The Ottawa Hospital (TOH) recently updated its electronic health record system that provides a platform for future advanced management of patient records.
The hospital’s record system is called Oacis, a Web-based product developed by the Canadian-owned company Dinmar.
The upgrade that TOH recently completed replaced the old browser with Dinmar’s Java-based browser. Valerie Gamache-O’Leary, director of Information Systems at TOH, said the new browser is “very elegant, very impressive,” and simplifies work processes for information systems staff. “The beauty of a Java browser is that we don’t have to visit every computer a doctor may use to view Oacis,” she said.
Oacis operates like a collection and viewing tool. It collects data about patients from ancillary services – for example, a test result from the radiology department – and arranges the information in a Web browser for the patient’s doctor. The system allows doctors to arrange information in different tables and to trend patient patterns in one panel.
The days when doctors would have to collect papers from every end of the hospital to make a diagnosis for a patient are gone. “You can get the information you need with just the click of a button,” said Gamache-O’Leary.
The network gives more than 6,000 clinicians at TOH immediate access to patient data, pharmacy orders, radiology images and other information necessary to deliver quality patient care. Knowledge bases embedded in the system can alert the doctor to important information, such as conflicts in medications prescribed to a patient.
The upgrade also provides a platform upon which the hospital can build advanced functionality. Over the next few years, Dinmar and TOH will roll out a series of improvements aimed at easing the paper burden on doctors and nurses. A pilot project will help doctors write electronic discharge summaries. Another will computerize physician orders.
With the current set-up, doctors’ orders are written on paper and sent to the proper departments where they are transcribed. In the future, a computerized physician order entry will automatically send the doctor’s orders to departments undertaking the work. This information will be shared across the network.
The driving force in the implementation of Oacis at TOH was operation challenge created when Ottawa-area hospitals and ancillary services were amalgamated into TOH nearly six years ago. The hospital, which services 1,016 beds, 53,000 inpatient episodes and 627,000 outpatient visits annually, needed a way for clinicians working in so many different locations to consult with one another.
“Picture that in a paper world,” Gamache-O’Leary said, “You couldn’t do it.”
TOH chose Dinmar and Oacis to communicate between locations and to allow doctors to gain a more complete medical profile of their patients.
Gamache-O’Leary said the open source compatibility of Oacis was one of the key selling points of the product. She said purchasing an EHR system from a vendor who required TOH purchase a suite of products would have been an unwieldy venture.
“We’d have to do a forklift replacement of everything we’ve done and spent millions to acquire,” said Gamache-O’Leary.
Ian Robinson, Dinmar’s executive vice-president and COO, said companies that entrench themselves in the market by limiting the compatibility of their products have an unrealistic approach to business. The health-care system simply cannot afford to replace software across an entire medical lab every time a hospital wants to change its EHR system.
Dinmarhas worked with the Ottawa Hospital for many years. The hospital has been an early adopter of Dinmar’s products, which were developed and designed with the help of the hospital’s clinicians.
Oacis is in operation in other healthcare facilities in North America. The system is used in all hospitals in the state of South Australia, giving doctors in any hospital in the area a complete record of their patients.
“It’s really a visionary implementation. Hopefully this is what will happen in Ottawa,” said Robinson.