemic. ployees tested positive for coronavirus, The COD software, acquired from Toronto Public Health ordered most of its Newfoundland and adapted by City of Ot- staff to work from home. By that point, tawa IT staff, can also “make connections there were 1,463 laboratory-tested cases in Dr. Eileen de Villa, Toronto’s Medical Officer of Health Dr. Vera Etches, Ottawa’s Medical Officer of Health between cases and add new variables to the city, delays in reaching out to them and track things like ethnicity,” said Dr. Etches. discrepancies in the number of cases re- vidual case investigation efficiently and contact tracing. Using CORES, the city is The Province of Ontario began using ported by the city and the province. share data with the provincial Ministry of closing in on the province’s target of con- iPHIS in 2005, but concerns about it were Something had to be done and on April Health,” said Associate Medical Officer of tacting 90 percent of cases within 24 hours. raised as early as 2007 in a report by the 16th, Toronto Public Health announced Health Dr. Vinita Dubey. “It will allow A similar scenario played out in Ottawa, Office of the Auditor General of Ontario. the deployment of its own internally devel- TPH to better keep up with the volume of culminating in an April 29 press release “By the time Ontario implemented oped Coronavirus Rapid Entry Case and new reports and prioritize individual cases announcing the abandonment of the iPHIS, the technology was 15 years old,” Contact Management System (CORES). such as healthcare workers that require ur- iPHIS case management and contact trac- the Auditor General reported. “The federal “While iPHIS has served us for many gent follow-up. Importantly, it also allows ing module and the deployment of its own government stated that it would no longer years, for the purposes of the current our front-line staff to work remotely from COVID-19 Ottawa Database (COD). provide technical support for the system COVID-19 emergency, we at Toronto Pub- home.” “The new Web-based, secure system al- after 2008 and that a newer system would lic Health quickly realized that this provin- Additionally, the software has been de- lows our team to more quickly and easily be made available to all provinces and ter- cial information system was not well- signed to capture socio-demographic and document each individual case investiga- ritories in that year.” equipped to deal with the data we need to ethno-cultural data “to help us understand tion and share data with the provincial The 2007 audit also detailed “significant quickly input,” remarked Dr. Eileen de if this pandemic is disproportionately af- Ministry of Health,” said Medical Officer quality problems with the system,” includ- Villa, Toronto’s Medical Officer of Health. fecting certain groups in our community, of Health Dr. Vera Etches. “This transition ing inconsistent and incomplete data, and “When we realized these limitations and and help inform ways to address these po- will position Ottawa Public Health to bet- “two-to-three week delays from the time that we needed a more nimble technology tential inequities,” she noted. ter manage COVID-19 case volumes, facil- local public health units first received case for our response, we quickly worked with Given the urgency of the need, Toronto itate remote work options for the case reports to the time the cases were entered our city partners to develop a new infor- Public Health turned to the City’s IT de- management team and continue to uphold into iPHIS.” mation technology tool to keep up with partment to develop the solution. provincial reporting obligations. Panorama, the new system the federal our evolving contact tracing demands.” By mid-May, Toronto was reporting At a May 15 media briefing, Dr. Etches government planned to make available to CORES allows Toronto Public Health close to 8,300 cases and had more than 500 told Canadian Healthcare Technology that the provinces and territories in 2008, was “to quickly and easily document each indi- staff working on case investigations and Ottawa Public Health “is able to grow our CONTINUED ON PAGE 8

Multi-site study tests virtual care for post-op patients

BY JERRY ZEIDENBERG Hamilton Health Sciences wished to im- elective and urgent surgeries. We can to hospital and was found to have had a plement the project quickly. “It’s a trial on also reduce the risk of patients becoming complete heart block.” AMILTON, ONT. – Re- steroids, when it comes to the starting infected with COVID-19.” Surgery was quickly performed, searchers and clinicians at times and recruiting timelines,” said Dr. While just getting off the ground, the which likely saved the patient’s life. Hamilton Health Sciences P.J. Devereaux, director of the Division of project has already helped patients at Dr. Devereaux is working in tandem are leading a multi-hospi- Perioperative Care at McMaster University home through the use of technology. with Dr. Michael McGillion, assistant tal study to determine if and one of the project leaders. Dr. Devereaux cited the case of one car- dean, Research, School of Nursing, Mc- theH numbers of discharged surgical pa- “If we can reduce the numbers of re- diac patient who was discharged from Master University. The scope of PVC- tients who return to hospital in the first admissions, we can increase our capacity hospital with the equipment. On just RAM includes all types of urgent, semi- 30 days after discharge – a critical period to do more elective and urgent surgeries,” the second day at home, the monitoring urgent and emergency care patients. Ex- for recoveries – can be significantly re- said Dr. Devereaux. “We may also reduce amples include oncology patients, as well duced through the use of remote moni- the spread of COVID-19 by keeping peo- as patients who have suffered hip frac- toring technology. ple out of hospital, whenever possible.” The project involves patients, tures or aneurysms. The project is called PVC-RAM, short Using advanced technologies, the re- clinicians and researchers at The team has received funding from for “Post discharge after surgery Virtual searchers are confident that patients can hospitals across Canada, using Hamilton Health Sciences, along with Care with Remote Automated Monitor- be effectively cared for virtually, from hos- pharmaceutical giant Roche, and it’s seeking” technology. pital-to-home. The real question is deter- advanced technologies. ing additional funds from various sources. It launched in May, and it’s rapidly mining how effective the system can be – The technology is being supplied by recruiting 900 patients at hospitals how many patients will have better out- equipment discovered a heart rate of Cloud DX, an award-winning Canadian across Canada – including Hamilton comes using remote monitoring, and how only 32 beats per minute and low blood company with headquarters in General, the Juravinski Hospital, St. many won’t have to return to hospital. pressure – triggering an e-mail notifica- Kitchener, Ont. Joseph’s Health Care, London Health “We know that 15 to 20 percent of tion to a nurse. The system, called Cloud DX Con- Sciences, Kingston General, the Ottawa post-op patients will come back to the The nurse followed up with a doctor, nected Health, beams the data gathered Hospital, as well as facilities in Edmon- emergency room or be re-admitted in who asked the patient’s wife to show a by a suite of Health Canada-licensed, vi- ton and Winnipeg. the 30-day period after discharge,” said view of her husband by using video on a tal-sign devices through a tablet com- Spurred on in large measure by the Dr. P.J. Devereaux. “But if we can reduce tablet computer. “It was clear that the puter (supplied by Bell Canada) from need to keep patients out of hospitals after that, we can free up beds and increase patient was in trouble,” said Dr. Dev- the patient’s home back to monitoring surgery due to the COVID-19 pandemic, the capacity of hospitals to do more ereaux. “The patient was brought back CONTINUED ON PAGE 14

4 CANADIAN HEALTHCARE TECHNOLOGY JUNE/JULY 2020 http://www.canhealth.com SPONSORED CONTENT HEALTHCARE INNOVATION

The pandemic is fast-tracking the transformation of healthcare technology The use of virtual meeting platforms is just the tip of the iceberg.

BY LISA CARROLL

s the COVID-19 pandemic unfolded ear- lier this year, healthcare facilities across the country found themselves – like so many other organizations – having to urgently reinvent ways to operate, provide patient care, manage supply chainsA and deploy resources, with many of the usual ways of doing things suddenly off the table. Personnel found themselves having to work from remote locations, yet still needing to closely collaborate with colleagues, sharing ideas and updated information in real-time. Quick response, immediate implementation and nimble redeployment of pre- cious resources became imperative, with every second counting. Numerous hospitals and other healthcare centres quickly moved to or significantly expanded their use of virtual meeting platforms, enabling teams to collaborate “face to face” no matter where they were located. But this was just the tip of the iceberg in terms of accelerating digital transformation across Canada’s healthcare sector.

ON THE EAST COAST, NUMEROUS HEALTHCARE ORGANIZA- TIONS found themselves under strain and looking for new ways to provide care, while also ensuring the safety of their employees and patients. The eHealth shared services organization, The Newfoundland with colleagues to treat patients has been truly trans- Hantho says the COVID-19 outbreak expedited and Labrador Centre for Health Information formational for NLCHI.” the rapid deployment of Teams and other Mi- (NLCHI), saw an opportunity to bridge this gap by crosoft services, and the resulting impact means a leveraging technology to support resources and as- THEN THERE IS THE STORY OF CBI HEALTH, one of the permanent shift to virtual care in CBI Health’s sets while minimizing the use of PPE. largest community healthcare providers in Canada. business model. NLCHI partnered with Microsoft, and within five The company normally provides in-person care and “This is not a ‘pandemic fix,’ this is a fundamental days moved nearly 4,000 healthcare workers to an treatment to clients through its network of Rehabili- shift in how we are doing business, at all levels, and Azure Virtual Desktop Environment and Microsoft tation Services clinics, but COVID-19 changed it’s here to stay.” Teams. This shift to a digital environment enabled everything. The virtual care/telehealth model is proving very them to rapidly expand their unified communication The pandemic impacts made them move quickly popular with patients as well. CBI Health says it has platforms providing their teams with a secure cen- to put all staff on a single communications platform, surveyed more than 1,000 clients since the new tralized repository for all COVID-19-related guid- Teams – which saw an incredible 3,000 clinicians and model was put into place, and satisfaction rates are ance, data and information. administrative users set up in less than ten days. higher than 90 per cent positive. This means their staff can screen patients for Teams was chosen for its security, data residency, COVID-19 virtually, their supply chain department privacy, and its alignment in the Microsoft stack. CBI THESE ARE JUST TWO EXAMPLES of the truly dramatic can order supplies remotely ensuring frontline work- digital transformation Canada’s healthcare providers ers have the resources they need to stay safe. Each Re- have become immersed in since the pandemic took gional Health Authorities Emergency Operations Personnel found themselves having to hold. Longer term plans for new digital infrastruc- Centre continues to collaborate over Microsoft work from remote locations, yet still ture have become urgent deliverables. Unification of Teams to address responses to the pandemic. This needing to closely collaborate with previously diverse patchworks of technology is hap- digital shift ultimately enabled NLCHI to reduce its pening at breakneck speed, while staff and manage- overall technology management costs, enhance colleagues, sharing ideas in real time. ment alike have been singing the praises of the bene- workforce productivity and transform patient care fits being delivered by these solutions for their own using technology, all while maintaining safe and se- Health was able to quickly begin video calls and virtual organizations and, most importantly, to the patients cure practices to reduce the spread of the virus. client treatment sessions, continuing to manage its who are relying on them. Robert Drover, Regional Director & CIO Central business seamlessly despite the pandemic disruptions. Ironically, the disruption which the pandemic has Health says that their success really stemmed from “The pandemic required us to quickly shift to a caused across our healthcare system will, in many the dedication of their senior leadership team, spe- primarily virtual care/telehealth model for remote cases, prove to be a beneficial catalyst going forward. cialists, and the strong direction of management who assessment and treatment to protect the health and The digital transformation it has initiated will only quickly pivoted and pulled together a team of dedi- safety of both our staff and our clients, while also en- strengthen the operations of these crucial care cated high-quality employees who worked diligently suring our clients receive the care they needed in the providers long into the future. So, perhaps there is a with Microsoft to make this transformation happen. safety of their own homes,” said Jon Hantho, presi- silver lining in this part of the COVID-19 cloud. Drover says this shift to digital has been “remark- dent and CEO of CBI Health. See how Microsoft is empowering healthcare profes- able, and, possibly even an everlasting story” that Now, CBI Health is averaging approximately sional to continue to provide even better experiences, continues to play out as these technologies change 100,000 virtual sessions per month. The company insights, and care: Visit aka.ms/healthcareincanada how care is being delivered during the pandemic. says as its virtual care/telehealth program matures, “Being able to connect to the health system using any Teams will allow it to potentially expand its reach Lisa Carroll is the Canadian Public Sector Lead at device to retrieve information and virtually meet and access to clients in underserved areas. Microsoft Canada. http://www.canhealth.com JUNE/JULY 2020 CANADIAN HEALTHCARE TECHNOLOGY 5 NEWS AND TRENDS Northern BC health authority sets up online COVID clinic in two days

