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University Health Network transforming patient care


When the University Health Network needed a better way to prepare clinically obese patients for bariatric (weight loss) surgery and follow up care, it partnered with IT consulting firm SyLogix to develop a solution that has revolutionized its patient care process.

The UHN Advanced Clinical Documentation (ACD) mobile tool revamps a complex and entirely paper-based system to allow effective and efficient documentation of a healthcare journey involving multiple-parties and multiple treatment modalities.

Preparing obese patients for bariatric surgery is a sensitive and intricate process. They must see practitioners from five different disciplines in a specific order.

Initially, they consult with a nurse before seeing a social worker, and then a dietitian. From there, they must be interviewed by a psychiatrist or psychologist, and finally the surgeon who must have all of the information collected by the other practitioners.

“This is a life-changing process for a patient,” explained Victoria Ramirez, senior project manager for IT transformation at UHN. “The preparation involves everything from dietary changes to monitoring the patient’s mood and sleep patterns. All of these steps, and the hand-off between those steps, is critical.”

There was no electronic record management system designed to support the creation and exchange of these records between all of the practitioners, but in 2012 the UHN team began thinking about what it would look like.

Michael Caesar, senior director of information management at UHN, said the organization didn’t simply want to digitally replicate existing paper-based forms. “This project tried to scrape away the old way of doing things, and look at it in a different way. We looked at what information the care provider needed to care for the patient, when they need it, what do they have to capture during their interaction with the patient and how is that information shared downstream?”

Rethinking the information gathering process has also led to some longer-term benefits, explained Dr. Sanjeev Sockalingam, the psychiatry lead for the project.

“The ability to document post-operative assessments allows for historical data to be easily viewed and trended, and clinicians will be able to pick up on signals much faster with longitudinal data,” Sockalingham said. “The ability to pull data to trend how the patient progresses is a quick win for the application.”

The project was completed in 2014, and the team has had time since to evaluate its results. It found a 33% increase in the number of patients seen within three months of deployment, and the system slashed surgery wait times in half from 128 to 63 days.

On the financial side, Ramirez notes that dictation time used by clinicians fell by 80%, representing a total saving so far of $240,000.