How many healthcare providers are allowing patients to update their own electronic health records? I don’t mean the patient’s personal record – I mean the record maintained by the hospital or primary care physician.
At Baycrest, that’s what’s happening. This type of breakthrough or radical innovation occurs when clinicians and informatics experts come together to solve a problem and focus on what’s best for the patient and the workflow of the clinicians. Too often, we fall back on the rigid structures of our electronic health records (EHRs) and our traditional ways of documentation, and fail to consider the alternative possibilities. Don’t get me wrong, this wasn’t an easy solution – it involved multiple systems (proprietary EHR, SQL database e-forms and a scripting solution); courage to let patients in the post-acute, palliative care setting record their symptoms on a tablet; and clinicians who would not just support the project, but champion it.
On our Palliative Care Unit at Baycrest Hospital, patients are now provided with tablets to do their own self-assessment of key symptoms – recording their levels of pain, activity, nausea, depression, anxiety, drowsiness, appetite, and sensation of well-being. The sum of the scores reflects the level of symptom distress that the patient is experiencing. Completed on a daily basis and automatically uploaded into the EHR where the scores are graphed and displayed over time, the information helps clinicians monitor changes in the patient’s well-being – an essential indicator in any healthcare setting, but critical for those in palliative care.
This mobile solution – creating a mobile app of the electronic version of the Edmonton Symptom Assessment System best practice tool – was not mandated by a provincial or federal healthcare strategy. It was not a project that received special funding. It was simply a solution to a problem that arose at the grassroots level on a hospital unit and was solved at this level. It came about from a desired outcome to reduce duplicate data entry and manual calculations and enable patients to actively participate in providing information on their own assessments of their well-being. This was healthcare and technology coming together to improve the world of the clinician and the patient. It’s an exciting success story for eHealth that has caught the attention of one of Canada’s most respected business magazines (story coming out this fall). It’s a success story that demonstrates Ontario’s strengths in grassroots innovation, in generating marketable solutions, and competing in today’s fast-changing global economy.
Baycrest is unique in the world, combining a comprehensive system of care for aging patients, one of the world’s top research institutes in cognitive neuroscience, dedicated centres focused on mitigating the impact of age-related illness and impairment, and unmatched global knowledge exchange and commercialization capacity.
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