Moving to electronic medical records has been described as the biggest transformation most physicians will experience in their lifetime. CST (Clinical Systems & Transformation) will change our work processes, our information systems, and our quality culture. It is one of the largest implementations of an electronic health record system anywhere in Canada.
To help physicians prepare, VCH and VPSA co-hosted a CST Townhall on January 27. It was a chance for the close to 100 attendees to interact with CST leadership and have hands-on opportunities to try out the workstations on wheels.
Dr. Stephen Van Gaal welcomed members on behalf of the VPSA.
“I’m here as one of your representatives from the Vancouver Physician Staff Association,” he said. “It’s our job to help with the CST project in a partnership that will represent your interests and to make the system work effectively for all of us.”
Dr. Van Gaal also referenced the follow-up survey that will be sent to all those in attendance. The results from the survey will help VPSA’s CST Task Group set priorities and help develop physician-centric metrics to evaluate how well the system is working for physicians.
Dr. Vinay Dhingra, Physician Lead for CST Vancouver, co-hosted the session.
He thanked everyone for coming and said, “We have presented in the past some of the timelines when CST Cerner was looking to go live at VGH, and you may have seen a number of roadmaps with July 2020. I’m here to clearly say CST will not be going live in July 2020. There will be an announcement by our project board as well as our CEO in the middle part of February regarding a realistic timeline that we can really work towards.”
PHC and LGH experiences
Drs. Charles Lo and Peter Edmunds, senior medical directors at Providence Health Care (PHC) and Lions Gate Hospital (LGH) attended the townhall and spoke about their experiences with the system.
PHC went live in mid-November 2019.
“We’re all still standing and still working; patient care has continued,” joked Dr. Lo. “I can’t say the whole process has been entirely perfect. Obviously, there’s a huge amount of transition and change and learning that goes along with this. But for the most part people are adapting and learning to use the system very well and we’re seeing the performance of physicians and nursing staff improve every day.”
Dr. Lo credited the CST team and the amount of work that had been done over the past several months to stabilize the system by the team at LGH and the VCH Coastal Region.
“We benefited from having a system we knew would work right out of the gate, which was a lot more confidence than they [LGH] had when they went live,” he added. “When you [VGH and Vancouver Acute] go live, you’ll have two to three years’ accumulated experience and stability.”
LGH physicians have been using CST since it launched there in April 2018.
“I can’t imagine doing it again, but it’s been great, and the system actually works,” said Dr. Edmunds. “I can’t imagine anybody at Lions Gate who’d go back to what we had before. There’s no question, it [CST] is better.”
He emphasized the importance of listening to people and their concerns, as well as answering their questions.
“Physicians,” he stressed, “are very important. If physicians adopt the system, it goes a long way to bringing others along.”
Dr. Edmunds also underlined the importance of getting as much exposure to CST as possible prior to going live with the system. That was a theme that Dr. Lo also highlighted. Two to three months prior to PHC’s go-live date, training was given to 950 attending physicians, 500 residents, and between 2,500 to 3,000 clinical staff.
“Learning wasn’t complete,” said Dr. Lo. “The utility comes from using the system.”
CST demonstrations
CST Senior Manager Max Besworth led physicians attending the townhall through a high-level overview of Cerner’s functions and took questions from the audience. His objectives were to show the clinical applications physicians will predominately use from how we will see our patients’ information, to order entry, and documentation.
Six workstations on wheels organized into specialty areas were also standing by after the presentation for attendees to try out.
Dr. Dave Wilton is VCH-Vancouver’s associate physician lead for CST. His role is to put a physician lens on the project to make sure we are well prepared. He recommends all physicians take some straightforward steps to prepare including consolidating multiple logins into one, making sure your ID is up to date, and knowing your LearningHub account before CST training. Investing the time now in things such as learning front-end speech recognition will go a long way to increase efficiency.
CST Townhall was broadcast via a live webcast, which VPSA members can view online. VPSA members asked many questions during the presentation and there was not time to address them on. With help from VPSA, the CST team is creating a venue to respond.