July and August represent the start of a new fiscal year for MedShare and what will it bring?  Before I answer that question, let’s reflect on where we have been. 

Almost every jurisdiction in Canada recognises eHealth will drive efficiency, capacity and quality in health care.  The Canadian Homecare association released their study, ICT in Home care, drawing the following recommendation;

“Policymakers, funders and home care leaders...    [should] invest in the implementation of an electronic clinical information system for home care that includes all elements of service delivery and is available at the point of care, wherever that service is provided.”

In their 2006 report, Clearing the Road to Quality, the Health Council of Canada recommends that the government, “Stimulate the rapid adoption of electronic health record systems by health care providers.  Providers need support in making the transition to electronic information systems...”.  And this comes at a time when 93% of North Americans believe an Electronic Health Record will improve the quality of care.

Aging at Home and Aging in Place programs recognise the increasing need to deliver assistance in daily living and chronic disease management for our aging baby boomers. The government is looking at ways to coordinate home care and provide continuity of care which is driven by information and communications technology (ICT).

It appears that the stars are aligning for full implementation of eHealth in home care.  When I refer to eHealth this is more than admission, billing and scheduling.  Agencies are ready to empower their health care workers with mobile access to clinical information, decision support tools and care documentation.  In the Research in Motion sponsored study “Wireless Home Care Solution”, the author found that the return on investment for technology can be as high as 960%.

MedShare has learned several important lessons that can speed adoption and increase the effectiveness of ICT.

100% system availability is essential for the successful adoption of point of care solutions.

Care coordinators and mobile workers will use real time communications and secure email to innovate and optimise many informal processes.

Mobile clinical solutions can be integrated with their existing “back-office” software

Agencies Showing Innovation

MedShare has seen a lot of eHealth activity in the last year including several marquee client projects.

Saint Elizabeth Health Care selected MedShare’s eMotion application as the basis for their Nurse eCharting solution. MedShare and SEHC staff integrated the system with the existing Procura billing and scheduling system. Nurse leaders developed a set of electronic charts for use in home care based on their existing paper forms. A Care Planning module is now used at the point of care and securely shared with others on the care team. The eMotion platform is being expanded to include wound care assessment and review enabling 1,100 nurses access to provincial ET specialists while in the home. SEHC are truly innovative and are investing to provide better home health care.

WeCare has seen the successful adoption of the BlackBerry by their personal support workers. A pilot group of personal support workers have been using the BlackBerry for 8 months. Real time access on the Blackberry is producing scheduling efficiencies while improving accuracy in the billing process. Care coordinators have used the secure email channel to solve many small yet significant communication challenges. This application caught the attention of Minister Smitherman who requested our presence in his office for a demonstration and business case.  The home care aides love the BlackBerry and the MedShare application!

Therapy Partners is the first agency we are aware of that is now fully electronic, using therapist self-serve access from their home office and BlackBerry access from the point of care and connected to a central electronic health record.  At Therapy Partners the BlackBerry is delivering clinical information and care documentation tools that help health care workers make more informed decisions.  Therapy Partners are featured in a Research in Motion published case study for their innovative use of BlackBerry technology

MedShare is focusing our research and development efforts on the point of care tools used by nurses, therapists and personal support workers.  Our two software platforms, eMotion and BlackBerry are being developed to provide workflow automation, integration with others in the community of care and making information available to clients and their care givers.
We see the BlackBerry becoming a low cost pervasive personal medical assistant used by all health care workers.  Nurses will use the BlackBerry to wirelessly capture vital signs in the client’s home.  Care coordinators will be able to track the location of their staff with the GPS-enabled BlackBerry.  Time sheets and expense forms will be generated automatically from the data collected, eliminating inefficient paper processes.
We see the advent of personal health records potentially changing the way home care fits into the community of care. 

“Home care is the first mile of the health care system”

The statement above makes us think about the relevance of home as a care location.  It is the first choice as a treatment location for most of us (except the doctors).  We have the best support network in the home with friends, family and neighbours providing an effective care giver network.  And in the case of chronic disease, viruses and infection the health outcomes are better. 

To effectively treat people in their homes, we need access to clinical information and care resources.  Information technology can provide the necessary tools to the home care provider, informal care giver and the client.  So why not put the technology in the hands of the client?  Let the client measure and manage their own care.  This will certainly empower the client and result in far greater engagement in their health care. 