BY DANIEL RAMCHARRAN, mine peak hours, which helped inform also provided up-to-date information and Northerners were anxious about COVID- ongoing staffing and process changes. escalation procedures. 19, and when word got out, over 800 calls hen a pandemic strikes, “From an IT equipment perspective, “The first week was absolutely crazy. I flooded in the next day. healthcare organizations the amount of effort by IT staff to move couldn’t have asked for a better team to “People simply needed information,” need to react quickly. As a the virtual clinic from concept to produc- support this,” says Dr. Furstenburg, North- says Kelly Gunn, VP Primary and Commu- result, remarkable things tion was immense,” says Joan Vanderlee, ern Interior rural medical director, and nity Care and Clinical Programs. canW happen. regional manager, Acute Care Solutions, one of the leads of the project. “Everyone There were over 4,430 calls the first Northern Health is the health authority Information & Technology Services. did a vital role in very short order.” week, with 70 per cent about COVID-19. serving Northern BC. In March 2020, it set Now that the infrastructure was ready, To keep everyone healthy, strict clean- To keep up, staff worked round the up an online clinic and COVID-19 infor- they needed staff. David Williams, VP of ing protocols were set up to ensure every- clock – some working 20 hours a day. They mation line in only two days. With thou- Human Resources, and his team put out a thing was sanitized between shifts. also balanced training new staff, managing sands of callers since inception, this service call for staff willing to be redeployed. The service, which initially operated technical requirements, and implementing has been crucial for Northerners. “There were many who stepped outside 24/7, provides three tiers: evolving messaging. All of this required “We were definitely building a plane in their normal roles to ensure we had suc- • Tier 1: Screens calls, provides informa- constant adjustments. flight,” says Dori Pears, regional manager, “There were changes every day,” says Primary and Community Care, one of the Pears. This initially strained the line’s re- leads in developing the Northern Health sponse time, which started at 30 minutes. COVID-19 Online Clinic & Information But after two weeks, it was only six minutes. Line. “It was great to provide the wraparound In early March, Northern Health’s Exec- support until we figured out what we utive tasked a small team to create a com- needed,” says Kara Hunter, Lead, Nurse bined help line and online clinic. The ser- Practitioners. vice would provide information and advice, Since then, the Northern Health helping reduce the transmission of COVID-19 Online Clinic & Information COVID-19 and decreasing pressure on Line has added other functions, including emergency rooms and other health services. providing information on mental health For two days, the team “locked down” and substance use; working with BC in an intense process to plan and imple- Housing and the First Nations Health Au- ment the new clinic. thority; and connecting local businesses The first challenge was space. The with Public Health Protection. Brunswick building in Prince George was Now that Northerners are more in- chosen – but it was fully occupied by IT Kara Hunter Dori Pears Dr. Dietrich Furstenburg formed and call numbers are dropping, the staffers. Thanks to Jeff Hunter, chief infor- service’s hours have been slightly reduced. mation officer, within hours all 200 staff cess. Nobody said, ‘this isn’t my job’,” says tion. Transfers medical questions to Tier 2. The service is still available for Northern were sent home to work remotely. Vanessa Kinch, regional manager, Clinical • Tier 2: Nurses assess callers, transferring communities, but with many doctors’ offices “I was amazed at how quickly they va- Informatics. those with COVID-19-related symptoms now offering virtual healthcare, Northern cated their building so we could set up the The pool of staff eventually grew to 250, or other complex medical issues to Tier 3. Health continues to advise people to call new clinic,” said Pears. including volunteer fourth-year nursing • Tier 3: Physicians and nurse practition- their primary care providers first. A small team stayed behind to install students and medical residents. ers provide immediate help and advice. As of June 10, the service had received equipment. Twenty-six workstations were “A lot of staff were providing frontline Before launch, practice calls and tests nearly 14,000 calls in total – impressive for initially created. As call volumes increased, care for the first time,” says Pears. ensured everything was working. Informa- a “plane built in flight” in only two days! new workstations were added. Information was changing daily. For tion technology experts also provided on- The team used Tableau software to consistency, scripts were developed using the-spot support to each tier. Daniel Ramcharran is Communications track wait times, call lengths, and call vol- BC Centre for Disease Control guidelines. On March 14, the service “soft- Advisor, Planning, Quality and Information ume. It provides heat mapping to deter- Population and Public Health leadership launched,” initially seeing a few calls. But Management, Northern Health.

Nurse Practitioner in rural Nova Scotia embraces virtual care for patients

BY DEIDRE TAYLOR practice adopted virtual care overnight,” physical assessments that can’t be cessible for patients. The patient popula- said Savage. “We talked about using completed virtually, and in-person tion that I am really interested in using usan Savage joined the collabo- Zoom one day, and the next day we were appointments are arranged for patients virtual care with are those who find it rative family practice team at doing it. I’ve been providing many of as clinically warranted. difficult to come in to the office, such as North Queens Medical Centre my appointments with patients online.” As a relatively new provider to the col- a mom with several young children, or in Caledonia, N.S. – 100 km Savage found it easy to adapt to virtual laborative family practice team, Savage an elderly patient who doesn’t drive.” west of Halifax – two years ago appointments, as she routinely provides has been accepting new patients into her Access to Wi-Fi or a data package on Sas a nurse practitioner with Nova Scotia appointments for her patients by phone. a mobile phone is another consideration Health Authority. “I have been providing telephone ap- that needs to be weighed when offering a The collaborative practice’s two nurse pointments for patients all along, as virtual appointment. “High-speed inter- practitioners and family doctor provide many healthcare providers do. Some pa- net is supposed to be coming to this area primary care for residents of the small, tients are not able to afford to travel to later this year, so that will make a big close-knit community, along with those the clinic, so I will speak with them by difference for this community, and living in the surrounding areas. phone to ensure they receive the advice hopefully it will be affordable.” At the end of March, Savage began and care they need.” Overall, adopting virtual care ap- providing virtual appointments for Sometimes an appointment by phone pointments has been well received. patients using Zoom for Healthcare, just isn’t enough, and that’s where a vir- “There have been some growing like many others, once it became tual appointment with a video compo- pains, but that’s the case with anything available for healthcare providers in nent can be helpful. Susan Savage on Zoom for Healthcare. new. This will possibly be the new nor- Nova Scotia. Currently, more than 3,200 “As a primary care provider, there is mal in my practice, as there is huge value healthcare providers in the province are so much you gather through observa- practice from the Need a Family Practice for clinic patients, as well as for primary using Zoom for Healthcare in response tion. By adding video, you can see the Registry. She finds that the initial ap- care providers. For example, when the to the pandemic. patient’s rash, wound, droopy eye lid or pointment with a new patient can be weather is bad and the roads are poor, “When it was indicated that we issues with mobility, which you can’t get done virtually with Zoom for Healthcare. rather than reschedule, a patient’s ap- should limit in-person appointments from a telephone call.” “Virtual care is a way to make appointment can be done virtually; it really due to the spread of COVID-19, our Savage does note that there are pointments in family practice more ac- will change how we deliver care.”

6 CANADIAN HEALTHCARE TECHNOLOGY JUNE/JULY 2020 http://www.canhealth.com SPONSORED CONTENT COVID-19 SOLUTIONS Contact tracing: Advanced analytics can help uncover patterns in the spread of COVID-19 Visualization, analytics and data management from SAS provide new tools for coronavirus tracking.

BY GREG HORNE, GLOBAL PRINCIPAL, HEALTH CARE, SAS ple who were unknowingly exposed to the infected text/SMS messages or emails. Based on the likelihood individual might carry on with their lives, unaware of close, extended contact, such as a work colleague, est, trace and treat is the mantra of that they, too, could be infected and further spread they may be notified to get a health assessment. communicable disease fighters, and it’s the disease. This is precisely where modern technol- no different with COVID-19. However, ogy – such as analytics and machine learning from Public health insights across Canada and the United States – SAS – can play a pivotal role. When assessing a patient’s network, public officials and in many parts of the world – A once cumbersome process that relied on an in- can rely on analytical insights from the data to fill in health authorities have discovered dividual’s often incomplete or inaccurate memory, some of the gaps to answer questions such as: Who Tthey’re hamstrung by a shortage of staff able to do the contact tracing has entered the digital era. Thanks to should be tested? Who is most likely to spread the work of tracing. advanced analytics and data visualization, public virus? How do I find missing or unknown linkages? The goal of contact tracing, of course, is to break health officials and investigators are finding new Which communities are at greatest risk? Is social dis- the chain of transmission by identifying people channels to quickly identify (with their consent) tancing working? who’ve come into contact with those who have con- people who have been exposed to COVID-19 so they tracted the disease, to test them, and if needed, iso- can self-isolate, seek treatment if needed and impede How we can help late them or provide them with medical treatment. the spread of infection. Analytics software can integrate data from a variety In April, the Canadian government asked for vol- of external sources to deploy the right data quickly to unteers to learn the art of contact tracing, and an as- The new role of data management and analytics our cloud-ready investigation and incident manage- tounding 27,000 people applied. For its part, the state The latest data management capabilities and cutting- ment solution. From there, users can easily create, of New York recently unveiled a contact tracing plan edge analytics give contact tracers a new set of tools triage and manage their efforts to make contact trac- that calls for the hiring of as many as 17,000 contact to work with. There are four areas where analytics ing more complete. tracers. And Belgium is hiring 2,000 “corona detec- can help. Advanced analytical modeling tools help health offi- tives” for a population of about 11.5 million people. cials and governments answer the critical questions Not all of these tracers are in the field. Some will be Contact transaction databases with entity resolution needed to implement smart public health policies. With at call centres, others will work with incoming data, These databases are the home for contact tracing data visualization abilities, users can perform deeper in- and some will be public health experts. data. They enable entity resolution that, for example, vestigations of contacts and data to uncover hidden pat- These modern contact tracing efforts can be en- links multiple records in perhaps multiple databases terns and share them across various health agencies. hanced by using data visualization and analytics to to the same person. This is a huge timesaver when Once links have been determined, you can gener- understand: speed is important – as it is with contact tracing. Us- ate alerts that public health officials can dispatch to • Missing or unexpected linkages in contact data. • Who should be tested. • Where the virus is spreading. • Which communities are at greatest risk. This increased awareness is a valuable tool that enables epidemiologists and healthcare officials to respond faster in instituting containment measures and issuing public alerts to COVID-19 “hot zones”.

Contact tracing: A history of disease tracking One of the most famous cases of contact tracing is that of “Typhoid Mary” in New York City at the beginning of the 20th century. The source of contagion turned out to be an asymptomatic carrier who was a roving household cook for a number of the city’s wealthy families. Only through the scientific and dili- gent work of George Soper (considered by many to be the first epidemiologist) were authorities able to not only identify the source but also realize that some people could carry and pass on the disease while ap- pearing to be healthy. Soper’s detective work, interviewing typhoid patients and their families, became the foundation for ing data management solutions means you can estab- communicate with contacts for a given patient. modern contact tracing. Much of the work has re- lish and display linkages between patients, their con- These alerts can convey health risk warnings and can mained unchanged and contact tracing has become a tacts and the places they might frequent to narrow be customized for each recipient, such as directing preventive medicine cornerstone. and focus the efforts of contact tracing resources. them to obtain a COVID-19 test at a specific facility or to self-quarantine for a specific number of days. Contact tracing in today’s world Enriched contact tracing data They can be sent via automated channels, such as A journalist’s standard set of questions – who, what, Using analytics and machine learning gives health text/SMS messages and emails. when, where and why – are the same that a contact officials new and important insights into each pa- tracer uses when interviewing someone who has tient’s network. Analytics can help determine who Greg Horne is the SAS Global Principal for Health and is been diagnosed with a contagious disease, like might be linked to a patient – such as family, friends based in Toronto. He joined SAS in August 2012. In this COVID-19. They seek information directly from the and neighbors – but also employer rosters, passenger role, Greg focuses on healthcare strategies and outcomes, source to help determine who the individual con- manifests and school rosters. Machine learning can as well as on the cost, quality and other challenges that tacted, when these interactions happened and where help automate that effort by building analytical any modern health system faces. He is a thought-leader they took place. Ultimately, the goal is to establish models that reflect real-world data and conditions. on the future of healthcare and the introduction of pa- linkages to help slow the spread of the virus. But tient focused technology. To learn how SAS is enabling that’s easier said than done. Intelligent alerting contact tracing for public health, visit SAS’s Contact Trac- What happens if patients can’t recall all of their Once the contact tracing team has sufficiently identi- ing For Public Health Resource Hub: sas.com/ca/contact- movements over the last two weeks? What if a patient fied a patient’s links and network, it can begin the task tracing, or contact Greg Horne, Global Principal Health- is incapacitated and can’t respond to questions? Peo- of automatic notification of people in that network via care [email protected] to learn more. http://www.canhealth.com JUNE/JULY 2020 CANADIAN HEALTHCARE TECHNOLOGY 7 NEWS AND TRENDS Tele-wound care helps patients recover at home during the pandemic

