What will change?

Do you have questions about what will change as a result of CST?

What will change when CST goes live?

We won’t have the full answer until we finish design, configuration and validation work; but we do know that:

Will we be paperless once the new system is implemented?

No, we will be "paper-light", not paperless. Some clinical documentation (such as Code Blue documents) will still be on paper; and paper documents will continue to arrive from outside VCH, PHSA and PHC.

Document imaging (scanning) will capture records that remain on paper after go-live. This will include all clinical documentation received in paper format and some non-clinical documentation, such as third party requests for information. Document imaging has clear benefits for patient care and will reduce the costs for storage and retrieval of records.

Will I be able to see historical data in the new system? How far back will records go?

Within the new system, you will be able to view relevant, remediated historical records that are currently available electronically. Most of the records will remain available as "View Only" data, due to the risk of errors introduced by mapping data from one system to the other.

Historical paper charts will not be scanned and won't be viewable in the new system. However, any paper that remains in use after the launch of the new clinical information system, such as handwritten documentation and patient-completed records, will be scanned in to the system going forward.

When will health care workers outside the hospital have access to the new clinical information system?

If a health care worker has privileges with VCH, PHSA or PHC, they will be able to access the shared clinical information system from anywhere, including off-site. This access will be effective when sites begin to go live with the new clinical information system.

While health care workers without privileges at VCH, PHSA or PHC will not be able to access the new clinical information system, we are currently investigating opportunities to expand the reports available electronically to health care workers through Excelleris.

As part of the CST project, we are building one of the key foundational pillars required so that a two-way exchange of information between the clinical information system and private electronic medical records can occur in the future.

Will records such as x-rays and lab results be attached to a patient’s record?

X-rays, lab results and records from ambulatory clinics and outpatient departments across VCH, PHSA and PHC will be available within the new clinical information system. Records that remain on paper after go-live will also be scanned and linked to patient’s record, giving health care providers access to a more complete patient record.

Will emergency tracking boards look different?

There is currently a wide range of variation in tracking boards at sites across VCH, PHSA and PHC.

The Emergency design team, made up of representatives from each Health Organization, has been working to design an integrated, electronic tracking board to be implemented as standard at sites across VCH, PHC and PHSA. Following the implementation of CST, tracking boards will be displayed on a large LCD screen (grease board).

No full patient name will be displayed on the grease board, but it will provide details staff members need to do their work. This includes icons to indicate what actions need to be taken for a patient and any relevant alerts.

For more details on electronic tracking boards, please read A Clear View of the Emergency Department.

Will allied health staff have access to the system and will that access be restricted?

Yes, allied health staff will have access to the new shared clinical information. Staff will have access to the information and functionality they need to do their jobs, regardless of job title. They will not be permitted to access information they do not need to see.

With a few specific exceptions, clinicians and clinical support staff will have access to all health information pertaining to a particular patient to whom they are providing care, including information that came from different facilities and programs.

Will patients have a summary sheet?

There will be an electronic version of a summary sheet in the new clinical information system called an mPage, which is much like the Kardex that we use now. It will be updated automatically based on electronic charting.

Will all flow sheets and vital-signs sheets be in the new clinical information system?

Yes they will.

Will the information required for 48/6 be in the new clinical information system?

Yes. We will be collecting the same information and still creating care plans for patients, but those plans will be contained in the new clinical information system. This information will be integrated with the admission assessment.

Will the hand-written medication administration record (MAR) be replaced by the new clinical information system? And how will we communicate with Pharmacy?

Yes, the MAR will be accessed electronically in the new clinical information system.

Here’s how we will communicate with Pharmacy: in acute-care settings, physicians and other ordering providers will enter medication orders directly into the clinical information system. The orders will be received and reviewed by pharmacy; the medications will be packaged and bar-coded, then dispensed using the new Omnicell automated dispensing cabinets. The bar-coded medication package will be scanned when the medication is administered and the system will check the drug against the order to ensure that the correct medication is being given.

This video, Get in the Loop, gives a good overview of the new process. 

Privacy and security

What privacy and security safeguards will CST put in place to protect personal health information?

We are committed to safeguarding the privacy and security of personal health information within the new clinical information system that is being developed as part of the Clinical & Systems Transformation project.

There is a Privacy Working Group that is overseeing the completion of a privacy impact assessment. This will identify privacy and security risks associated with the CST project and make recommendations to address such risks. The working group will also be responsible for:

  • Development of an access model that is based on need-to-know to carry out user job duties;
  • Design and implementation of a robust, effective privacy audit solution;
  • Establishment of appropriate privacy controls, such as enhanced information security flags and clinical relationship attestation;
  • Development and implementation of user privacy and security training, along with confidentiality undertakings;
  • Development of a system and data governance framework; and
  • Assurance that data sharing is done in accordance with the General Health Information Sharing Agreement (GHISA) and complies with the BC Freedom of Information and Protection of Privacy Act (FIPPA).

For more information please visit the Privacy and security page.

If a patient doesn't want their family provider to view their hospital summary can this be kept private?

The automatic distribution of discharge summaries and other information to patients’ family doctors supports better care. Health outcomes are improved when family doctors are collaborating and communicating with health care providers in the hospital. Systems, practices and procedures are currently set up to facilitate this type of communication across VCH, PHSA and PHC.

There may be situations where a patient does not want this information to be shared. The CST Privacy Working Group, which has overall responsibility for addressing privacy risks associated with the CST project, is currently exploring the possibility of creating exceptions to general practices or standard procedures where it is legitimately required for privacy reasons.

Please read Privacy and security for more information on the Privacy Working Group.