Mackenzie Health Connected Health Strategy… Introducing weHealth
The Internet of Healthcare Things is fundamentally changing the way in which people communicate with each other, and with the world around them. Connected healthis a model for healthcare delivery that utilizes digital communications and the Internet of Healthcare Things to provide quality healthcare outside of the traditional hospital setting. Connected health provides flexible opportunities for patients to engage with healthcare providers, often leveraging readily available consumer technologies. However, traditional connected health strategies are predominately focused on the consumer end of the market, rather than taking an integrated and seamless approach to transitional health care from home, to outpatient, to inpatient settings. At Mackenzie Health, we recognize that an integrated connected health strategy should link care within the hospital, the community, and the home, in order to maximize flexibility and autonomy, and improve quality, efficiency, and cost of care. To reflect a deep commitment to a connected health strategy, Mackenzie Health has developed its own wired/wireless eHealth platform - “weHealth”.
What is weHealth?
WeHealth is Mackenzie Health’s connected health platform that links patient healthcare inside and outside the hospital. Centred around the Smart Hospital hub at the new Mackenzie Vaughan Hospital (MVH), and utilizing both wired and wireless technologies, weHealth will fundamentally improve the healthcare delivery model in Ontario.
The weHealth platform is supported by the pillars of Autonomy, Best Practices, Innovation, and Communication. Autonomy means education and support in helping patients make decisions about their health, tools to help patients actively participate in their own healthcare, and a focus on privacy and personal independence. Best Practices means using evidence-based medicine and quality improvement to help guide patients’ healthcare decision making and deliver the best care to them, in a safe and comfortable environment. Innovation means thinking outside the box, approaching problems from new and different perspectives, and collaborating on improving the delivery of healthcare. Communication means ensuring that a patient’s healthcare providers (nurses, doctors, consultants, pharmacists, and other health professionals), both in the hospital and the community, talk to each other and to each patient openly, honestly, collaboratively, and with a deep appreciation for the patient’s values, beliefs, and social situation.
By leveraging the Smart Hospital infrastructure at both MVH and Mackenzie Richmond Hill Hospital (MRHH), secure hosted or cloud-based services will be developed that include unified communications (audio/video) both between providers and between patients and providers, patient portals, community provider portals, home health tools such as wireless sensors for home management of healthcare problems, a formulary of mobile applications, and a unified repository of private and secure patient electronic records (the “single source of truth” for MH patients’ confidential health data).
Imagine a patient presenting to a family physician with a decompensated chronic illness, such as congestive heart failure. Investigations, including blood tests, echocardiograms, and cardiac stress tests are performed. Therapies, such as medications, may be added or changed.
The patient’s condition is monitored through follow-up appointments. If the condition deteriorates, the patient is referred to a speciality congestive heart failure clinic. Investigations, including blood tests, echocardiograms, and cardiac stress tests are again performed, because not all of these results are available to the specialist. Therapies, such as medications, may be added or changed again. The patient’s condition is monitored through additional follow-up appointments, or through referral back to the family physician. If the patient’s condition deteriorates further, the patient is admitted to hospital. Investigations, including blood tests, echocardiograms, and cardiac stress tests are again performed, because not all of these results are available at the time of hospital admission. Therapies, such as medications, may be added or changed, without knowing the outcome of previous attempts at the same. The patient’s illness is stabilized in hospital. At discharge, a summary of therapy changes and investigations in hospital is provided to the patient, and a copy is sent to the patient’s family physician who may, or may not, receive this information in a reasonable time period. The congestive heart failure clinic may, or may not, receive a copy of this information.
Outpatient services, such as CCAC homecare, may be requested. Follow-up appointments will be required after hospital discharge. The coordination of these various activities may be left up to the patient, the patient’s family physician, or the patient’s various specialists who may, or may not, be aware that they are taking the lead. Such a situation is fairly commonplace with existing non-integrated health care delivery models.