BY NEIL ZEIDENBERG “You use the app on any smartphone to scan the wound,” said Perez. “It uses ma- ith COVID-19 infections chine vision to capture a scientifically cali- continuing in great num- brated image of the wound, including mea- bers, social distancing is still surements, with an accuracy of over 96- one of the most effective percent, and then transmits that informa- strategiesW for containing the spread of the tion to a wound expert remotely, who uses virus. However, physical distancing has se- this data to inform vital care decisions.” verely affected highly vulnerable wound “The app also tracks data over time, patients, who have been unable to see their storing the complete history of the wound. wound care specialists. Without quality This is essential in understanding how it’s and timely access to care, an untreated healing, to determine if additional or more wound can quickly lead to infection, am- urgent intervention is required.” putation, hospitalization or death. Patients gain access to the app through To address this challenge, leading health- their healthcare provider and use it to not care and health-technology organizations only scan the wound and provide images and have banded together to form the Tele- measurements to their caregiver, but to also wound Coalition, a trusted, best-practice connect in real-time to discuss the care plan. collective of clinical experts, care providers, Coalition members across North America, – every day – keeping patients healthy and Wound care is challenging at the best of and innovators who aim to provide imme- and that number is continuing to grow. in-place, and out of the hospital. times, said Perez. However, being forced to diate access to remote wound care experts The Coalition ensures tight coordination The Telewound module is a secure, spe- conduct it virtually due to a pandemic throughout the COVID-19 crisis. of care between patients, their care team, cialized telemedicine system for use at the takes it to a new level. And at the core of the coalition is a vir- and wound specialists, enabling the best point-of-care, while a patient is at home. It “If you miss your wound care appoint- tual visit technology that allows wound course of treatment to be determined has two parts: one that’s used by a provider ments a patient faces a greater risk of care professionals to effectively treat pa- without travel or in-person visits. and the other that’s used by the patient in harm, re-admission, or worse – death,” tients while at a distance. This collective of experts and thought their home. commented Perez. Coalition members include: Swift Med- leaders from across North America also Wound care is a visual specialty that de- Wound care is a highly visual discipline ical, SE Health, AlayaCare, Woundpedia, creates a network for new knowledge cre- mands a high level of precision in images. that requires high-resolution images with the University Health Network’s Michener ation and sharing to accelerate and ad- That’s why basic videoconferencing and sub-millimeter accuracy. This means that Institute, and more than 20 other organi- vance the adoption of virtual wound care. standard telehealth platforms just don’t cut common virtual visit solutions are inade- zations. The Coalition connects patients Swift Medical is providing the key tech- it. Video images are highly compressed and quate and inappropriate for remote with wound specialists and facilitates de- nology, a new Telewound module, accessi- they easily pixelate when you try to enlarge wound care – and thus the need for a spe- velopment and dissemination of remote ble to patients at no cost. It will enable them to examine details. Also without cialty solution with a medical-grade, AI- wound care best practices – bringing im- thousands of virtual visits between patients, colour calibration, lighting bias can make a powered visioning system to support pre- mediate telehealth relief to thousands of their care providers, and wound specialists healthy wound look green and infected. cision wound images. Canadians in need. The Telewound Coalition aims to: • Ensure accessibility and continuity of wound care throughout the crisis; Toronto, Ottawa switching to simpler, user-friendly systems • Preserve the health and safety of vulnerable patients and care providers; and CONTINUED FROM PAGE 4 and confusing. It uses clinically incorrect over the $37.7 million budget for the na- • Alleviate hospital capacity pressures by and counter-intuitive terms and different tional build. “Panorama was a difficult and supporting patients in the community. finally deployed in British Columbia in terms for the same function in different complex undertaking,” commented Bell- “By preventing healthy people from go- 2011, but it too has come in for harsh crit- parts of the system,” she noted. ringer. “The system needed to meet the ing into hospital, we can prevent further icism. A 2015 audit by British Columbia Co-sponsored by the Government of needs of numerous jurisdictions of varying risk of exposure,” said Carlo Perez, CEO, Auditor General Carol Bellringer reported British Columbia and Canada Health In- sizes with different public health processes, and co-founder, Swift Medical. over 11,000 defects. foway, Panorama was delivered by IBM and be translated into two languages. B.C. Currently, there are more than 20 “It is difficult to navigate, complicated, three years late and close to $30 million alone has spent $115 million, and will spend a further $14 million per year on a system that is not fully functional.” As recently as November 2017, then Ontario Ministry of Health chief information officer Lorelle Taylor acknowledged the challenges British Columbia had with Offload support Panorama’s Investigation and Outbreak module, which is probably why Ontario and maintenance and several other provinces and territories chose not to deploy it. “We will have to invest more money in to the experts order to get a modern investigation and outbreak management tool – yes, in all Healthtech delivers industry-leading application support likelihood,” she told the Legislative Assem- bly’s Standing Committee on Public Ac- services that free your team for more strategic projects. counts. “I don’t want to predetermine the We provide expert support and maintenance at a guaranteed conclusions from the analysis that will be fixed cost. done up to and including the spring (of 2018), but if you were to ask me my best • Tier 2 application support estimate, my best guess today, it will re- • Upgrade and testing quire a financial investment to implement a new province-wide investigation and • Full-service implementation, technical, and legacy support outbreak management solution.” Today, the iPHIS system is still in use but nordicwi.com/htsupport Ontario’s two largest public health units have taken the initiative to go their own way. However, the province’s Minister of Health Christine Elliott conceded the need to prioritize the development of a new system once the pandemic is behind us.

Canadian Healthcare Technology Mag 7x4-v3.indd 1 6/8/20 1:29 PM 8 CANADIAN HEALTHCARE TECHNOLOGY JUNE/JULY 2020 http://www.canhealth.com Connected Health

“Remote automated for Remote Patient (*)$/*-$)"*!1$/'.$").ƚ - discharge - post surgery - is Monitoring the way of the future. This technology gives health care providers the ability to detect early signs of For critically or chronically ill patients, daily remote monitoring can mean the complications and optimize $Ȃ - ) /2 )# '/#4/Ҋ#*( - *1 -4*-#*.+$/'- Ҋ ($..$*)ѵ medical management, 4*($)$)"/# ./*!/ ' ( $$) 2$/#- (*/ 1$/'.$")(*)$/*-$)"Ѷ *ƙ -$)"/# +*/ )/$'/* +/$ )/.0-1 4.) .(-/)*/$ޔ/$*).Ѷ/# '*0 *)) / '/# keep patients out of the +'/!*-(ҡ''*2.+#4.$$).Ѷ'$)$$).) - / (.-*.. ) /*1$-/0''4- !*-+/$ )/.!-*(#*.+$/'/*#*( ѵ hospital and in the process facilitate more elective and ғ0/*(/ (*)$/*-$)"*!+/$ )/1$/'.ѷ'** /0- о2 $"#/ urgent surgeries and reducepressure, pulse rate, SpO؋Ѷ/ (+ - ғ 0/*(/$''4)*/$ޔ .#*0' the spread of COVID-19.” symptoms change - Dr. PJ Devereaux, Professor, Director, ғ# 0' / ' # '/#1$ **)! - ) $1$.$*)*!- $*'*"4) $ )/$͗ Leader of the Anesthesiology, ғ-$"" -+- Ҋ++-*1 Ҁ/$*)+').ҁ/* Perioperative Medicine and # '++/$ )/.) !($'$ .+-*/$1 '4 ҡ'*0 *)) / '/#$. Surgical Research Group at PHRI, respond to changes in condition '/#) '$ ). ) ' - ѵ McMaster Health Sciences.

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BOLD EPIC INNOVATOR AWARD NEWS AND TRENDS Critical communication lessons from the Notre Dame cathedral fire

BY BENJAMIN KANTER, MD was present. But the smoke detection alarm persisted. ust over a year ago, on April 15th, • The attendant tried to reach his boss to 2019, one of the world’s architectural clarify the situation but was unable to con- and spiritual treasures was nearly de- nect with him. Approximately 10 minutes stroyed when fire razed the Notre later, his supervisor called back and in- Dame Cathedral, in Paris. The fire structed the attendant to tell the guard to go Jdevastated an iconic monument that up to the church nave’s attic – a steep and had stood for more than 800 years, leav- lengthy climb into the forest – where the ing a burnt-out husk. How could such a fire’s presence was subsequently confirmed. thing happen? Are there lessons that we in Manual confirmation of the fire was de- healthcare can learn from such an event? layed, and so was the notification of the As it turned out, the potential for fire in Parisian fire department – by 30 minutes – the cathedral was anticipated, almost ex- 30 minutes the great cathedral did not pected, given that much of the structure have to spare. beneath the heavy, lead-shingled roof was Mapping gaps in healthcare communi- a nest of ancient oak beams affectionately cation: The disaster at the Notre Dame called “The Forest”. Cathedral was primarily due to break- To head off such an event, tremendous downs in communication. For healthcare efforts were expended to craft a highly cus- leaders, it is especially important to note tomized detection and response system – because communication errors are among in a hospital what we’d call an “early warn- handled. We will then look at how the sit- common language and numeric codes. The the most common precipitating factors in ing system” – a system used to trigger a uation could have been more effectively information had to be manually decoded hospital sentinel events. A communication rapid response or medical emergency controlled. and subsequently communicated to a single delay, missed information, or a miscom- team. And yet, the cathedral was all but de- Here, in brief were the sequence of security person within the cathedral. munication can lead to a cascade of events stroyed. What went wrong? events that took place that day in Paris. • Once the message was decoded and re- increasing over time the degree to which The cathedral did have an alarm system, • The cathedral’s smoke detection system layed to the security guard at the cathedral, the system fails. It happened at Notre yet a root cause analysis of the fire revealed went into an alarm state at about 6:10 pm. the guard responded by going to the wrong Dame and it happens in hospitals, where several gaps in communication. Alarms It did what it was meant to do: sense that location – to the Sacristy, a building used patients are at risk. did not go to the right people. Messages smoke was present and sound an alarm to for storage that was attached to the side of Monitoring systems – or what I will call were unclear, and there were no systems of notify someone. the Church. This misdirection likely oc- incident detection and response systems – backup or escalation. For healthcare lead- • The notification was sent to a single sta- curred because the decoded alarm notifi- are designed to shorten the time-to-act in ers who want to avoid disaster of their tion manned by a single attendant – a sin- cation indicated that smoke had been de- response to an event. In your hospital’s own, there are lessons to be learned by the gle point of failure. As bad luck would have tected in the Attic Nave Sacristy – a loca- systems, how many events are constantly fire at Notre Dame Cathedral. it, the employee on duty that evening was tion that did not actually exist. taking place, and how many clinical and Root cause analysis: It is useful to ex- new – it was his third day on the job. • Upon arriving outside the Church and operational systems are sending alerts amine what happened when the blaze • The smoke detection system message that looking into the Sacristy, the guard called about these events? Too many to count. started at Notre Dame, and how it was the monitor attendant received was a mix of the alarm attendant back, stating no fire CONTINUED ON PAGE 23

Digital resources support mental health clinicians and patients

BY IMAN KASSAM, MHI COVID-19, many mental healthcare Health Resource Document mental health professionals and clients AND GILLIAN STRUDWICK RN, PhD professionals have had to alter their de- (https://tinyurl.com/digitalMH) was cre- with information about how to use the livery of care to limit face-to-face inter- ated by the Centre for Addiction and identified digital mental health resources, ORONTO – Each year, one in action with clients. Mental healthcare Mental Health (CAMH) in collaboration who the resource would be most useful five Canadians is affected by a professionals have opted to employ the with Canada Health Infoway. This re- for, whether the resource is designed for mental health problem or ill- use of digital health technologies, such source document was developed to sup- use in the client interaction and the tech- ness and one in two Canadians as video conferencing, to continue pro- port the increased use of digital mental nological requirements of the resource. isT at risk of developing a mental health viding quality care to their clients. health tools in mental health clinical The document further highlights how condition, according to a report pre- As mental healthcare providers are practice in Canada and to assist health- the identified resources can be imple- pared for the Mental Health Commis- accepting and adopting digital health care providers in empowering their mented into clinical practice by outlin- sion of Canada. Despite the high preva- tools as suitable solutions for care deliv- ing the barriers and facilitators that may lence of mental health problems and ill- ery, now more than ever they and their influence the uptake of digital mental nesses in Canada, the Canadian health- clients need guidance on the digital health tools. Considering the COVID-19 care system is ill-equipped to meet the mental health resources and tools that crisis, this document is well suited to growing demand and need for mental are accessible to them. support providers and clients in navigat- health services. Although some digital mental health ing the use of digital health technologies In early March, the World Health Or- tools are being created to support clients during these uncertain times. ganization declared COVID-19 a pan- through their care and recovery journey, By ensuring that providers are aware demic. The growth of COVID-19 cases in there remains a surplus of similar and of the appropriate resources to support Canada, and globally, has at times created effective technologies that currently exist the integration of digital mental health a parallel fear, anxiety and depression for but would benefit from increased pro- tools into the client and provider inter- those who are directly impacted by the motion and use. Gillian Strudwick Iman Kassam action, access to mental healthcare and virus and those suffering from the eco- Moreover, the resources to support quality of care delivered during these nomic, emotional and social uncertainty. the uptake of these digital mental health clients and caregivers to use digital men- times may be improved. Given the detrimental impact this cri- tools are not widely known nor have tal health tools. sis has created on the mental well-being they been consolidated into a single doc- Through consultation with experts in Gillian Strudwick RN, PhD is an Inde- of individuals, the demand for mental ument. Additionally, not all providers digital mental health across Canada and pendent Scientist, Centre for Addiction healthcare services is expected to rise. are well-equipped with the digital a search of academic and grey literature, and Mental Health, Toronto, Assistant This, coupled with an already over- knowledge or capacity to recommend, 18 resources were identified that can be Professor, Institute of Health Policy, Man- burdened mental healthcare system, will direct or engage their clients in the use used to facilitate the integration of digi- agement and Evaluation, University of force mental healthcare providers to seek of clinically beneficial digital health re- tal mental health tools into the patient Toronto, and President, Ontario Nursing alternative methods of care. sources and associated tools. and provider interaction. Informatics Group. Iman Kassam, MHI, is Currently, with the rapid onset of To address this, a Digital Mental The resource document provides a research trainee at CAMH.

10 CANADIAN HEALTHCARE TECHNOLOGY JUNE/JULY 2020 http://www.canhealth.com TO TAKE CARE OF PEOPLE, YOU NEED MORE THAN TECHNOLOGY. WE UNDERSTAND.

