[news 2007 - 2008]

AdapCS.Canada-Hotel Dieu alliance to develop access to care systems for ambulatory care

May 30, 2007

KINGSTON, ON – Southeastern Ontario residents enduring the anxious wait between physician visit and specialist consultation for outpatient procedures may soon find the waiting a little less onerous, thanks to a new undertaking by Kingston’s Hotel Dieu Hospital to streamline access to ambulatory services.

Hotel Dieu has entered into an agreement with AdapCS.Canada Corp., a Kingston-based healthcare informatics company, to help develop and implement information management systems that will address many of the issues associated with patients’ and physicians’ access to services in the outpatient sector of hospital care.

Kicking off the new partnership will be work on a system to manage access to, and monitor and manage delivery of, endoscopy and other non-operating room procedural services such as minor plastic surgery for the removal of skin cancers.

Hotel Dieu and AdapCS.Canada are striving to support better management of access to care — from family physician visit through specialist consultation, investigation, treatment and follow up. Tools envisaged include:

• an electronic referral system, enabling physicians to supply specialists with the standardized information needed, as well as to ensure rapid patient triage;
• processes to select the most appropriate and available consultant;
• processes to ensure timely and appropriate investigation;
• enhanced communications between patients, physicians and specialists.

The project addresses a little-known fact about patient care in the ambulatory care sector, says Dr. John Marshall, President and CEO of AdapCS.Canada and former chief of staff of Kingston General Hospital.

“Much attention is paid to the wait for services once the decision has been made that they’re needed,” he says. “However, surveys have shown us that people are more concerned about the wait for access to the specialist who will make that decision, than they are about the wait after the decision is made.”

“That shouldn’t be a surprise. Prior to seeing the specialist, patients must deal not only with the wait, but also the uncertainty about what’s wrong with them. “

A further concern is the often-fragmented nature of the process that patients must navigate before receiving this outpatient care, he adds.

For example, family doctors have no ready-to-hand source of information about the availability of specialist services.

“There’s no central database that details specialists’ expertise and their earliest available appointment, making it difficult for family physicians to make the most appropriate referral within the desired time frame,” explains Dr. Marshall.

As well, information transferred from physician to specialist is currently not standardized, and communication can be fragmentary, which can lead to further delays. For example, X-rays taken prior to a specialist appointment may not be noted on the patient’s record and may not be available at the time of the appointment, often resulting in delays or in repeat X-rays.

“The obvious solution is to offer patients full information on the availability of services, as well as enhanced communication all along the way,” says Hugh Graham, executive director of Hotel Dieu. “This approach ensures both greater efficiency and, we hope, reduced stress on people waiting for outpatient services.”

The new system, he says, would also provide data on met and unmet needs and thus inform allocation of resources and system change to meet these needs.

“The majority of patient management IT systems for hospitals are focused on inpatient management,” Mr. Graham says. “We’re excited to have found a partner eager to develop solutions tailored to our outpatient mission. We believe that we need to take a leadership role in this sector of healthcare and we see this partnership as a vehicle to assist us in that goal.”

The project builds on Kingston area hospitals’ pioneering work with AdapCS.Canada in better managing their surgical wait lists through the testing and eventual adoption of an electronic wait-list tool. The tool was recently held up as a “best practice” for Canadian hospitals by Dr. Brian Postl in his Final Report of The Federal Advisor on Wait Times.

“We look forward to working with the Hotel Dieu to construct systems that not only provide better management, but also provide data to give a more complete understanding of the needs of this segment of the system,” says Dr. Marshall.

Contact:
Dr. John Marshall
President & CEO
AdapCS.Canada Corp.
P: 613. 531. 3008 x 202
E: jmarshall@adapcscanada.com

Anne Rutherford
Hotel Dieu Hospital
613-544-3400, ext. 3380

About AdapCS.Canada.Canada:
AdapCS.Canada. was founded in 2003 by Dr. John Marshall and John Lott of Kingston, Ontario and AdapCS. Inc. of Marina, California, with the assistance of PARTEQ Innovations, the technology transfer office of Kingston General Hospital and Queen’s University. AdapCS.Canada offers information technologies and services for the Canadian healthcare market that focus specifically on clinical and financial outcomes, accountability, and access to care.
http://www.adapcscanada.com/


About Hotel Dieu Hospital:
Hotel Dieu Hospital is the ambulatory care teaching hospital for Kingston and Southeastern Ontario, providing expert care to more than 500,000 people in the region. Our specialized services include outpatient pediatrics, ophthalmology, diabetes education, breast assessment, day surgery, urgent care and mental health programs. Affiliated with Queen's University, we are partners within Kingston's university hospitals, delivering quality health care, leading innovative research and training the health care professionals of tomorrow.
http://www.hoteldieu.com/