Now, imagine the same patient under the MH weHealth connected health strategy. The patient presents to the family physician with a decompensated chronic illness, such as congestive heart failure. Investigations, including blood tests, echocardiograms, and cardiac stress tests are performed. The results of these tests are transmitted to a central data repository where they can be compared with and placed in the context of other recent investigations. The family physician (and the patient), can access these results through a secured portal. Therapies, such as medications, may be added or changed. These changes are transmitted in real-time to the data repository as a comprehensive problem list and active care plan, including medication reconciliation. The patient’s daily weight, blood pressure, and heart rate are monitored at home using wireless sensors that transmit information securely back to the data repository. The family physician (and the patient) can access this information through a secured portal, reducing the need for follow-up appointments.
Follow-up appointments, if necessary, can be scheduled through the patient portal. If the condition deteriorates, the patient is referred to a speciality congestive heart failure clinic. The specialty clinic accesses the patient’s problem list and active care plan, medication reconciliation, wireless home-monitoring data, and recent investigations via a secured portal. The care plan is modified and the new plan and medication reconciliation is transmitted in real-time to the hospital data repository, which provides all care providers with an update on the patient’s status and care plan. This is particularly important when a patient has multiple specialists treating multiple medical conditions, where the treatment of one may affect the treatment of another. The patient continues to be monitored at home and in the community by the family physician and specialists. If the patient’s condition deteriorates further, the patient is admitted to hospital. In the hospital, physicians can review the patient’s problem list and active care plan, medication reconciliation, wireless home-monitoring data, and recent investigations both from the family physician and all the specialists involved in the patient’s care. There is no time-delay in finding out exactly what treatments and investigations have been performed previously and alternative therapies and investigations can be initiated much earlier. If further clarification is required, the hospital’s secured unified communications (audio or video teleconferencing, secure email, secure personal social media) are used to connect the inpatient care team with the patient’s family physician and/or specialists. The patient’s illness is stabilized in hospital. Prior to discharge, the hospital’s secured unified communications (audio or video teleconferencing, secure email, secure personal social media) are used to connect the inpatient care team with the patient, the patient’s family physician and/or specialists, and other allied health services involved in the patient’s care, and a comprehensive discharge plan is designed to reduce the risk of readmission, and ensure safe transition of care post-discharge. At the time of discharge, the patient’s updated problem list, comprehensive care plan, and medication reconciliation is transmitted in real-time to the data repository, and out-of-hospital care providers are automatically notified. Further home wireless monitoring is arranged, as required, prior to discharge.
The weHealth platform will include, but not be limited to:
1) Unified access via a secured portal to a single source of truth electronic patient record for hospital care providers, community care providers, and patients, with access levels tiered by the type of care being provided, the type of care provider, and any relevant privacy restrictions that provides:
a. Access to investigations, documentation, and traditional EMR data
b. Access to home device monitoring
c. Medication reconciliation across community and hospital settings
d. Problem list reconciliation across community and hospital settings
e. Comprehensive care plan reconciliation across community and hospital settings
f. Patient educational resources related to problem list, care plan, and medications
g. Patient/provider hospital scheduling services, with the option of providing scheduling services to community setting
h. Continuity of access (same look and feel) for patients transitioning to/from hospital, community, and home settings
2) Unified hospital communications system, allowing point-to-point communication (audio/video/data as required by the task and acuity) between staff, care providers, and patients, both inside and outside the hospital, with the of option of providing communications services to community setting
3) Mobile hospital app formulary with applications that support hospital way finding, patient care, patient education, scheduling, asset management, etc.
4) Mobile app formulary of third party applications that are endorsed by the hospital for patient use
5) Secure hosted or cloud-based services to collect telemetry from wireless medical devices both inside and outside the hospital
Mackenzie Health is the registered owner of the Official Marks for
“IOHT” (Internet of Healthcare Things) and “ICAT Healthcare”