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1-877-418-2210 evidenthealth.ca NEWS AND TRENDS Medtronic team uses data and analytics to reduce wait times at hospitals

BY MELICENT LAVERS-SAILLY healthcare professionals to improve outcomes by working side by side to find so- inston Churchill famously lutions. And because we guarantee our re- said we should never waste a sults over the long-term, we support the good crisis. The COVID-19 implementation of solutions and help with pandemic may have imposed course-correcting.” Wmassive short-term changes on Canada’s One example that helps contribute to healthcare system, but the silver lining may problem solving is a simulator that can be be that the pandemic could also help expe- customized for specific situations. The sim- dite the adoption of new tools and processes ulator can turn raw data into useable in- that will allow for long-term, sustainable sights that can help save staff from over- improvements benefitting patients, health- time, reduce length of stay, and improve de- care providers, and the healthcare system. sign flow for such issues as safety protocols. Prior to the emergence of the COVID- For example, in Newfoundland, IHS 19 virus in Canada, hospitals already oper- helped Eastern Health reduce inpatient ated in a complex, high-pressure environ- wait times for the catheterization lab by 56 ment. They strived to provide the best care percent across the province. The simulator possible to a growing number of patients tool was integral to understanding how while dealing with strained resources, process improvements would improve crowded hallways, and lengthy wait times wait times without increasing costs. for procedures. “In many ways it’s like watching a The road ahead is only going to get movie,” says IHS Project Manager Farbod more challenging. Hospitals will need to tual care is being used for over 50 percent helping hospitals improve wait times by Abolhassani. “It’s a really good tool to determine how to effectively resume ser- of patients at the Peter Munk Cardiac Cen- taking a deep dive into operational data power decision-making. The simulation vices that were paused during early stages tre. And in New Brunswick, Vitalité Health such as staffing variables, bed availability, helps our clients understand the changes of the pandemic – such as elective surgical Network has set-up a drive-thru pace- processing times, government guidelines, we are proposing and the impact of mak- procedures – while navigating new safety maker clinic to address a growing backlog and changes in supply, including personal ing those changes.” protocols and infection control measures of patients waiting to have their cardiac protective equipment. Medtronic IHS data Other considerations hospitals will have that are further straining capacity and devices checked. science and analytics experts design cus- to make in the wake of COVID-19 will in- staffing, and increasing wait times. “The new hospital environment will be tom simulation and modeling tools to re- clude physical redesigns to limit transmis- Hospitals will also need to adapt to new significantly more complex than what it view process flows, identify bottlenecks, sible infections within the hospitals and expectations from patients who have been was before the pandemic and it was already and determine solutions to improve care optimizing the flow of patients to reduce exposed to the convenience of virtual care extremely complex,” says Gene Macdonald, pathways and patient outcomes. time on site. Providing more remote mon- and may be anxious about staying in a director of Integrated Health Solutions “In healthcare, everyone is doing their itoring of patients with chronic conditions waiting area for too long. (IHS) at Medtronic. “Life post-COVID-19 best to provide optimal care and achieve will also help improve safety of both pa- Several hospitals across Canada have al- isn’t about returning to normal in health- the best outcomes for patients,” says IHS tients and caregivers. ready risen to the challenge. For example, care. It’s about helping hospitals regain Senior Program Manager Morteza Fraser Health in British Columbia is now control of their caseloads, while accounting Zohrabi, MD. “However, there are many Melicent Lavers-Sailly is Senior Manager, doing pre-admissions assessments virtu- for new expectations from patients.” system-related issues that need to be ana- Stakeholder Engagement & Strategy, Canada, ally for surgical patients. In Ontario, vir- The Medtronic IHS team specializes in lyzed and improved. Our job enables at Medtronic.

Scarborough develops order set for discharging COVID-19 patients

BY GENEVIEVE TOMNEY tients. And through a partnership with may have inadequate housing. ing as a frontline care provider. There’s AND DANAE THEAKSTON Think Research, a Canadian health tech- “So, if that’s the case, the hospital can enough stress just coming to work dur- nology and clinical content company, help connect patients with the commu- ing this time, so developing a tool that or patients admitted to hospi- this crucial information will now be nity and bridge them into appropriate can keep staff informed of any changes as tal with COVID-19, the road available through that company’s cloud- housing, and this order set prompts things evolve relieves additional stress.” to recovery can be harrowing. based clinical content library, to every those conversations.” By making the order set available People with severe illness can hospital in its network. Standardizing the discharge process through the Think Research network undergo intubation, ventila- The order set works as a checklist for in this way also means providing peace and delivering it right to the fingertips of Ftion, and paralytic drugs. doctors, nurses and other hospital staff of mind to frontline healthcare workers those frontline healthcare workers, The patient’s recovery continues after who are responsible for ensuring that a who are already facing an exhausting Kirsten Lewis’ hope is that more hospi- discharge, and the coaching and prepa- patient can safely go home. It helps to or- workload, under the added strain of fac- tals will be able to provide that support. ration they receive from front-line ganize communication to the family doc- ing infection risk every day. “With appropriate planning, we can healthcare professionals is critical. tor and others who will be supporting “People are struggling with informa- help prevent patients from falling be- “These patients have been very sick the patient when they leave the hospital. tion overload at the frontline,” says tween the cracks of the system. And that’s and they may still have a long recovery If they still need to self-isolate, the or- where the Discharge Order Set comes in. ahead of them,” said Dianne Tomarchio, der set asks the clinician to confirm that The order set works as a This tool allows us to ensure that all of manager of Quality Improvement and the patient is able to arrange safe trans- the people in the patient’s circle of care, Clinical Standardization at Scarborough portation home and that their living sit- checklist for doctors, nurses including their family doctor, are aware of Health Network. uation will allow them to follow proper and others to ensure that a what happened to them in the hospital, “Families may worry that we’re send- isolation practices. patient can safely go home. what treatment they were provided with ing patients home before they’re neces- “Speaking to many doctors and and what the next steps are. sarily fully recovered,” said Tomarchio. nurses working on the frontlines, they’ve “All the information and follow up “People wonder if patients may still be told us what trips them up with COVID Tomarchio. “Having a guided tool at the management is organized through the contagious. Securing transportation is not having any clear standards around point of discharge that answers those order set and ultimately this can de- home often proves difficult. There are so when it’s safe to send someone home,” questions and makes sure that we’re pro- crease the likelihood that the patient will many variables and concerns to address said Kirsten Lewis, vice president of Re- viding the standard of care for our pa- return to Emergency because of a pre- to ensure a successful transition home.” search and Development for Think Re- tients is so important. There’s a lot of ventable issue.” To learn more about the That’s why Scarborough Health Net- search. “Many people who’ve been af- anxiety around taking care of these pa- COVID-19 Discharge Order Set and the work decided to develop a clinical play- fected by COVID are from vulnerable tients, about providing the best care, and Think Research clinical content library, book, called an order set, to specifically groups – people who have economic keeping everyone safe. visit www.thinkresearch.com/ca/covid- address how to discharge COVID-19 pa- challenges, or mental illness and they “It’s a very difficult time to be work- 19-tools/.

12 CANADIAN HEALTHCARE TECHNOLOGY JUNE/JULY 2020 http://www.canhealth.com NEWS AND TRENDS Virtual care after the pandemic abates: Maintaining the momentum

BY DR. RASHAAD BHYAT ment in these resources. most regions had some codes for remuner- will need to refine them to best determine Modernizing remuneration: Clinicians’ ation for care provided virtually, in limited how they can support quality virtual care rior to the COVID-19 pandemic, 10 remuneration structures (commonly and restricted clinical settings. That has and continuity of care afterward. to 20 percent of healthcare visits in equated with billing codes in fee-for-ser- changed rapidly across the country, as vir- PCanada were conducted virtually. vice arrangements) are perhaps the biggest tual care billing codes were opened-up Dr. Rashaad Bhyat is Clinician Leader, AC- That number is now about 60 percent, ac- factor when considering long-term adop- temporarily. Jurisdictions that recently in- CESS Health at Canada Health Infoway cording to statistics tracked by Canada tion of virtual care. Prior to the pandemic, troduced fee codes for virtual care services and a family physician. Health Infoway. My clinic group, located in the Greater Toronto Area, is currently “seeing” more than 90 percent of our patients through phone appointments, alongside some additional “visits” conducted through video chat. Virtual care has enabled Canadians to continue to access healthcare while maintaining physical distancing and safety as much as possible. The uptake has been rapid, but we need to make sure it’s sustainable beyond the ZZZGDSDVRIWFRPFRYLGVHUYLFHV pandemic. Four policy themes can help ensure that virtual care remains part of Canada’s “new normal.” Clinical and politi- cal leadership: Clin- ical groups and the provinces and territories have shown remarkable leadership and collaboration in implementing virtual care swiftly and broadly. Dr. Rashaad Bhyat The policy work of several years has been accomplished within a few weeks, but 9,578$/:$/.,1&/,1,&$33 it must continue. Individuals and organizations such as hospitals, clinical and industry groups and associations can work with jurisdictional leaders to influence )253267&29,'(5$ policy at the provincial, territorial and national levels. Patient advocacy: Patients’ voices are :cVWaZeVi^ZcigZ\^higVi^dcVcYVhhZhhbZci"cjghZ indispensable. Individual patients and patient organizations can provide significant support for maintaining the virtual care ig^V\^c\"VcYXa^c^X^Vck^gijVaXdchjaiVi^dc services that not only keep them safe during a pandemic, but also represent a modern approach to healthcare. Infoway’s 2018 and 2019 surveys of Canadians found that patients with access to their personal health information feel more confident and involved in managing 3RZHUHGE\ their healthcare. The benefits of modern- ized access to healthcare will last far beyond COVID-19, and it is critical that patients share their experiences. Support for clinicians using modern tools to benefit patients: Clinicians are making do with existing resources – primarily the telephone – along with a host of video visit apps and digital work-arounds that mostly do not fit into our workflow. While this is sufficient to weather an acute crisis, our tools and processes must be re- fined if virtual care is to last beyond the pandemic. It will take an enormous effort to manage this change process. This might mean supporting clinicians with modern, integrated, easy-to-use tools to privately and securely deliver optimal virtual care. It could mean making interoperable remote monitoring tools as commonplace and in- expensive as a thermometer. But it’s not really about the technology. Education, training and clinician peer networks are needed to refine, teach and rein- force best practices regarding the use of virtual care. We will need adequate invest- http://www.canhealth.com JUNE/JULY 2020 CANADIAN HEALTHCARE TECHNOLOGY 13 MEDICAL IMAGING PocketHealth sends images from one hospital or clinic to another

BY JERRY ZEIDENBERG hospitals. Images used to be prepared on disk and sent with patients. atients have been using the With services like neurosurgery, or PocketHealth software plat- when its own trauma bays are full, patients form to easily gain access to are usually transferred to peer hospitals. In their diagnostic images in vari- these cases, Osler may have done imaging ous hospitals and to keep them that needs to go with the patient to the inP a secure, cloud-based repository. Using new site. the system, patients can take ownership of “In the past, we’d sometimes have to their images and provide online access to wait for the images to be printed and sent caregivers when and where the images are with the patient,” said Dr. Ossip. needed. With PocketHealth, an ‘Access Page’ can In just a few years, PocketHealth, a instead be generated and sent to the re- Toronto-based company, has become an ceiving hospital or clinic, either by email, international success story with its innova- electronic fax or as a printed page. At that tive solution. In April the company raised end, a healthcare worker can enter a code $9.2 million in venture funding and an- on his or her computer and access the ap- nounced plans to rapidly grow its foot- propriate images. The DICOM imaging print across Canada and the United States, and reports can then be downloaded into where CDs are still the primary form of the new institution’s PACS. image exchange. Already, some 500 hospi- Aimee Langan, director of Diagnostic tals and clinics across North America are Imaging and Laboratory Services at Osler, using the cloud platform to provide pa- Aimee Langan (L) and Dr. Marc Ossip have been leading the implementation of the image sharing solution. said the PocketHealth system is easy for tients with quick and easy access to their users to learn. own medical images and reports. sonal visits to pick up the disks, as well as which would be time-consuming to create She mentioned that other organizations Now, moreover, clinicians are also using time and expense for all involved. And and difficult to keep track of. All too often, are steadily adopting the solution as well, the system to quickly move patient images with the COVID-19 crisis, hospitals are patients and organizations lose the disks. and once both sides understand how to use to each other using its ‘Provider-to- trying their best to keep all but the most In some instances, patients will seek it, it’s much easier to transmit images and Provider Sharing’ functionality. It’s espe- urgent cases out of their premises, to con- care in other provinces or countries, and reports than to print disks. And in this cially useful when they are caring for a pa- trol the spread of infection. disks need to be shipped via courier – time of COVID-19, it helps keep “non-es- tient who is going from one institution to Here, too, it is easier – and safer – to adding more time to the process. sential” visitors out of the hospital. another, and the diagnostic images are send the patient images electronically, via As well, said Dr. Ossip, “New computers For his part, PocketHealth co-founder needed for the follow-up care. the Internet. It’s a faster process, and it don’t even have CD players anymore. The and CEO Rishi Nayyar, said 86 hospitals The rapid transfer of images through eliminates the need for the patient to phys- rest of the world has moved on from CDs and imaging clinics across Canada have the PocketHealth secure cloud eliminates a ically visit a hospital. and faxes, and we’re still using them.” adopted the Provider-to-Provider Sharing big problem – namely the slow process of “With COVID-19, it became obvious to He added, “[PocketHealth] appeared to functionality of the platform, including burning images onto CDs, which has been us that this was the way to go,” said Dr. be a much better method.” North York General Hospital, St. Michael’s the traditional method of sending images Marc Ossip, chief of Radiology and med- Just one month after implementing Hospital and Sault Area Hospital. from one organization to another. ical director at William Osler Health Sys- PocketHealth for provider-to-provider With COVID-19 increasing the need Indeed, it often happens that a patient is tem, a three-hospital organization with sharing, Osler had already used it in 85 pa- for virtual image sharing, he predicts sev- about to be transferred from one site to sites in Brampton and Etobicoke. Osler tient transfers. That represented about half eral hundred more sites across Canada and another, but both the patient and care- implemented the Provider-to-Provider of the image sharing for patient transfers, the United States will be using it by the end teams must wait for his or her images to be version of the PocketHealth platform in versus about 50 percent with the tradi- of 2020. printed and packaged. March, just as the coronavirus pandemic tional CD burning. Langan added that Osler’s radiology In other instances, outpatients needing spurred hospitals to restrict access and fo- Dr. Ossip mentioned several scenarios and lab departments are trying to mod- follow-up care at a second hospital or cus on caring for COVID-19 patients. where the PocketHealth solution has been ernize when it comes to CDs, which she re- clinic will often return to the hospital But even before the pandemic hit, said useful. gards as an antiquated technology that has where they originally received care, in or- Dr. Ossip, there were good reasons to in- For its part, Osler provides a wide range been superseded by newer solutions – such der to obtain copies of their images. stall the image sharing system. If patients of medical services, but not all. For things as web and cloud-based systems. “We’d They must arrange for the images to be needed treatment at several different hos- like neonatal intensive care, patients are also like to eliminate faxing,” she said, but burned onto CDs, which can involve per- pitals, they would require multiple CDs, often transferred to Toronto’s downtown noted the process will take some time.

