eNotifications: Timely Improvement of Patient Care and Health Outcomes
e-Health ePoster Library. Labadie E. Jun 5, 2017; 167126; EP04.03
Eric Labadie
Eric Labadie
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Abstract
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Purpose/Objectives: eNotifications are events triggered by patient encounters within a health care setting, such as a hospital department (emergency department or in-patient) or a health care program (e.g. a Continuing Care Access Centre (CCAC)) or a patient status change in a clinical repository. Typically these brief messages are delivered to recipients (e.g. primary care physicians’ electronic medical record, hospital information system (HIS) or a CCAC) in near real-time. eNotifications aim to support better patient care and health outcomes through the timely availability of patient information (e.g. CCAC patient status, Health Link status, presenting condition) following trigger events such as hospital admit, transfer, discharge. What is the best approach for delivering eNotifications to recipients within the EHR eco-system?

Methodology/Approach: Ontario’s current eNotifications landscape: Hospitals currently send multiple HIS admission/discharge/transfer (ADT) feeds to various recipients, including the provincial client registry (PCR), the Ontario Association of CCACs (OACCAC)/CCAC’s client health and related information system (CHRIS) and clinical data repository (CDR). Each of these ADT feeds differs slightly with respect to the type and format of the information it carries. The CHRIS system transforms the ADT message to a hospital report Manager (HRM) document targeted to the specified EMR recipient. An eNotification HRM document notifies the primary care physician that their patient has been admitted or discharged from hospital. The CHRIS system also sends an eNotification message to the OACCAC patient’s care team (e.g. registered nurse, meals on wheels) to let them know that the patient is in hospital. Finally, the CHRIS system sends an eNotification message to the sending HIS system about the community care status of the patient. Other circle of care partners have also asked to be notified when patient health status is changing.

Finding/Results: Current electronic eNotification options exist as point-to-point interfaces to several solutions, creating multiple connections for health service providers to manage. This forces hospitals and clinics to maintain high IT resource levels, which is neither cost efficient nor effective. As Ontario builds centralized repositories and registries, we also need to provide eNotification capabilities for these EHR assets.

Conclusion/Implication/Recommendations: A provincial approach to eNotifications presents an opportunity to coordinate and streamline Ontario’s investments in this type of communication, and to avoid implementing multiple point-to-point solutions to deliver eNotifications. eNotifications should be sent from health providers through a central solution to regulated or unregulated practitioners (recipients) who have a time sensitive need to know about the patient’s disposition, in order to facilitate delivery of patient care. eHealth Ontario is currently building a prototype eNotification solution in its Innovation Lab to validate design, feasibility and clinical value .

140 Character Summary: eNotifications is a centralized solution to support better patient care and health outcomes through timely availability of patient information.
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