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Vancouver Coastal Health, Provincial Health Services Authority and Providence Health Care

Documentation flexibility aids the adoption of the CST project


Releasing the true potential of a technology transformation project is made easier when the end users are keen to adopt it, and they’re more likely to do that when it works well for them. This has been a consideration of the Clinical & Systems Transformation (CST) project, which is improving the safety, quality, and consistency of patient care across three organizations in British Columbia.

Vancouver Coastal Health (VCH), the Provincial Health Services Authority (PHSA), and Providence Health Care (PHC) are working with Oracle Health on the system – based on Cerner Millennium®. Known locally as CST Cerner, the system is helping to establish common standards for both clinical and administrative staff. These include workflows, order sets, clinical guidelines, integrated plans of care, and a shared electronic health record (EHR).

In 2018, the CST journey began 2018 with VCH facilities: Lions Gate Hospital, Squamish General Hospital, Pemberton Healthcare Centre, and Whistler Healthcare Centre. Since that time, the CST project has been working on ways to better engage with providers to support the adoption of the system – as Dr. Johanna Bonilla, CST’s physician experience team director puts it, “it is a journey”.

As with most journeys, it begins with users taking the first step. “We start to prepare and show providers the system as early as possible through what we call ‘familiarization sessions’. We initiate conversations about what is going to be hard to change and it helps us tailer the learning both to the providers’ specialties and site specific workflows,” indicates Dr. Bonilla.

The ability to accommodate more than 50 medical specialties in the system is a key factor to support greater adoption of CST Cerner, as the system is flexible enough to allow users to focus on the information that is pertinent to their role. As Dr. Bonilla explains, “Each medical specialty has unique information requirements and we work with each to adapt the system to their needs.”

This flexibility “marks a huge step towards adoption”, according to Dr. Bonilla. “CST Cerner is a tool that I am able – as an end user – to fit my needs and what I do day to day”.

That certainly seems to be the case at PHSA following its go-live at BC Children’s Hospital and BC Women’s Hospital + Health Centre in February 2022. Across the organization, 99.5% of documentation is now being done electronically, with CPOE averaging 95.7% from October to December of 2022.1

Health professionals in acute care facilities use a fully electronic closed-loop medication management process. This helps improve patient safety by making sure each medication is prescribed and given to the right patient, in the right dose, at the right time, with the right documentation.

The user-friendliness of the CST Cerner system didn’t happen by chance – clinicians have been involved in the design process throughout, as they are experts in their specialty and requirements. Dr. Bonilla confirms, “When we identify our provider champions, we engage them as early as possible, we get them to know the system, play with the system, and help us to design the system.”

A system that makes life easier for providers has benefits for patients too. With real-time access to the information the providers need, patients will spend less time repeating themselves and undergoing duplicate tests, enjoy safer medication management, and receive quicker access to therapies and lab results.

As Dr. Bonilla concludes, “The end result is better continuity of care for patients regardless of where they are receiving care across VCH, PHC, and PHSA. Clinicians will have the most up-to-date information for the patient.”

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1 Data sited from LightsOn network for Q4 2022.

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Client outcomes were achieved in respective settings and are not representative of benefits realised by all clients due to many variables, including solution scope, client capabilities and business and implementation models.