Specialty Leads Work Collaboratively on Clinical Documentation and Order Sets

In March, 44 members of Island Health’s medical staff started in their roles as IHealth Specialty Leads, supporting efforts to advance integrated, region-wide use of the Cerner electronic health record (EHR) across programs and services. Medical staff who represent different surgical and medical specialties will work with their colleagues to harmonize electronic clinical documentation practices and digitized order sets within their specialties.

The group came together in February for the first of several preparatory sessions. During these sessions our specialty leads learned more about the IHealth project, best practices in use of the electronic documentation tools and the need for order set review and development. The group was also introduced to IHealth governance structures and their work’s relationship with Island Health’s existing quality structures.

“This is such a welcome and necessary step, and we are so pleased to see the interest and dedication from all of these members of the medical staff in quality and in playing a key role supporting their peers through this significant change in the way we work,” said Dr. Mary-Lyn Fyfe, Chief Medical Information Officer.

Two Specialty Leads share their experience

Dr. Pooya Kazemi has worked with fellow anaesthesiologists across the region for the past two years to prepare for electronic clinical documentation and to have a single set of Island-wide anaesthesia order sets.  In his leadership role with the IHealth Specialty Leads, he will share the experience he has gained in his specialty, as well as on site during the recent activation of electronic clinical documentation at Royal Jubilee Hospital.

“I think the most important thing is to have Island-wide representation and bring the various departments across the Island together,” Dr. Kazemi said. “That’s what this new project is about: ensuring the needs and concerns and requests of all the sites are heard and addressed, but also that we standardize things to become one system, one speciality as much as possible.”

Dr. Alyson Osborne, a geriatrician and specialty lead for her field of practice, is looking forward to working with her colleagues across the Island to expand collective use of the EHR.

She arrived at Island Health from Ontario after completing her training 18 months ago, and brings a perspective that she hopes will benefit the specialty leads’ work. During her residency at Western University, Dr. Osborne became familiar with PowerChart when it was rolled out with CPOE.

“I’m quite familiar with how it works for order entry, so I thought this position seems like a good fit for me,” she said. “And personally, I’ve been looking for ways that I can try to take on more of a leadership role in my division and here in Victoria in general.”

Dr. Osborne shared examples of what geriatricians might consider when weighing in on harmonization of order sets and electronic documentation for their discipline.

“I’m hoping we can bring a geriatric lens to some of the generalized order sets that will be used over and over for patients who are elderly, and help prevent them from getting medications that we would rather they not get, or tests we’d rather they not get,” she said.

“It’s really important that geriatricians are a part of this, because so many people who are in hospital are elderly and they’re not all seen by geriatricians. But by being part of creating these order sets that hospitalist physicians will use, for example, we will get a chance to have input even if we’re not directly involved.”

Associate Chief Medical Information Officer supports onboarding

Dr. Eric Shafonsky, Associate Chief Medical Information Officer, has been working with the IHealth Specialty Leads group to help define their role and support their onboarding. He says the engagement of the specialist physicians in this work fits with the goal that the IHealth initiative “is clinically driven and led.”

Dr. Shafonsky points to what he considers an important final objective for the group organizing a panel of peers who will act as subject matter experts (SMEs) in support of the change.

“Interdisciplinary, inter-specialty review of harmonized orders and clinical documentation tools makes it easier for us to actually adopt once it’s available to use on the electronic platform,” he said. “We can all benefit from efficiencies. One of the key principles of clinical order sets is they are grounded in their content by SMEs, so they should be decision support tools, as well as efficiency tools. It’s important to remember that technology is an enabler here, but quality improvement, consistency and standardization are key drivers behind this long-term change we are making.”

See below for a list of IHealth Specialty Leads; this list also includes departments/divisions that continue to recruit for the position.

IHealth Specialty Department Leads

IHealth Specialty Leads – Divisions of Medicine

IHealth Specialty Leads – Divisions of Surgery