Next Generation CareSafety and Quality in the Digital Age

Jennifer Zelmer (@jenzelmer)President, Azimuth Health GroupMay 6, 2016

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2 Healthcare Doesn’t Look Good on Paper2

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Challenges Of Complexity: Patients Seeing More Doctors More Likely To Report Errors

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The Opportunities & Challenges of a Data Deluge

MINS/ARTICLEHOUR/DAY1 15

OF ARTICLES

0.3%

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The Digital Advantage & What Canadians Say

Read

Find

Share

Use

Learn

96%keeping health records electronically important (Nielsen, 2016)

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History KnownRegular doctor/place of care

always knows important information about medical

history

HEALTH ITUSED TO LOOKUP AT LAST APPOINTMENT?

PATIENTS MORE LIKELY TO REPORT

Receive ResultsAlways receive lab and

imaging test results

Get RemindersReceived reminders about

needed preventiveor follow-up care

Source: Harris Decima survey for Canada Health Infoway, 2012

!

V

b

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7 Are We There Yet?7

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Diagnostic Images in Hospitals

100%

Dispensed Drugs63%

Lab Test Results

88%

Clinical Reports

99%

Telehealth Videoconferencing

in 98% of Hospitals

Source: Canada Health Infoway. Forecast availability as of March 31, 2015. Digitization does not measure the extent of use by providers, but rather the information and systems that are in place.

Storage & Connection to Point of Care

77% of GP/FP

using EMRs

73% of CommunitySpecialistsusing EMRs

Digitizing Core Health Information

Client & Provider

Demographics100%

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EHR Use is Growing

9Source: Canada Health Infoway. 2014/15 Annual Report.

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• Includes telehealth, drug information systems, diagnostic imaging solutions, and community-based EMRs

Studies estimate value of access, quality, & productivity benefits at $13B for 2007-14

Source: Canada Health Infoway. 2014/15 Annual Report.

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Patient online solutions still relatively new in Canada

< 1 in 10have

accessed

> 8 in 10 want

access

Sources: Ipsos Reid surveys for Canada Health Infoway, 2010 & 2013

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12 Safety and Quality in the Digital Age12

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First Do No Harm: COACH eSafety Guidelines

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Opportunities for Smarter, Safer Care

EMPOWERED PATIENTS

SEAMLESSSERVICES

INFORMED CARE

Scaling up consumer health solutions &

OpenNotes/OurNotes

From connected systems to connected

services

Enabling a high-performing learning

health system

⥁ j

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Faster test results: BC patients

accessing lab results online more than 2X as

likely to get results in a few days, vs other

access options (e.g. call or office visit)

77%of Nova Scotia PHRusers said that they felt more involvedwith their care

47-63%of patient online solution users said they avoided an in-person appointment (2014)

Empower Patients ~ Streamline Care

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4 of 4 case studies showed âhospital stays

&/or ED visits

Pat com

pliance

Pat satisfaction

Quality of life

ED

vis

its/

hosp

ital

sta

ys

Car

egiv

er b

urde

n

Per

cli

ent

heal

th $

Source: Ernst Young Summary of Documented Benefits of Remote Monitoring for Chronic Disease (2014)

Managing Serious Chronic Diseases

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Quality-Focused, Seamless Services

49%Reduction in inappropriate opioid prescriptions when Pharmanetintroduced in BC

88%Clinicians using Nova Scotia’s EHR say it improves quality of care

8-80%Improvement in e-medication reconciliation at NYGH

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Source: National Physician Survey (2013)

Change in Quality of Care Reported by Family Physicians since Implementation of e-Records

01020304050607080

<1year 1-2years >2yearsBetter MuchBetter

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• EMR practices identified patients who needed 6 types of care more quickly

• Also report higher confidence in results

Source: https://www.infoway-inforoute.ca/index.php/resources/reports/benefits-evaluation/doc_download/548-population-health-management-challenge

73% of Canadians think they should get reminders of needed preventive/follow-up care; 30% did (2012)

EMRs Outperform Paper Records for Preventive or Follow-up Care

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20Making the Right Thing to Do the Easy Thing to Do20

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“It’s better for everyone when health care IT is used meaningfully. … The question is, if it’s so good, why aren’t we there yet? For everybody? For all the patients, not just the lucky ones in modernized systems? ….”

“The reason is because it’s hard. Moving from paper legacy systems to modern IT is a big change. New hardware, new skills, new attitudes, new assumptions. It’s reallya new culture and you don’t get there in one step.”

Source: Don Berwick speaking at meaningful use press conference, July 13, 2010

Don Berwick on health IT as culture change

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Essentials of Change Management

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Care that is centred onpatients & families

Leveraging digital health

Acceleratingquality & safety

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The Direction of Travel

DIGITAL HEALTH &

VIRTUAL CARE

IN-PERSONHEALTH

SERVICES

RIGHT CARE~

RIGHT WAY(in a digital world)

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@jenzelmer

www.azimuthhealthgroup.ca

Thank You

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