Health application transforms patient transfer process

The Ontario Ministry of Health is preparing to build upon a relatively inexpensive software solution that has been credited with helping the province manage last year’s SARS crisis.

Last May, the government implemented the Ontario Air Ambulance Program’s Provincial Transfer Authorization Centre

(PTAC), which on Tuesday was named .Net application of 2003 by Microsoft Canada. The online process, which is still being used, consists of three stages.

An acute care or long-term care facility that must transfer a patient to another facility can visit PTAC’s secure Web site and fill in information such as the patient’s medical condition, which is then scanned by algorithms in the application, explained Michael Lonsway, vice-president, consulting services of DapaSoft Inc. of Markham, Ont., PTAC’s creator.

Lonsway said a simple transfer with no SARS concerns is automatically approved and the sending facility immediately receives its transfer authorization number.

“”If the system identifies anything that requires further investigation —— if there’s anything that might be an indicator of SARS or another infectious disease —— then the system will automatically route it to the second part of our system here, which is the PTAC back-office application,”” he said.

PTAC, which has paramedics constantly monitoring transfer requests, can forward medical questions to physicians on wireless handhelds, Lonsway said.

PTAC’s immediate impact was to automate the government’s paper-based transfer review process, he said, adding Ontario deals with an average of 1,300 daily transfer requests. “”This whole concept of reviewing transfers did not exist in Ontario prior to the SARS outbreak. Prior to the technology . . . it was just paper spewing out of fax machines and very limited tracking and a very labour-intensive process.””

In fact, under the old system there were no mechanisms for simple things like checking the status of a transfer request, added Frank Kim of the Ontario Air Ambulance Base Hospital Program in Toronto. “”There were long delays caused because people would take piles of paper and then another batch of files would come in and that would get stacked on top. So the electronic system has really driven a lot of efficiencies into the process.””

But the overriding benefit of adopting DapaSoft’s technology is the government now has a safer system, Kim said. “”The obvious (advantage) is the infectious disease control, but also it really puts an element of accountability into the system.””

The Ontario Air Ambulance said it’s mulling proposals to upgrade PTAC, which was recently expanded to screen for other infectious diseases. “”It’s capable of handling the bird flu but to date it’s not,”” said Kim.

Kim said future improvements to the system, which cost the province less than $500,000, will likely include researching data collected during nine months of patient transfers since PTAC was implemented. He said this may mean looking at other infectious, respiratory diseases such as flu outbreaks.

DapaSoft’s application can be used “”anywhere where you’ve got a front line of defence that’s doing a repetitive, manual task,”” whether it’s a police officer recording a driver’s licence number or a physician writing down an Ontario Health Insurance Plan number, explained Ben Watson, national marketing manager, developer and platform group, Microsoft Canada of Mississauga, Ont.

He added that as long as these types of health care projects are based on open standards, systems can link together and provide a means for researchers to look at aggregate data without jeopardizing people’s privacy and personal health information.

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