so that nurses can video-chat with pa- Dr. McGillion noted that six to 10 already planning the next study, called Virtual care tients every day for the first 15 days, and nurses will be managing patients at the Vision 2. In it, they intend to enrol CONTINUED FROM PAGE 4 every two days for the following 15 days. majority of the hospital sites, and that 20,000 patients worldwide to test the Secure two-way text messaging is also 20 are already working on the project at technology, which will progress to the stations at the various hospitals. available on the tablet so that patients the Hamilton General and Juravinski use of automatic, continuous monitoring Software designed by Cloud DX, and are able to contact the nurses 24 hours a hospitals. of vital signs using a next-generation ver- customized for PVC-RAM, monitors the day, seven days a week, if they feel un- It should be noted that PVC-RAM is sion of Cloud DX technology called the vital signs and notifies trained nurses if well or need support or reassurance. enrolling a total of 900 patients, of Vitaliti continuous vital sign monitor. there are unusual readings, so that “When patients hear they can have As well, the system will incorporate nurses can immediately get in touch 24-hour, around the clock access to artificial intelligence. “By applying this with the patients or their families for nurses, it’s plain and simple – they want A follow-up project called to 20,000 patients, it will allow us to col- rapid assessment. it,” said Dr. McGillion. “We really believe Vision 2 will enrol 20,000 and lect Big Data. And using that data, we’ll If nurses believe the help of a physi- this is going to become part and parcel use AI to predict bleeds, be able to develop algorithms that can cian is needed, they can escalate to an of healthcare in the future.” predict bleeds, sepsis, surgical site infec- on-call doctor. In most cases, nurses The virtual care support, day and sepsis, and other problems. tions, injuries to the heart muscle, and with training in tele-health will be able night, can help on many fronts. “There other problems,” said Dr. Devereaux. to help the patients in the moment, have been night-time issues which re- whom half will be given the Cloud DX He explained that often, readings of vi- thereby keeping them healthy at home. quire immediate intervention,” said Dr. monitoring technology, while the other tal signs, taken individually, do not appear The Cloud DX platform can send a McGillion, “such as adverse drug reac- half will be discharged home and cared significant to human observers. But ma- survey to patients every day, and auto- tions or the urgent need to adjust med- for in the traditional manner. The pro- chine learning can take a more nuanced matically scores the answers. A secure, ications.” In many cases, nurses and ject will evaluate the outcomes of one approach, and detects how seemingly inmedical-grade version of Zoom has been physicians are able to resolve the issue randomized group versus the other. significant, multiple factors may together integrated into the Cloud DX platform, remotely, keeping the patient healthy. Dr. McGillion and Dr. Devereaux are indicate the onset of a serious problem.

14 CANADIAN HEALTHCARE TECHNOLOGY JUNE/JULY 2020 http://www.canhealth.com MEDICAL IMAGING MIIT 2020: a virtual IT radiology and AI conference in the time of COVID

BY DR. DAVID KOFF professor of Radiology at McMaster Uni- where Dr. Cree Gaskin, professor of Radi- clinical practice, and how it improves the versity reported his experience developing ology, associate chief medical information experience of referring physicians, patients his year is not like any other an AI solution to automate the LIRADS officer, University of Virginia and Dr Les and radiologists. year. COVID-19 has brought classification for liver malignancies. Folio, lead CT radiologist at the National Kevin O’Donnell, senior research and disruption and havoc to our In the afternoon, we covered topics Institute of Health (NIH), Bethesda, development manager at Canon Medical routines, pushed four billion highlighting new trends in our profession. shared with us their experience with inter- Research, our Standards anchor at the Tpeople on the planet into confinement, To start with, we had a discussion panel active multimedia reporting technology in CONTINUED ON PAGE 23 stalled the global economy, grounded air- lines, and pushed many people to the brink of bankruptcy. It has underlined several weaknesses in hospitals worldwide, such as limited access to critical care beds and equipment. We did a good job in this country in flattening the curve, through rigorous planning for the surge, and we scrambled to create capacity in our crowded hospitals. Even if we KeepKeeppp patientspatients started relatively late to close our borders, we’ve been able to avoid the worst, thanks to the responsible connecconnectedctedd with and engaged behav- iour of most of the population. their loved ones Like all other conferences this year, MIIT Easily.Easily. Securely.Securely. SustainablySustainably.. 2020 was impacted too. With Don Den- nison, my co-Chair, Hospital patients araree struggling with isolation, we decided very early loneliness and anxietyanxiety.. Now there’sthere’s a better on to move the con- Dr. David Koff ference to a virtual solution to keep them connected. format, long before the major conferences were cancelled. MIIT is designed for an audience of medical imaging informatics professionals and fills a unique niche in Canada. Each year, the conference brings opinion leaders and subject matter experts to give an update on a variety of topics, from standards to new technology, workflow integration and to share real-life FAMILYFFAAMILLYY CHCHATHAATT experiences. So, for its 15th edition, MIIT went vir- available on myHealthHubub tual and it worked really well. Together, 10 speakers and 115 audience members par- Connect patients with family anda friends. ticipated, with sponsorship from Real Time Medical, GE Healthcare and Sectra. • Easy to use, with no accountt set-ups With all the hype around Artificial In- telligence, it’s no surprise that we spent • End-to-end encryption most of the morning talking about issues related to AI development and implementation. However, the tone was different and • A unique session for each call more practical than last year, showing that AI is finding its role in the diagnostic • Built for hospitals in Canada imaging workflow. Dr. Adam Prater, a neuroradiologist at Emory University and director of Imaging Informatics at Grady Memorial Hospital, told us about the hurdles in implementing Artificial Intelligence in practice and how important it is to engage and communicate, and also to figure out data policies and legal ramifications. “At a time when physical distancing is critical, yet compassionate carcaree and Dr. Vamsi Narra, professor of Radiology contact with family rremainsemains vital, the value of virtual connections has never been grgreater.eaterr.. at the Mallinckrodt Institute of Radiology talked about the key concepts and theo- Thank you HealthHub for all your support for our patients andnd stafstaff.”fff.” ries behind Change Management, the role of behavior and culture and common — Lorrie Reynolds, DirDirectorector of Patient Experience, Southlake Regional Health CentrCentree barriers to change. Dr. Tessa Cook, assistant professor of Radiology at University of Pennsylvania and co-director, Center for Practice Transformation, gave us an interesting perspective on the role of AI in radiology, stating that it may not be the image com- ToTo bookboo a freefree demo, visit healthhubsolutions.ca/covid-solutions ponent which holds most value, but rather how AI can improve the pre and post-imaging workflow. Dr. Christian van der Pol, assistant http://www.canhealth.com JUNE/JULY 2020 CANADIAN HEALTHCARE TECHNOLOGY 15 Physicians create HaloHealth to invest in Canadian health-tech innovators The company is already working with more than 40 startups across the country.

VIEWPOINT BY DR. SUNNY MALHOTRA them to make decisions quickly, connect companies zation like HaloHealth to provide the physician-en- with other expert clinicians, and credibly introduce abled due diligence to make meaningful investments. anadian healthcare is ready for dis- them to the major medtech companies,” said Robert They were looking for the emergence of such a group. ruption as we move towards value- Brooks, founder & CEO of Forcen. Furthermore, it was the demand and organic fit based care. The evidence is clear, “Finding product-market fit and defining value that allowed HaloHealth to syndicate with two ma- physicians are often exhausted due to for payers, providers, and patients is critical for early jor VCs in the Toronto area, work collaboratively antiquated systems in place that take with other angel groups and ecosystem partners, time away from allowing them to do and become a destination for health incubator grad- HaloHealth was formed so that Cwhat they do best – providing quality care to sick pa- uates to help them secure funding faster, and on- tients in need. physicians can invest in the innovations board key opinion leaders that was the right fit to This frustration was in fact part of the reasons of other physicians. They provide advice, help them grow. why HaloHealth M.D. founders started searching for Just a few months out of the gate, HaloHealth as technological answers to effectively improve the financing and introductions to others. of today has 127 physicians ready to advise, invest, healthcare system and to produce sustainable results and connect. Fully understanding this need to support innova- stage health tech companies. I can’t think of a better In addition, after the first HaloHealth Live! event tive Early Stage Healthcare Startups (ESHS) that can way to do this than partnering with HaloHealth, in late January of this year, where ESHS were invited help fix the broken healthcare system, Drs. Ben Fine, which allows me to work with providers who to pitch in front of 60+ HaloHealth MD members Sam Elfassy, Dan Nayot, David Kelton, Michael are also my investors,” said Derek Sham, in the audience, HaloHealth has been receiv- Varenbut, and Jeff Alfonsi took matters into their founder & CEO of COSM. ing requests from MDs from Vancouver to own hands and founded HaloHealth – a not-for- What was even more incredible to learn New Brunswick wanting to join to aid in profit physician angel group that acts as an infra- was that organizations in the ecosystem – the mission of helping propel Canadian structure to connect, advise, and invest in ESHS. such as healthcare incubators, academic health tech startups to the next level. The founders have collectively invested $1.2 mil- accelerators, VCs, family offices, and other With the help and support from ecosystem lion into 15 different startups over the course of angel groups – saw the need for an organi- partners such as the National Angel Capital roughly a year. Throughout this journey, the need for Organization, Ontario Center of Excel- such an organization became clear from the feedback Dr. Sunny Malhotra is a US trained sports lence, H2i, York Angels, Maple Leaf Angels, received from the startups: cardiologist working in New York. He is an BDO Canada, HVE Healthcare assess- “HaloHealth is an intersection of clinicians who entrepreneur and health technology ments, and Macadamian, Halo- understand the full picture and gives flexible support investor. He is the winner of the Health is currently in the process that is not as prescriptive as other VCs or angel orga- national Governor General’s of helping 40+ ESHS from nizations,” said Jonathan Ng, founder & CEO of Iter- Caring Canadian Award 2015, across the nation grow and ative Scopes. NY Superdoctors Rising Stars work towards advancing “HaloHealth is unique in the depth of insight and 2018 and 2019. Canadian healthcare support that clinician angels can provide. This allows Twitter: @drsunnymalhotra innovation.

EMR connects COVID-19 patient data across continuum of health

BY SONIA PAGLIAROLI any healthcare worker interacting For patients who require monitor- someone went looking for it. with that patient.” ing while isolating at home, Island “We had a patient being managed n Vancouver Island, local When a patient first demonstrates Health has developed an intensive for COVID-19 symptoms [at home], health authority Island symptoms, they often reach out to a home monitoring program, where who had some cognitive impairment OHealth is using its integrated primary care provider. community health nurses follow pa- and ended up in the ED,” said electronic health record to help clini- If the patient needs a COVID-19 tients’ progress remotely via report- Williams. “The patient was unable to cians diagnose and treat patients ef- test, the primary care provider con- ing from biometric equipment in the tell us about their history and didn’t ficiently while maintaining patient nects them to a central registration home. meet the criteria for a swab test. As a and staff safety during the COVID- service organized by Island Health, That data integrates with the EHR result, our care team did not initiate 19 pandemic. which arranges an appointment time and populates a special MPage with isolation precautions and continued Island Health leverages Cerner and provides directions to the as if there was minimal risk. We took Millennium to communicate each screening location. While results are this incident seriously and looked patient’s status and treatment plans. pending, an order triggers alerts to COVID-19 test results are for solutions to better protect our The EHR also helps support clini- any clinicians interacting with the returned in real-time to the healthcare workers as well as provide cians in reaching out to the commu- patient. Those alerts provide infor- primary care provider and efficient, appropriate care.” nity to provide in-home care and mation about the testing status and Island Health leaders imple- monitoring, as well as public health precautions that should be taken. to the patient, via a portal. mented new rules and logic to auto- surveillance in communities and res- Test results are returned in real- mate processes and make COVID-19 idents who can be difficult to reach. time to the primary care provider the pertinent COVID-19 informa- information more readily apparent. “Outreach, testing centers, assess- and are made available to the patient tion. If the patient needs to visit an “It’s freed up our staff time. They ment centers, community health and via Island Health’s patient portal, emergency department, clinicians trust things have already been done public health – they all connect with MyHealth, enabled by Cerner’s have full access to that information and don’t have to reorder tests or do our acute care system,” said Amy HealtheLife solution. If the patient in the MPage. certain assessments again. They can Williams, director of Clinical Infor- tests positive, the EHR alerts public When the pandemic first hit, Is- see if they were completed a day or matics for Island Health. “No matter health surveillance officers, so they land Health leaders realized they even just hours ago,” said Williams. where a patient ends up in their can quickly begin the contact tracing needed to improve communication. journey with COVID-19, that infor- process and determine if the patient While all the information was there, Sonia Pagliaroli is Chief Nursing mation will be at the fingertips of needs additional monitoring. it wasn’t readily apparent unless Officer at Cerner Canada.