I believe tele-homecare can be effective when supported by the health care team.  You might think of daily “virtual nursing visits” in addition to weekly nursing visit by the care professional.  Vital signs capture, medication compliance, patient education, and communication can be delivered in the home.  Results are monitored by the care team and alerts generated when the client's status goes outside acceptable parameters.  In essence, we are talking about making the client part of the care team. 

If home care is the first mile of the health care system, then tele-homecare puts the client behind the wheel.  Clients participating and controlling their own health care.

Barry Billings, President, MedShare
barry.billings@medshare.com

We are pleased to introduce the newest feature to MedShare: Care Planning!

Bringing MedShare’s Care Plan solution to the point of care provides your agency with a powerful instrument for continuous quality improvement through outcomes data analysis.  The program is made up of two integrated components:

• A flexible administrative component designed to enable your clinical leaders to develop and maintain a suite of standardized forms for use by your care workers, and;
• A seamlessly integrated clinical component that ties into the client’s Electronic Health Record.

The administrative component enables your clinical leaders to create and configure care plans in three phases:

• Define the elements – Define and organize the problems, issues, interventions, goals, and reasons for goals not met.  Arrange the elements into categories and sub-elements to make them easier to find and maintain.
• Create a Template(s) – Using a visual tool, choose from a list of options for defining the look of the care plan.  Define peripheral information to display, such as client profile or service-related information.
• Build the Forms – Select a problem and associate the issues, interventions, and goals to the specific problem.  Indicate in what order these elements should appear on the care plan.

The clinical component follows on MedShare’s vision of providing technology at the point of care.  Care workers can complete and update care plans directly from their PC, laptop or tablet computer.  This component is seamlessly integrated into both our HC and eMotion products.  The care worker can complete a care plan in two straightforward steps:

• Choose the care plan form(s) – From the client’s EHR (Electronic Health Record), the worker chooses from a list of forms, either creating separate care plans for each problem or a single consolidated plan.
• Complete the plan – By simply choosing from the pre-defined list of issues, interventions, and goals, the worker can quickly construct the client-specific care plan.

There are endless data analysis opportunities once the care plans become electronic.  Combined with the existing referral information, data collected from the plans can be mined and transformed into meaningful patterns for analysis.  Conclusions can be drawn for the purposes of improving quality of care and operational efficiencies.

MedShare and Saint Elizabeth Health Care are teaming up to develop wound care software!   Wound Care involves the comprehensive assessment, planning, and treatment of wounds in the home care setting and includes consultation with wound care specialists, called Enterostomal Therapists (ET), to augment the home care nurse’s ability to diagnose and treat complex wounds. 

The wound care application is intended to be a standard tool that each visiting nurse will have access to in the home.  ETs will be able to access information and recommend treatment to patients as required.  Data validation and workflow will assist the nurses in completing assessments while insuring quality and best-practice implementation.

The project is now underway, with MedShare and SEHC staff working closely together to build a wound care application that is fully integrated with MedShare's eMotion application, thereby being able to run with or without an internet connection.  The application is designed to be intuitive to allow each and every nurse to access the features and functions with minimal training. 

As part of Canada AM's series on how Wireless Technology is changing Health Care in Canada, Dr. Marla Shapiro profiles the eMotion tablet computer and electronic wound care technology. St. Elizabeth Health Care and MedShare have partnered to build the Wound Care application that will be built upon MedShare's expansive home health care suite.

Watch the Canada AM interview.

MedShare eMotion
As MedShare focuses on bringing technology to the point of care, MedShare eMotion continues to evolve based on input from our customers.  Geared toward nurses and therapists, the application allows professionals to access and add to a client’s electronic health record without the need for an internet connection.  We are working to bring more capabilities to the point of care to increase efficiency, improve decision support, reduce errors, and enhance job satisfaction and employee retention.

MedShare HC
We continue to improve MedShare HC, based on valuable client feedback and emerging industry trends.  We have acted on our client input by building out a series of enhancements to improve the intake, scheduling, and billing processes.  By growing our administrative foundation, we persist in our efforts to improve data accuracy and increase productivity back in the office, while providing the groundwork for our mobile solutions.

MedShare™ for BlackBerry®
Working closely with our Trail Blazer partners and our BlackBerry Expert Panel, we have been working to further enhance our mobile application in response to their desires and concerns.  Our recent releases incorporate significant data usage improvements, in addition to several new features including: permission-based access to functions; visit check-in; GPS coordinate capture at check-in and checkout; along with better replication error handling.  The success of this product is directly related to the input and feedback contributed by our customers.