The VA Provider Digital Health (DHC) Committee meets monthly; members work to identify Cerner changes that would be most helpful to providers. VPSA provides sessional funding to the nine physician representatives on the committee for time spent in meetings and doing other committee work. The following is a summary of the committee’s June 11 meeting.

Goals of Care

Informatics teams from VCH, PHC, and PHSA are working closely with Regional Digital Solutions on planning upgrades to the current Goals of Care and Advance Care Planning components. We are aligned on making Goals of Care information easier to document and easier to find.

Code upgrade

A bug was detected in the Oncology Order Entry workflows that required manually setting details for certain orders. Oracle needs to repair the bug before we can move forward with the code upgrade. Things that were dependent on the code upgrade, including a clinical digital assistant, are now being pushed to September but Oracle may be able to fix the bug by July.

Medical analytics

The committee’s co-chairs, Dr. Stephen Van Gaal and France Mytropan, are part of a medical analytics group of physicians who work with data and analytics to try to answer clinical questions using data. Committee members can bring questions to them to see if the medical analytics group can run these as mini projects.

Resident ordering in the Emergency Department

Currently, when a resident from a consulting service places a diagnostic order for an emergency patient, the report is only delivered to the emergency provider and not to the resident’s supervising physician. This is likely to cause gaps in care for patients.

The only fix available is to stop pre-filling the ordering physician name on resident orders. Based on our analysis, it seems likely that by making this change, we will reduce this error, without causing new errors for admitted patients.

Dr. Van Gaal and Ms. Mytropan will bring the recommendation to stop auto-prefilling attending on relevant orders forward to the Medical Informatics Council. If the change is approved, we will systematically monitor the effect of this change for at least six months.

Inter-team communication

Professional Practice team members gave a presentation on inter-team communication. This includes nursing handover, communication tools such as patient key activities and team communication, person-to-person allied health and provider communication, and non-urgent communication.

Team communication

The Team Communication (Actions & Situational Awareness Component) provides an easy method for physicians and allied staff to communicate about non-urgent issues. One limitation of this component is that it may require the physician to declare which team they are working for:

We are working with Regional Digital Solutions to determine whether any fix is available to eliminate the need for this manual step.

The CIS team will set up a tracker to manage this issue and start tracking decisions and deliverables.

Next meeting

The committee meets again on July 9. If you have an item you wish to be brought forward at one of these meetings, please contact Manager, Provider Strategic Initiatives & Engagement, Laura Mc Evoy.