16 CANADIAN HEALTHCARE TECHNOLOGY JUNE/JULY 2020 http://www.canhealth.com VIEWPOINT Ontario doctors receiving COVID-19 notifications can act sooner

BY SARAH HUTCHISON only HRM, but OLIS, ConnectingOntario barriers to information flow between hos- If you’re a clinician using a certified ClinicalViewer, eConsult and the In- pitals and other healthcare provider sites, EMR, OntarioMD staff can help you im- ntario’s frontline providers – sights4Care Dashboard began to surge as and clinicians. plement HRM. Contact us at support@on- across all healthcare settings – clinicians realized that these tools would be HRM delivers patient information from tariomd.com to get started. have quickly leveraged digital useful during this critical time and beyond. more than 500 hospital and specialty clinic health technologies to protect HRM is contributing to the integration sites to the EMRs of more than 11,000 Sarah Hutchison is Chief Executive Officer, Otheir patients and themselves during the of Ontario’s health system by removing clinicians across the province. OntarioMD. COVID-19 pandemic. OntarioMD worked with government and vendor partners to adapt our Health Report Manager (HRM) digital health tool to notify community- based physicians and nurse practitioners in their EMRs when COVID-19 test results are available in the province’s Ontario Lab- oratories Information System (OLIS). HRM COVID-19 notifications provide a prompt to clinicians to check OLIS through the EMR-integrated patient query to support timely follow-up with patients based on the results. HRM also delivers discharge information from hospitals that are COVID-19 assessment centres to EMRs. This is in addition to the 2 million other reports per month it delivers from more than 500 hospital and specialty clinic sites across Ontario to EMRs whenever patients are discharged. Reports that are COVID- 19 related are clearly identified to get the clinician’s attention. We continue to work with hospitals to identify any COVID-19 related encounters and deliver these reports to family physicians’ and nurse practitioners’ EMRs through HRM. These clearly labeled reports enable them to monitor patients who may have the virus – even if they have not yet tested positive. Hospitals that are offering dedicated COVID-19 Assessment Centres, such as the Michael Garron Hospital and Guelph General Hospital, have created notifications to be delivered through HRM to primary care when patients are assessed. “HRM is a very useful tool in helping our patients during the COVID-19 pandemic. Receiving notifications electronically in my EMR about COVID-19 test results being ready and receiving reports about COVID-19 related encounters in hospitals, also in my EMR, helps me deliver excellent ongoing patient care, partic- ularly when I need to communicate virtually with my patients,” said Dr. Daniel Glatt, a family physician in Napanee. On another front, OntarioMD manages a curated list of nationally available virtual care tools for clinicians on OntarioMD.News. This resource helps them select tools that they and their patients would be comfortable Over 1,000 Canadians have volunteered in the with and that use common devices and apps. While we currently don’t endorse any But we still need your help. خtool, we recognize the value of consolidat- ˛ǐǘɈƊǐƊǞȁȺɈ!ȌɨǞƮׁٌ׉ ing and presenting the options to make easier for clinicians to navigate. As we move forward together with clinicians and the vendor community, we will increasingly be Help complete focussed on integration and workflow to advance how seamlessly and comprehen- sively care can be delivered considering the the circle. needs of clinicians and their patients. OntarioMD has been working with community-based physicians and nurse Join a trial. practitioners and their practice staff for the past 15 years to equip them with digital health tools to enhance the excellent pa- Visit CovidTrials.ca and register as a trial participant. tient care they provide and help them gain some practice efficiency. When COVID-19 hit Ontario in early March, demand for not http://www.canhealth.com JUNE/JULY 2020 CANADIAN HEALTHCARE TECHNOLOGY 17 18

CANADIAN HEALTHCARE TECHNOLOGY JUNE/JULY 2020 FEATURE REPORT expanding the possibilities of smarter care. smarter expanding thepossibilitiesof genomics. in partner isatrusted Allscripts medicine forpoint-of-care patient that ensure patientsafety, andprecision healthcare journeys, anesthesiasolutions tools thatempower patientsontheir EHR inCanada, we deliver engagement technology. 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We represent Digirad, equipmentand nuclear medicineimaging ADN Canadaisyour premier source for Web: www.adncanada.ca Contact: JamieGiles E-mail: [email protected] T: 905-655-4364 Ashburn ONL0B1A0 9225 HeronRoad ADN Canada over 15,000Providers usingthesolution. EMRinCanadawith largest single-platform configurable to suitany practice. It isthe clinic andpatientmanagementmodules, Medical Records solutionthatincludes AccuroEMR isapowerful Electronic Web: http://accuroemr.com Contact: MichaelHall E-mail: [email protected] T: 1-866-454-4681 Kelowna BCV1Y9Y2 300-1620 DicksonAvenue AccuroEMR Annual directory of leadinghealthcare of Annual directory information-technology suppliers information-technology Additional vendor canbefound onourwebsite, listings atwww.canhealth.com Contact Us Today forPremier Pricing! Printers, Media, Medical Recorders &More! Monitors, 5MP-12MPMammo Monitors, Cath LabMonitors, 4K3DSurgical since138 Countries 1982. 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Ascom is communicated directly to purpose-built Wi- care and atthe pointof andalarms alerts systems, providing intelligent integrations nurseand wired callandemergency Healthcare includesbothwireless Platform patients andfrontline staff. The Ascom closer to thepeoplethatreally matter: your healthcaresystems management andbring more affordable andsustainablehealthcare make aprofound towards contribution This innovative, yet solutioncan practical features Integrated Workflow Intelligence. healthcare. The Ascom Healthcare Platform complete andefficientworkflows for mobilization solutionsthatdeliver smooth, and capabilities provide integration andsoftware architectureportfolio solutions. Ascom’s uniquesolutions OSCAR EMR. 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By providers access to tools forfaster, easier thatgivesplatform frontline healthcare Auxita isapowerful, free software Web: https://www.auxita.com Contact: JulieTremblay Roy T: 613-800-5585 Ottawa ONK2M2G8 65 DenzilDoyleCourt,Suite201 Auxita Inc. www.ascom.us http://www.canhealth.com

ILLUSTRATION: LINDA WEISS 2020 SOURCE GUIDE

Change Healthcare and supports, innovative and best-in-class medical 10711 Cambie Road, Suite 130 equipment and software solutions. Our team of Richmond BC V6X 3G5 250 specialists provides clinical expertise to T: 1-604-279-5422 support our 1,500 healthcare customers coast to F: 1-604-279-5468 coast. Along with exclusive international partners E-mail: [email protected] we offer worldwide healthcare innovation and Contact: Heidi Brown Christie Innomed technologies to the Canadian market. Our Canadian Pharmacists Association Web: www.changehealthcare.com 516, rue Dufour, Saint-Eustache QC J7R 0C3 Enterprise Medical Imaging Solutions for a Healthcare IT solutions are state-of-the art 1785 Alta Vista Drive T: 1-800-361-8750 patient centric approach to help reduce costs, E-mail: [email protected] products that support decision making to Ottawa ON K1G 3Y6 increase efficiency, uncover operational insights to Web: www.christieinnomed.com significantly improve patient care and workflow T: 1-800-917-9489 deliver excellent care and realize better outcomes. Christie Innomed develops, distributes, integrates efficiencies for increased satisfaction and better E-mail: [email protected] Web: www.pharmacists.ca Medication therapy management – it’s what our publishing department has specialized in for more than 55 years. Our drug and therapeutic resources can be found in every clinic, pharmacy, physician’s office and hospital, and many other health care institutions across Canada. Whether you’re a physician, nurse, dentist, pharmacist, optometrist, midwife, naturopathic doctor or other Leading International Trade Fair health care provider, we have the information you need to help make the best decisions and improve health outcomes for your patients. Contact CPhA to find out more about RxTx. DÜSSELDORF, GERMANY 16–19 NOVEMBER 2020

www.medica.de Member of Canon Medical Systems Canada Limited 75 Tiverton Court Markham ON L3R 4M8 T: 1-800-668-9729 BE PART OF THE NO. 1! E-mail: CMSCA-Inquiry@medical-canon WORLD FORUM FOR MEDICINE Web: ca.medical.canon Canon Medical Systems Canada offers a full range of medical imaging solutions and services with specialties in CT, X-Ray, Angiography, Ultrasound and MRI. All sales, services and operations are Canadian-based; reporting to Canon Medical Systems Corporation in Japan keeps close ties to our research, engineering and product specialists.

Carestream Health Canada Company 8800 Dufferin Street, Suite 201 Vaughan ON L4K 0C5 T: 1-866-792-5011 F: 416-665-0595 E-mail: [email protected] Contact: Bob Hamilton Ground-breaking Web: www.carestream.com From community hospitals to large academic providers, we offer flexible imaging solutions that can be tailored to your facility’s needs and budget. medicine up close Accelerate and evolve your digital transition with wireless DR solutions; both in-room and mobile, 3D extremity CT imaging, advanced imaging software and more – all designed to improve workflow, staff productivity and the quality of patient care, while reducing your costs. Electromedicine and medical technology in halls 9 to 17

www.medica.de/MEDTECH2 Cerner Canada ULC Markham Executive Office 3601 Highway 7 E, Suite 400 Markham ON L3R 0M3 T: 514-967-8880 E-mail: [email protected] Web: www.cerner.ca Cerner’s health information technologies connect people, information and systems at more than 27,500 facilities worldwide. Canadian German Chamber of Industry and Commerce Inc. Recognized for innovation, Cerner solutions Your contact: Stefan Egge assist clinicians in making care decisions and 480 University Avenue _ Suite 1500 _ Toronto _ Ontario _ M5G 1V2 enable organizations to manage the health of Tel.: (416) 598-1524 _ Fax: (416) 598-1840 E-mail: [email protected] populations. Cerner’s mission is to contribute to For Travel Information: LM Travel /Carlson Wagonlit the systemic improvement of health care delivery Tel: 1-888-371-6151 _ Fax: 1-866-880-1121 and the health of communities. E-mail: [email protected]

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2020-05-31 MEDICA 2020_Kanada_Elektro_177,8 x 254 mm_Canadian Healthcare Technology_4c_9189.indd 129.05.20 09:22 2020 SOURCE GUIDE outcomes. As one of Canada’s largest medical Credz Inc. Emerald Health Information Systems imaging and biomedical Multi-Vendor Service Box 25, 10600 Main Street 1 Antares Drive, Suite 400 organizations, we are a single point of contact who South Mountain ON K0E 1W0 Ottawa ON K2E 8C4 meets your needs for improved service-level T: 873-354-5494 T: 800-393-0278 x74161 response, reduced clinical risks and greater E-mail: [email protected] E-mail: [email protected] financial return. Our 65 years in the industry is a Contact: Kevin Vickers Contact: Guy Bujold testimony of our commitment to excellence. Web: https://credz.net Web: https://www.emeraldhis.com/ Credz is a SaaS platform that digitizes the Emerald Health Information Systems provides credentialing process. 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Web: https://www.harrishealthcare.com/ 88 Queens Quay W, Suite 2900 placements and residencies, to regional and pan- From the start, Harris Healthcare has focused Toronto ON M5J 0B8 Canadian credentialing for physicians. 100% on healthcare and providing solutions to Contact: EMREACH Inc. improve productivity, efficiency and accessibility, https://engage2demand.cisco.com/LP=11069 1001 Champlain Avenue, Suite 204 Web: https://www.cisco.com/ Burlington ON L7L 5Z4 ensure regulatory and legal compliance, and Cisco inspires new possibilities by reimagining T: 289-348-1231 F: 289-348-1231 enhance the quality of patient care and safety your applications, securing your data, transforming E-mail: [email protected] while keeping the financial side of hospital your infrastructure, and empowering your teams Contact: Dave Bard operations securely in the black. Within Harris for a global and inclusive future of healthcare. Web: www.emreach.ca Healthcare you will find an extensive suite of We focus on simplifying processes for healthcare clinical solutions, secure clinicians providers (HCP) to facilitate patient access to communications, Patient Flow & Bed Utilization, Cycom Technology Solutions Inc. treatments. By working with EMR providers and Infection Control & Surveillance, Health 31 Prince Andrew Place the life sciences industry, we deliver Workload and planning solutions as well as all the North York ON M3C 2H2 enhancements to the physician EMR experience related services you would expect. Our solutions T: 416-494-5040 to ease patient access to medications. can be mixed and matched to meet the needs of E-mail: [email protected] small practices or large regional networks, and are Contact: Siraj Ali Enovacom Web: http://www.cycom.com used in hospitals and health systems and their 521, avenue du Prado associated facilities throughout the world. 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Contact: Paul Hemburrow Richmond Hill ON L4S 0B8 scheduled visits using Microsoft Teams. Web: www.healthhubsolutions.ca T: 1-800-387-5045 F: 905-707-2020 115 University Avenue, Suite 1600 E-mail: [email protected] Toronto ON M5H 3B7 HealthHub Patient Engagement Solutions Contact: Joe Simms Deep 6 AI T: 800-263-8716 empower healthcare providers and their patients E-mail: [email protected] Web: www.compugen.com 1055 East Colorado Blvd., Suite 410 to have a positive and caring hospital experience Contact: Steve Oblin As Canada’s largest privately owned and operated Pasadena CA 91106 USA through myHealthHub, our interactive, secure, Web: http://www.fujitsu.ca IT solutions provider, Compugen offers practical, T: 1-626-585-8586 central patient engagement platform and our technology driven solutions that address E-mail: [email protected] As a leading manufacturer of document scanners, integrated bedside terminals. Our services are organizational business issues and priorities. 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20 CANADIAN HEALTHCARE TECHNOLOGY JUNE/JULY 2020 http://www.canhealth.com 2020 SOURCE GUIDE

