UHN automates patient flow between departments

TORONTO – University Health Network is dealing with the challenge of moving patients from one facility to another by using a computer algorithm that has more than tripled referrals from its emergency room, its CIO said Thursday.

Speaking at a roundtable that was exploring patterns of practice in Canadian health care, Matthew Anderson said the algorithm, which was deployed about a month ago, allows referrals to be automatically generated to places like a community care access centre (CCAC). Like many care providers, University Health Network (UHN) is trying to improve the flow of patients from emergency wards to in-patient units. In many cases, patients who aren’t deemed sick enough are sent home, then wind up back in the ER not long afterwards. By automating the processes, Anderson said patients will be set up with the home care or other support they need.

The concept of navigation – helping patients make their way through the various places they need to access in the health-care system – is still largely manual and ad-hoc, Anderson told the audience. In some facilities, for example, the process of discharging a patient from an acute care bed to a long-term bed is only planned on the day of the discharge. That process usually entails making phone calls to a variety of other hospitals, he added.

“The way it ends up working is, the first (health-care facility) that calls back wins, and that’s where the patient goes,” he said. “That’s like taking a flight from Toronto to Phoenix and having to take a connecting flight from Atlanta, but only booking that connecting flight once you’re in Atlanta.” 

UHN has also set up electronic forms that will allow providers to begin planning for discharge at the pre-admission stage, Anderson said.

The other challenge around navigation is that patients often travel between facilities with little information about their previous treatment, Anderson said. That is why UHN recently created a network link between its systems and that of West Park Healthcare Centre, also in Toronto. Patient data, including their chart, is now being exchanged the day before they are discharged. 

“What’s great is that they don’t have to reorder tests. They can look at the test results from that day,” he said.

Mary Kardos Burton, Assistant Deputy Minister, Acute Services Division in Ontario’s Ministry of Health & Long-Term Care, said the province is trying to empower care providers with more IT through the establishment of its Ontario Health Technologies Advisory Committee (OHTC). The group is charged with guiding the uptake, diffusion and distribution of IT across the system, she said. So far, OHTC has conducted 65 reviews of various technologies, each of which are done over a 16-week period. 

“Everybody wants certain things – how do you decide what should be funded?” she said. “What we find is that in most cases it’s not something new that’s being used. If you introduce something, it’s an add-on.”

Kardos Burton said the OHTC reviews could be challenged and submitted through a re-review process. The intention is to create a “case law approach” to evaluating technology based on previous reviews, she added.

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