Ongoing Update – Cochrane Report – March 31, 2017

The following was sent on behalf of Damian Lange, Director Clinical Operations, NRGH, and Dr. Ben Williams, Medical Director, Oceanside, to all Nanaimo Regional General Hospital, Oceanside Health Centre and Dufferin Place physicians and staff

Dear Colleagues,

As outlined previously, Island Health President and CEO, Dr. Brendan Carr has asked that we provide you with regular updates.

The following are highlights from this week.

1. Letter from Dr. Brendan Carr
On Wednesday you should have received a letter from Island Health’s President and CEO indicating the Executive and Board’s support for the direction taken by NRGH leaders to support, rather than suspend, CPOE. The full letter can be found on the IHealth public website.

2. CPOE (and other) supports
You should have also received a letter this week from Island Health Chief Medical Information Officer Dr. Mary-Lyn Fyfe outlining key elements of a go-forward plan for the Electronic Health Record (EHR) at NRGH, Dufferin and Oceanside. These include supports for specific specialty areas as well as all provider groups, technology improvements, and new mechanisms for quality assurance, reporting and decision-making.

The go-forward plan and other changes will be reviewed at the next meeting of the Local Quality and Operations Committee on April 6, 2017, and refinements will be made as necessary.

The full letter from Dr. Fyfe can also be found on the IHealth public website.

Key supports include:

• Quality Assurance (QA) Communication Order
A new Quality Assurance (QA) Communication order has been developed to rapidly investigate and follow-up on issues as they arise. This order is intended to provide a real time Quality Assurance process. Between the hours of 0800-2200hrs, 7 days a week, a Nurse Informaticist will contact you within 15 minutes at the phone number that you must provide in the order (a mandatory field). After discussion with you, they will do a Chart and System audit to identify answers to questions you may have, such as:

o Where did my order go?
o The order I placed is not what I intended it to be?
o Who changed my order and why?
o I placed an order, but the Nurse is seeing something different.

• 1:1 Ordering Provider Coaching
One-on-one coaching with a designated Provider Education Informaticist to optimize your EHR use is available from 0700-2300, 7 days a week. Email:

• New devices and technology upgrades to ensure reliability and usability
A team of technical experts was on-site in February 2017 to diagnose root cause issues that are contributing to reliability concerns. Physical hardware is being upgraded and/or replaced and other technical changes are also being made. New computers are already in place, and more are on the way.

• Real-time, in-the-moment, paper-to-electronic Quality Assurance (QA) for orders
In response to NRGH medical staff concerns regarding CPOE, and specifically the view and management of orders across the interdisciplinary team, an in-the-moment quality assurance process will be made available to demonstrate the translation of paper-based orders into the CPOE enabled environment. The quality assurance process has been initiated with General Internal Medicine (GIM), and will proceed based on the needs by service.

3. Who can help me?
Members of the informatics team will be rounding regularly and be clearly identified with new black vests and name badges starting next week. Please say hello and ask for help if needed! Help is also available via the easy button, 1:1 coaching, CPOE and QA communications orders and the clinical solutions desk.

4. Welcome Dr. Dipboye
Many of you will have met Dr. Keith Dipboye when he was onsite providing external feedback on the EHR. Dr. Dipboye has a long history of leadership in health IT projects, most recently working on the lower mainland. We are pleased to welcome Dr. Dipboye to our Island Health team where he will be helping develop a system for rapid cycle change.

Yours Sincerely,

Damian Lange
Director, Clinical Operations, NRGH

Dr. Ben Williams
Medical Director Oceanside