HÔPITEL Inc. Meditech 8225, Labarre Street MEDITECH Circle Montreal QC H4P 2E6 Westwood MA 02090 USA T: 514-739-2525 F: 514-739-1436 T: 781-821-3000 F: 781-821-2199 E-mail: [email protected] E-mail: [email protected] Contact: Gary Schneider Contact: Nick Palmieri Web: https://www.hopitel.com/Reseau/en/index.html Web: https://ehr.meditech.com/ Northwest Telepharmacy Solutions Hôpitel’s mission is to cost effectively deliver Lanier Healthcare Canada MEDITECH is Canada’s leading EHR solution provider with nearly half of the hospital market PO Box 606, 2 Alexander Place infotainment services that ultimately enhance the 980 Adelaide Street S, Suite 36 share. 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We help unburden clinicians, radiologists Montreal QC H3K 1G6 approved four parts integrated platform: E-mail: [email protected] and care teams with efficient new ways to capture T: 514-949-5195 (1) homologated class II medical device- clinical information, applying real-time Contact: David Bouchard SIAscope, (2) HD camera for skin surface E-mail: [email protected] intelligence for better decision making across the Web: https://reacts.com/ imaging, connected to (3) a secured cloud-based Contact: Yiou Huang continuum of care. REACTS is a secure, collaborative platform with network-DermSecure, (4) complete with a Web: https://www.logibec.com/en/home unparalleled interactive features designed to suit patient management system for remote the multiple needs of healthcare professionals and Logibec is the leader in the development and assessment of the skin and suspicious lesions. Nuon Imaging Inc. patients. Integrated innovative tools like implementation of IT ecosystems in healthcare. 3221 97 Street NW augmented reality facilitate remote virtual With nearly 40 years of experience in the Edmonton AB T6N 1B7 industry, Logibec continues to innovate and Toll free: 1-866-455-3050 guidance, supervision and training. Deployed Mfran Enterprises Inc. internationally, HIPAA and PIPEDA compliant, develop technology solutions that enable its E-mail: [email protected] 81 Balmoral Avenue partnered with Philips Healthcare and others. customers patient care optimization. Web: www.nuonimaging.ca Toronto ON M4V 1J5 Nuon Systems (a division of Nuon Imaging) T: 416-706-1120 provides customized diagnostic imaging E-mail: [email protected] IT solutions to meet the needs of Imaging clinics Contact: Myrna Francis across Canada. We supply Digital Radiography Executive coaching and advisory services (DR) & IT Hardware/Software from the industry’s most trusted manufacturers. In addition, we offer maintenance plans, general service & support to ensure your equipment is Medeo Virtual Care well maintained, secure and working perfectly for Intelerad Medical Systems 300-1620 Dickson Avenue many years to come. Kelowna BC V1Y 9Y2 800 de Maisonneuve E Blvd, 12th Floor T: 1-866-454-4681 Montreal QC H2L 4L8 E-mail: [email protected] E-mail: [email protected] Contact: Michael Hall Contact: William Hart – 1-833-446-8567 Microquest Inc. Web: https://medeohealth.com/ Web: www.intelerad.com 4404 94 Street NW Intelerad, a leader in enterprise workflows, Discover more ways to connect, with Medeo Virtual Edmonton AB T6E 6T7 specializes in diagnostic viewing, and reporting Care. Medeo’s Online Booking, secure Video Visits T: 866-438-3762 F: 780-434-6018 solutions for hospitals, imaging centers, and and Patient Messaging solutions make it easier to E-mail: [email protected] reading groups. Renowned for their innovative communicate with patients from anywhere, while Orion Health giving Providers control over the conversation and Contact: Emmie Cadrin features and functionality, Intelerad’s Enterprise, 120 Adelaide Street W, Suite 1010 saving time and effort on both sides. Web: https://www.microquest.ca Cloud, and SmartWorklist solutions increase Microquest Inc. is the provider of Alberta’s Toronto ON M5H 1T1 productivity and streamline workflow in premier EMR, Healthquest, and the freely T: 1-888-860-1651 distributed and complex environments. For more available dr2dr Secure Messaging system. Founded Web: www.orionhealth.com information, visit www.intelerad.com in 1993, Microquest has been delivering effective Orion Health is a leading global technology healthcare solutions for over 25 years. Healthquest company that develops software to support the provides a full suite of tools, including electronic delivery of optimized healthcare. With over 25 charting, claim entry, appointment scheduling, years’ experience, we provide flexible technology online booking, automated appointment solutions that allow organizations to target the reminders, customizable intake forms, and a right patients and deliver the right kind of care at complete set of virtual care tools. the right place, supporting the management of individualized patient care. Kronos Canadian Systems, Inc. 110 Matheson Blvd W, Suite 320 M/L Software Documentation Mississauga ON L5R 4G7 MEDFAR Clinical Solutions 7351 Victoria Park Avenue, Unit 101 PatientKeeper, Inc. T: 1-800-225-1561 1224 Stanley Street, Second Floor Markham ON L3R 3A5 880 Winter Street, Suite 300 Web: https://www.kronos.ca Montreal QC H3B 2S7 T: 905-947-1557 Waltham MA 02451 USA Kronos Workforce Dimensions offers a unique T: 1-855-MEDFAR1 E-mail: [email protected] T: 781-373-6100 F: 781-373-6120 staff scheduling solution that allows Canadian E-mail: [email protected] Contact: Mark Bernick E-mail: [email protected] healthcare to be agile and responsive to patient Contact: Kassandra Paquet Web: www.words-tw.com Contact: Mike Staples care while meeting unit needs and budgets, and Web: https://www.medfarsolutions.com Since 1994, Words That Work has been PatientKeeper’s EHR optimization software enabling compliance with union rules. When MEDFAR provides more than an electronic medical producing and maintaining effective content for solutions streamline physician workflow, integrated with your EMR, this powerful, flexible record: the MYLE ecosystem is the only Care software companies of all sizes, from start-ups to improve care team collaboration, and maximize platform enables a unique, integrated view of Management Solution. Designed to enhance the established multi-nationals having delivered over EHR performance. Physicians can easily access patient AND staffing information, as well as entire patient care pathway, MYLE streamlines the 700 projects for over 255 software companies. and act on all their patient information in a insightful reports based on historical data that full range of clinical and virtual care operations. For many customers we act as their off-site single, intuitive and secure electronic enable more accurate and more cost-effective MYLE improves clinical efficiency, patient documentation department, developing and environment – from PCs, smartphones and scheduling. experience and quality of care with clinical analytics. maintaining their external and internal user and tablets – fully integrated with a hospital’s technical content. existing clinical and transactional systems.

http://www.canhealth.com JUNE/JULY 2020 CANADIAN HEALTHCARE TECHNOLOGY 21 2020 SOURCE GUIDE

PhenoTips 100 College Street, Suite 210 Toronto ON M5G 1L5 T: 888-682-5252 E-mail: [email protected] Contact: Sanjay Sodhi Web: https://phenotips.com/ TELUS Health PhenoTips is the world’s first Genomic Health Sectra 630, Rene-Levesque Boulevard W Record, designed to solve the problems commonly 2000 Argentia Road Montreal QC H3B 1S6 faced due to the lack of genetics functionality of Plaza 4, Suite 250 T: 514-665-3050 Electronic Health Records (EHRs). PhenoTips Mississauga ON L5N 1W1 E-mail: [email protected] integrates seamlessly with any EHR, unifying T: +1-437-889-0600 F: 1-437-991-6416 Contact: Carolyn Jolin standardized, usable genetic information to E-mail: [email protected] Web: www.telus.com/en/health Vigilance Santé empower clinicians to provide lifesaving care. Contact: Kjetil Nilsen TELUS Health is a leader in digital health 440, Notre-Dame, Suite 202 Web: https://sectra.com/ technology solutions such as home health Repentigny QC J6A 2T4 With 30 years of innovation and approaching 2,000 PocketHealth monitoring, electronic medical and health T: 450-582-3917 installations worldwide, Sectra is a leading global E-mail: [email protected] 100 University Avenue, 5th Floor records, virtual care, benefits and pharmacy provider of imaging IT solutions that support management as well as personal emergency Web: www.vigilance.ca Toronto ON L5N 6B3 healthcare in achieving patient-centric care. Sectra response services. TELUS Health is leveraging the For nearly 30 years, Vigilance Santé has been T: 1-855-768-4455 offers an enterprise imaging solution comprising power of technology to improve access to care E-mail: [email protected] PACS for imaging-intense departments (radiology, empowering healthcare professionals by combining Contact: Rishi Nayyar and revolutionize the flow of health information pathology, cardiology, orthopedics), VNA, and knowledge, intelligence, and technology to develop Web: http://www.pocket.health to create better outcomes for Canadians while sharing solutions. For seven consecutive years, analytical software and databases that promote the Patient-centric image exchange platform targeted Sectra PACS has been awarded ‘Best in KLAS’ for facilitating collaboration, efficiency and optimal and safe use of drugs. Our flagship products at eliminating 100% of CD burning and CD the highest customer satisfaction in the U.S., and in productivity for physicians, pharmacists, health are: RxVigilance, a powerful pharmacotherapeutic retrieval. Currently deployed at over 500 hospitals 2020 we also received the KLAS award for Canada. authorities, allied healthcare professionals, analysis and reference software; and RxPhotos, a pill and imaging clinics across North America. insurers, employers and citizens. TELUS Payment identification software. Solutions complements our health solutions by PointClickCare delivering secure, industry-compliant payment SensoryOne 5570 Explorer Drive and lending solutions that connect lenders, 8695 Escarpment Way, Unit 7 Mississauga ON L4W 0C4 payors, insurers, extended health care providers VitalHub Corp. Milton ON L9T 0J5 T: +1 905-858-8885 and financial institutions to their customers 480 University Avenue, Suite 1001 T: 1-866-315-9305 E-mail: [email protected] E-mail: [email protected] across Canada. Toronto ON M5G 1V2 Contact: Sarah Elsisi Contact: Alan Fine T: 1-855-699-0123 Web: https://pointclickcare.com/ Web: http://www.sensoryone.com/ E-mail: [email protected] PointClickCare helps long-term and post-acute SensoryOne is your single source for unique, Think Research Contact: Niels Tofting care providers gain the confidence they need to innovative and award-winning sensory products. Web: http://www.vitalhub.com navigate the new realities of value-based 351 King Street E, 5th Floor Our professionally trained consultants help to Care Evolved – Software for Health and Human healthcare. Toronto ON M5A 0N1 design inspiring, calming and stimulating multi- T: 416-977-1955 Services Providers Designed to Simplify the User sensory environments for all ages and abilities. E-mail: [email protected] Experience & Optimize Outcomes. Contact: Martin Persaud Web: http://thinkresearch.com Think Research, an enterprise clinical content and technology company, delivers PrivacyWorks evidence-based clinical tools grounded in best 4469 Percival Avenue practice. We organize the world’s health Burnaby BC V5G 3S4 knowledge so everyone gets the best care. Our T: 604-218-0434 cloud-based, digital tools empower clinicians Vocera Communications E-mail: [email protected] Siemens Healthineers around the world in 2,200 facilities and have 8 Market Street, Suite 300 Contact: Adam Stinson 1577 North Service Road E, 2nd Floor impacted millions of patients across acute, Toronto ON M5E 1M6 Web: https://www.privacyworks.ca/ Oakville ON L6H 0H6 primary, long term and community care. T: 647-490-1637 PrivacyWorks was founded to help organizations T: 905-465-8000 F: 905-465-8162 E-mail: [email protected] navigate the complex and ever-changing privacy E-mail: [email protected] landscape across Canada. Healthcare is our Web: www.siemens-healthineers.ca Contact: Clark Hadden specialty – no other industry has the same level of At Siemens Healthineers, we believe that Web: https://www.vocera.com scrutiny and compliance requirements. We treat transformational changes will make it possible to Vocera offers the leading platform for improving privacy as a competitive advantage that, when turn today’s challenges into opportunities. That is clinical communication and workflow installed at done properly, can set your team apart and make why it is our purpose to enable healthcare 1,700 hospitals and healthcare facilities your project a success. providers to increase value by expanding precision Thrive Health worldwide. Care team members communicate medicine; transforming care delivery; improving 890 West Pender Street, Suite 720 and collaborate with co-workers by securely patient experience; and digitalizing healthcare. Vancouver BC V6C 1J9 texting or calling, and to be notified of important Real Time Medical T: 1 250-692-6423 alerts and alarms with our hands-free, wearable 7111 Syntex Drive, 3rd Floor E-mail: [email protected] Vocera Smartbadge and Vocera Badge. Mississauga ON L5N 8C3 Softworks Contact: Allie Dickson T: 1-888-590-5060 1174 Mount Pleasant, Suite 1 Web: www.thrive.health E-mail: [email protected] Toronto ON M4N 2T2 Thrive Health was founded to fundamentally Contact: Ian Maynard T: +1-226-314-2519 improve the delivery of healthcare in Canada Web: http://www.realtimemedical.com E-mail: [email protected] and around the world by empowering patients Real Time Medical is a healthcare diagnostic Contact: Matt Gallagher to play an active role in their health journey. In efficiency and innovation company. It develops Web: http://www.softworks.com partnership with the BC Ministry of Health and vendor-neutral, diagnostic productivity, peer Softworks Employee Scheduling, Patient Acuity Health Canada, Thrive Health has developed the Zebra Technologies learning, communication, and clinical and Time & Attendance solutions enable hospitals BC and Canada COVID-19 apps that have collaboration software solutions. These solutions and other healthcare providers to easily manage 2100 Meadowvale Blvd supported millions of Canadians through the Mississauga ON L5N 7J9 improve the timeliness, efficiency, and quality of complex scheduling as well as employee hours, epidemic so far. service delivery to patients across the health annual leave and planned/unplanned absences. We T: 905-812-6400 system. It also operates a round-the-clock can help you drive efficiencies, cut costs and E-mail: [email protected] tele-radiology service in Canada. ensure labour law compliance, while Contact: Bas Ali simultaneously delivering exceptional patient care. Uniphy Health Web: http://www.zebra.com RLDatix 1 Antares Drive, Suite 400 Zebra is at the forefront of innovating the latest Ottawa ON K2E 8C4 1 Yonge Street, Suite 2300 Swift Medical technology solutions in healthcare. Our products, T: 800-393-0278 x74161 Toronto ON M5E 1E5 1 Richmond Street W, Suite 500 software, services, analytics, and solutions are E-mail: [email protected] T: 416-410-8456 Toronto ON M5H 3W4 used to intelligently connect people, assets, and Contact: Guy Bujold E-mail: [email protected] T: 1-888-755-2565 x712 data. We provide patient-centric care with Web: https://uniphyhealth.com/ Contact: Derek Rose Email: [email protected] purpose-built healthcare technology – including Uniphy Health’s mobile-first solutions enable Web: https://www.rldatix.com Contact: Phil Wigmore wristband and label printers, scanners, mobile Web: swiftmedical.com highly-effective care team collaboration and RLDatix is on a mission to change healthcare. We computers, RFID solutions and software. help organizations drive safer, more efficient care Swift Medical is a leader in digital wound care communication across the care continuum. Ensuring the right patient, receives the right care, by providing governance, risk and compliance management, delivering advanced wound care The Uniphy Care Platform creates a network that tools that drive overall improvement and safety. visualization and touchless measurement through aligns organizations’ acute and ambulatory care at the right time is critical. Zebra’s healthcare Our suite of cloud-based software helps its smartphone-ready Swift Skin and Wound teams, skilled nursing facilities, home caregivers technology solutions help your care team provide organizations report on adverse events, reduce software. Swift’s enterprise-grade solution and patients. This helps healthcare systems a higher level of patient care – empowering those healthcare-acquired infections and ensure patient streamlines clinical and administrative wound care achieve key initiatives faster, deliver high-value on the front line in healthcare with a safety learnings are implemented across the management workflows, ensuring superior wound services at a lower cost and provide patients with performance edge. continuum of care. care delivery, documentation, and outcomes. measurably higher-quality care.

