In the three years since the approval of University Health Network’s last information management strategy, care@uhn, significant resources have been invested in developing a highly integrated, content-rich and reliable information infrastructure. As a result, UHN is effectively using information and technology to support the delivery of care and business processes. Despite the progress made in reducing the organization’s dependence on manual systems and paper-based information storage, there remains a significant opportunity to leverage the investment made to date and profoundly improve patient care through increased access and use of information and technology.
While the long-term vision for information management established in care@uhn remains relevant, the strategic objectives and implementation plans needed to be updated to align with organizational, industry and technological developments, including:
§ UHN’s new corporate strategy, Strategic Directions 2011, identifying specific objectives for the use of information and technology at UHN;
§ SARS and its impact on hospitals, highlighting the need for improved access to information from remote locations to support ongoing operations in the event of an external disaster;
§ Investments at the national and provincial levels to accelerate the use of technology in health care, presenting new infrastructure funding and partnership opportunities for UHN;
§ Increasing public awareness of the role of information and technology in health care especially around patient safety;
§ Developments in technology, introducing new opportunities to deploy low-cost reliable devices that support decision-making wherever information is required.
As a result, in February 2004, UHN introduced Information Management Strategy 2009: Information Enabling Care, moving beyond the traditional theme of reliability and availability of technology and focusing instead on the use of information and technology to profoundly change and improve the delivery of patient care.
To be successful, we realized this strategy requires significant involvement and engagement from UHN and external stakeholders, particularly the clinical community – not an easy task to accomplish for a 1,000-bed integrated teaching health-care organization that includes Princess Margaret, Toronto General and Toronto Western hospitals. We would need to build on the previous information management strategies, while articulating the future information management vision for UHN and aligning with key internal and external developments.
There was no place better to start than with our Clinical Decision Support (CDS) technology.
Clinical Decision Support
We wanted to improve our utilization numbers, so we implemented Misys’ Order Entry system and it worked. For example, let’s look at a drug called Troponin, an appropriate test used for indicating risk in suspected myocardial infarction patients. The modified order screens improved effective ordering by non-cardiologists less familiar with the intricacies of cardiac markers. If they were to inappropriately order the drug, they would receive an advisory indicating why it was not needed as well as additional information supporting the advisory (e.g. online articles).