Technology and application deployment reduce medical wait times

Advanced applications and Web-based technology can lead to significantly reduced medical procedure wait times and improved patient care, according to physicians speaking at the Third Annual Electronic Health Records and Information Systems Conference held in Toronto last year. Anthony Fields, VP of the Alberta Cancer Board and a member of the oncology department at the University of Alberta, and Alan Hudson, head of a wait-times reduction initiative in Ontario, both tout the positive benefits that technology and the Internet can bring. Fields spoke of the technology improving the quality of patient care, while Husdon talked about using technology to reduce time to treatment. Fields said that closer tabs have to be placed on the performance of key healthcare players such as surgeons. Speaking specifically of cancer surgeons, he noted "If we are able to pull up the quality of cancer surgery in our province, it will make a substantial difference in the outcomes of people who have cancer. "We have to capture data on what our surgeons are doing now. If we don’t have that data available, then how do we know where to start?"To begin gathering that particular data, the Alberta Cancer Board developed a Web-based patient report to monitor which procedures are being performed by the province’s surgeons, the frequency of these procedures, the technical elements involved in the procedure, as well as the pre-operative and post-operative care that patients received."We have to be leaders to improve our standards in surgical care," said Fields. "This will be achieved by having more accountability for care of cancer patients and a sense of responsibility for the outcomes."Since physicians are very concerned with optimal time management, the completion of reports can be done in five or six minutes, noted Fields. A total of six of Alberta’s nine health regions are compiling information in the Web-based reports, which are then being entered into a provincial database. The Alberta Cancer Board received funding to the tune of $1.4 million from Canada Health Infoway to adopt the Web-based reports."We can show what is happening by provincial region, by hospital, and by surgeon," explained Fields. "We are still in the early stages of implementation, and want to implement this across all nine regions of the province. One of the barriers that we face is linking to other electronic systems around the province. We have to consider issues like privacy."Future reports would also document the quality of the surgery by including input from pathologists, according to Fields. "This would be a means of quality control," he said. "The quality of the excision would be measured. In a litigious society, if the grade was "D" , what would then be the repercussions for the surgeon?"If the validity of the Web-based tool is established in cancer surgery, it can apply to other types of surgery and can be implemented outside Alberta, noted Fields. He gave a scenario that will be unacceptable once the Web reports exist across the province: such as a patient with an abnormal chest x-ray waiting one year before entering the operating room for lung cancer surgery."We may see a rollout in other provinces," he said. "We could then collaborate and share the work. We would develop and maintain standards of (cancer) surgery."Hudson, who has held positions such as president and CEO at both Cancer Care Ontario and Toronto’s University Health Network, headed the initiative on reducing wait times in Ontario in September 2004 for the province’s Ministry of Health and Long-Term Care. The wait-times strategy targets specific areas: cancer, cardiac, hip and knee, cataracts, and diagnostic imaging.Since September 2005, wait times for cataract surgery have fallen by 86 days, 87 days for knee replacement, 70 days for hip replacement, 22 days for angiography, 16 days for MRI scans, five days for angioplasty, and two days for CT scans. "The focus in cancer needs to be in surgery because 80% of patients undergo surgery while 50% undergo radiation," said Hudson. "Surgery has been left out of the equation in cancer care, and we need to get that under control. We have been measuring the wrong thing."When the province’s hospitals see how they fare against all institutions, and this information is available for public consumption via the Web, it will be a motivation for hospitals to improve their outcomes, according to Hudson."If you were having lung cancer surgery, there may be a mortality rate of 14% at one hospital and 3% at another hospital," said Hudson. "When we see quality reports go up on the Web site that will change behaviour quite quickly."

Technology and application deployment reduce medical wait times

News | January 19, 2007

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