An Integrated System to Improve Data Sharing and Quick Accessibility of Patient Information within Palliative Shared-care Teams in HNHB-LHIN (Hamilton Niagara Haldimand Brant - Local Health Integration Network)

Abstract

Delivery of palliative care to patients in a patient’s home, where they live with their family or in a retirement or nursing home, is an improved, shared-care team approach of providing quality healthcare services at the end of a patient’s life to reduce pain and stress. The palliative care shared-care teams in the Local Health Integration Network (LHIN) for Hamilton Niagara Haldimand Brant (HNHB also called LHIN4) manage patient health care through documents and trackers created and retained by providers within the circle of care, using several different systems and communication tools. These systems are not currently integrated and are unable to connect in a way that enables the preview, transfer, and receipt of data between these systems to support the needs of palliative care users. The primary objective of this thesis is to provide a proposal to improve the user experience of palliative care users through enhancement and integration of some of the systems currently in use. These include OSCAR EMR (Open Source Clinical Application Resource Electronic Medical Record) Hospice – InfoAnywhere, CHRIS (Client Health Related Information System) and Clinical Connect. Integration of these systems will address other limitations the shared-care teams are facing, such as communication, system or organizational policies and privacy and information security concerns that stem from the sharing of patient information across the systems, to support a shared-care team’s ability to provide patient care. During this study, an extensive requirements gathering and analysis was carried out: in-person interviews and teleconference meetings, brain storming sessions on the current systems and review of the secondary data with key stakeholders in the palliative care community. The local hospice sites were visited and extensive input was received from hands-on palliative shared-care teams and hospices across the HNHB LHIN, to ensure that the project team implemented their expressed needs into the integrated solution. The used case and prototyping approach of gathering the requirements is then used on the initial requirements gathered by sending out an initial draft to the users and stakeholders for their review, changes and additional requirements, hence fostering communication between the business and the development teams each time the brain storming session is held to review the refined requirements, resulting in the development of a high-quality Business Requirement Document (BRD). The project manager, lead developer, software architect, and users/testers were all utilized throughout the entire delivery process to ensure they were all in sync with the documented requirements. This lays the foundation for programmers to implement a quality end product with a technical solution that will enhance and integrate the systems to improve the user’s experience at the point of care.