22 CANADIAN HEALTHCARE TECHNOLOGY JUNE/JULY 2020 http://www.canhealth.com New Vaughan hospital will incorporate leading-edge technologies

BY MAURIZIO BEVILACQUA egy in place to help fund, build and com- transform an 82-acre parcel of land at Jane healthcare, innovation and jobs to our plete construction. My commitment to Street and Major Mackenzie Drive into a growing community. This site has the po- ong before the world had ever seeing it through explains why I chair the cluster of enterprise, opportunity and in- tential to be a place that will connect peo- heard of COVID-19, the City of Mackenzie Health Foundation’s $250-mil- novation in the life ple and spaces and bring together different Vaughan began preparing for a fu- lion Ultimate Campaign. I am proud to sciences sector. sectors to become an epicentre of health- ture with healthcare at the heart of announce that $177 million has been The feasibility study care excellence felt across Canada. Lcity-building. raised toward reaching our goal. will determine how A consultant has now been retained to The new $1.6 billion Cortellucci The provincial government made the best to create a complete the study. A report is expected by Vaughan Hospital – named in honour of right decision to ensure construction world-class health the year’s end. the Cortellucci family, which donated $40 presses ahead during these uncertain experience. It will As part of our efforts, I led the City’s million to the centre – will mark a series of times. This new hospital will double access examine various op- business mission to Israel. Our delegation firsts. It will be Vaughan’s first hospital, the to healthcare in southwest York Region. In tions, including a included partners from the Vaughan first new hospital built in York Region in 2021 doors are expected to open. Citizens new space for ven- Healthcare Centre Precinct project. more than 30 years and Canada’s first will be able to access care, and nurses and tureLAB to expand We met with Dr. Rafael Beyar, an expe- “smart” hospital. physicians will be there to help. Maurizio Bevilacqua and create another rienced, accomplished and trusted leader The 1.2-million square foot site can The new hospital is also the catalyst for regional innovation with the world-class Rambam Medical house up to 550 hospital beds. The hospi- the Vaughan Healthcare Centre Precinct hub in Vaughan, in addition to opportuni- Center – one of the largest medical centres tal will employ more than 1,800 full-time Project – a first-of-its-kind initiative. In ties for collaboration between Mackenzie in Israel. Dr. Beyar discussed his country’s hospital staff. It will feature fully inte- October 2019, the City entered a memo- Health and York University in the field of extensive efforts to bring together startups grated smart technology systems and med- randum of understanding (MOU) with health sciences. and academic institutions to create medical devices that can speak directly to one York University, Mackenzie Health and The goal of this unique partnership is ical breakthroughs and enhance front-line another, creating improved patient care. ventureLAB – a commercialization hub. for the Vaughan Healthcare Centre health services. The City has a long-held funding strat- The City is leading a collaboration to Precinct to leverage resources to bring Our meetings followed a study tour of the Rambam Medical Center and The Ruth Rappaport Children’s Hospital. We saw first-hand the cutting-edge technologies Critical communication lessons from Notre Dame cathedral that are improving patient care. Rambam Hospital provided a significant opportu- CONTINUED FROM PAGE 10 the result of his diagnostic test back as soon chats and a time for text chats, and both nity for us to learn of proven best practices. as possible, whether positive or negative. need to be available. This global pandemic is felt here at Lab systems are constantly churning out When the COVID-19 test has been re- • Automate the delivery of critical infor- home and in communities around the results (think COVID-19 test results as but sulted and added to the patient’s EHR mation. Alarms are just one source of deci- world. Now more than ever, we need the one example) that need to be monitored, record, it triggers an automatic communica- sion-support messaging. We can reduce Vaughan Healthcare Centre Precinct to messaged, and acted upon. Patient moni- tion. The Vocera platform knows which points-of-failure in the chain of commu- come to fruition. tors, radiology systems, and more have room the patient is in from the EHR ADT nication by automating the delivery of similar responsibilities. feed, and it also knows which nurses are cur- critical information to those who are best Maurizio Bevilacqua is the mayor of And then there are the host of opera- rently caring for the patient based on role prepared to react. Vaughan, Ont. tional systems for throughput, bed avail- assignments made at the beginning of the In Paris, the smoke alarm did not go ability, and the like. If we look closely, are shift. It also knows which nurse is actually directly to the fire department. The in- there communication weaknesses that available based on presence information. formation could have been sent directly could result in a disaster? The test result can be immediately sent to to both the fire department and the in- MIIT 2020: Notre Dame Cathedral had only one the patient’s available nurse along with other ternal security person on his or her mo- a virtual conference major system to monitor and it failed. relevant clinical information. If there is no bile device. What makes a hospital ‘smart’ is its ability confirmation of receipt by the first nurse, • Simplify processes. At Notre Dame, the CONTINUED FROM PAGE 15 to coordinate and make use of multiple in- the message can be automatically escalated sensing system, monitoring person, escala- terrelated detection and response system to one or more people until the delivery has tion paths, and responders were not united conference, showed us that DICOM simultaneously, so that your clinical and been confirmed. This automated process on one communication platform. This is alive and well with many relevant administrative operations are optimized. gets the information into the hands of makes handoffs more complicated, and additions to the standard. The only way to accomplish this is to have post-hoc analysis of events more difficult. Brittany Tomlin, business analyst a communication platform that can inter- In a hospital, if your nurses receive infor- with Alberta Health Services, in- operate between various clinical and oper- Alerting systems should be mation about labs on one system but have formed us about the ambitious, ational systems, aggregating the data from integrated, and staff members to use another to contact physicians about province-wide Connect Care project, the disparate systems and putting rules should be given the equipment the result, information must be retyped – which aims to implement a single around that information. increasing work for the nurse and bringing clinical information system. By doing it this way, data is turned into they need to work effectively. in the potential for errors of both omission Michael Toland, director of Enter- actionable information, which can be and commission. prise Radiology Imaging Systems, communicated directly to the person who someone who can act on it as soon as possi- • Provide the right equipment to your University of Maryland, discussed needs to know it. Data integration, aggre- ble, and it eliminates the burden of the nurs- staff members. There was no reason the with us his experience transitioning gation, transformation and communica- ing staff from needing to constantly look alarm information could not have gone di- departmental application support to tion are hallmarks of the modern commu- into the EHR to see if the result is back yet. rectly to the guard inside the cathedral centrally managed enterprise support nication and collaboration platform, in- Applying lessons learned: Fire to pan- through a smartphone app or a dedicated for imaging informatics. cluding the Vocera Platform. The commu- demic: Okay, so what exactly can we learn device. Similarly, the message could have Dr. Ted Scott, vice-president Re- nication and collaboration system is a fun- from what happened in Paris and apply it gone to the guard for action and to the fire search at Hamilton Health Sciences, damental component of a smart or real- to our current situation? While it might be department as a ‘tap on the shoulder’ – told us about CREATE, the innova- time health system. tempting to lay the blame on the alarm at- modern systems can be customized to tive health informatics service that Designing a real-time health system: tendant, it was really system design that led meet specific needs. HHS is implementing. How does an intelligent communication to the disastrous fire. Finally, COVID-19 places an additional In conclusion, the conference shed platform work? Interoperability is key. • Eliminate single points of failure. Build burden on you to provide communication a new light on the new directions Data from the EHR, nurse call, location in smart automatic escalations for critical options while protecting your staff and that our industry is taking, from the systems, lab, pharmacy, etc., are all consid- communications. And include clear con- preserving your supply of personal protec- integration of Artificial Intelligence ered inputs to the platform. The data is ag- cise contextual information. In order to tive equipment (PPE). In the midst of the to the move to Enterprise Imaging. gregated and subsequently integrated and make decisions, staff need not just the pandemic, it has never been more critical It is very encouraging to see how rules written that transforms individual alarm result, they need immediate access to keep staff and patients safe and con- our field keeps evolving and improv- pieces of data into meaningful and action- to the context. At Notre Dame, the context nected with each other. ing; I can’t wait until MIIT 2021 to able information. of the alarm was the location information, hear the stories and experiences our In the case of COVID-19, an intelligent which was neither clear nor precise. Benjamin Kanter, MD, FCCP, is the Chief speakers will share with us. communication platform enables the fol- • Send the right information to the right Medical Information Officer at Vocera, lowing workflow to take place: A patient has person on the right device. Using modern where he works closely with clinicians and Dr. David Koff is Chair, Department been admitted from the emergency depart- digital systems, communications can be engineers to co-design the next generation of of Radiology, McMaster University, ment with a presumptive diagnosis of made almost instantaneous by using mul- real-time communication and collaboration and a Staff Radiologist at HHS. COVID-19. It is very important that staff get tiple modalities. There is a time for voice solutions for hospitals and health systems. http://www.canhealth.com JUNE/JULY 2020 CANADIAN HEALTHCARE TECHNOLOGY 23 TO RECONNECT, WE MUST BREAK THE CHAIN.

Contact tracing is crucial to slow the spread of COVID-19.

We’re working with global health organizations and governments to automate contact tracing capabilities, creating links between patients, contacts and places. When we can identify those who are most at risk, we can ensure the safety and health of all citizens and pave the path to economic recovery. sas.com/ca/contact-tracing

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