It has taken 10 years of development, but one of the largest electronic health record projects ever to be undertaken in Canada has reached full operational capability.
The Canadian Forces Health Information System (CFHIS) has now been fully deployed to 44 sites where the Department of National Defence provides health services to Canadian Forces members. The project is now in the process of closing out.
CFHIS, a joint project between the Canadian Forces Health Services and the Information Management Group within DND, addresses many of the shortfalls associated with paper-based health and dental records by implementing a computerized solution to better manage the everyday delivery of medical and dental services. CFHIS supports patient registration and scheduling, clinical notes, results review, electronic prescribing, allergy/drug interaction checking, immunization tracking, laboratory, diagnostic imaging and dental treatment.
In very basic terms, the system allows the whole business process of delivering health services to flow more efficiently; it integrates everything and puts the data at the fingertips of the caregivers in order to provide a holistic view of the patient within a secure environment.
“It is this integration that makes the system unique, compared to other electronic health records systems in existence,” said Satya Puttaswamaiah, the CFHIS project manager.
“Canada is a leader in this and the CF is a leader in Canada. We’ve integrated medical, dental, lab and radiology information management across 44 clinics. It’s deployed internationally; it’s on ships and it’s a secure environment. This type of project with such a broad scope has not been achieved in any Canadian jurisdiction, whether federal, provincial or municipal. So it’s one of a kind,” she said.
CFHIS is contributing to helping CF members receive the best healthcare possible wherever they are located. Information is collected accurately, stored safely and provided to health and dental care providers on a need-to-know basis. The ability to provide collaborative multi-disciplinary health services is enhanced. All the patient information entered into the system is instantly and simultaneously accessible to all authorized users from all points of access.
“We ensure health information is available when and where it is needed to confirm that members are healthy before they deploy and to ensure that they receive the best possible care when they are wounded or injured, so that they can return to active service or be supported as they transition to civilian life,” Puttaswamaiah said.
The process of adopting the system was not without its challenges. CFHIS has computerized a sector that had traditionally been paper-based, and users were confronted with a change in culture, not just a change in technology.
“This is one of the last bastions of automation. It hit the banking industry, the financial sector and the manufacturing sector ages ago. There’s an acceptance of technology in those environments, but computerization in the delivery of healthcare is relatively new,” Puttaswamaiah noted.
She said they encountered some users who did not even know how to type, which made putting the initial patient information into the system somewhat onerous. But once these hurdles were overcome, the reaction to the system was “fantastic” and medical professionals were clambering to have it implemented at their clinics.
And it’s not surprising – the benefits of CFHIS to the health care community are manifold. For healthcare managers and administrators, it allows population health data to be gathered and analysed to give health care providers an idea of the health of their patient community. It also helps with workload management in terms of tracking patient visits and managing scheduling.
For the doctors providing care, CFHIS uses the concept of a cumulative patient profile which summarizes all of a patient’s information into one view, thereby providing an “at a glance” overview of their health status.
But for Puttaswamaiah, it is the actual impact on the patient that she finds most rewarding.
“This is the first time in my career where I’ve actually seen the impact of what I do on the recipient, not just the user but the recipient of the services delivered by the users.
“I see how this works in the clinics. I’ve seen patients looking over their doctor’s shoulders and say ‘wow’ because all of a sudden they can see trending of their blood pressure or trending of blood sugar levels, for example. They can take a look at their diagnosis and discuss it with the doctor. It gives a voice to the patient in his/her treatment and it’s very gratifying to see how significant an impact CFHIS has had.”
The Canadian Forces Health Information System project has been selected as an honouree for this year’s Government Technology Exhibition and Conference (GTEC) Distinction Awards Program. The winners will be announced on November 5 at the Distinction Awards Gala.
Jes Ellacott is a communications officer with the Information Management Group.