Since June 19, 2021, when a provider who uses CST Cerner either orders or is copied on lab results, from almost any lab in the province, including labs across VCH, PHSA and PHC as well as provincial lab partners, these results are available in the patient chart at all CST Cerner sites. In addition, BC Cancer – Vancouver centre providers have started receiving near-real time lab notifications via Message Centre within CST Cerner.
“It’s been great to have lab results from multiple sources now viewable in one clinical information system and in almost real time ─ an important advance to ensure that results are viewed and acted upon in a short time frame. This is especially critical for BC Cancer patients as up-to-date lab results are needed for many treatment decisions,” says Dr. Dan Renouf, executive medical director, BC Cancer – Vancouver.
This is a first for the province because, while provincial lab results are viewable in CareConnect, no other clinical information system is integrating labs information at this level for comprehensive, near-real time access. It means that patients who attend Vancouver centre, and soon other facilities using CST Cerner (e.g. Vancouver Coastal’s Lions Gate and Squamish General hospitals, Providence’s St Paul’s Hospital and BCMHSUS’ Heartwood Centre for Women), can have peace of mind knowing their health care team has immediate access to this information.
The work behind the scenes to build this new External Lab Messaging Service (ELMS) has been described as “one of the most outstanding accomplishments of the Clinical & Systems Transformation (CST) project to date,” (Dr. Eric Grafstein, CST Chief Medical Information Officer for Vancouver Coastal Health and Providence Health Care.)
Reducing the number of lab results missed or not delivered
Integrating results from labs across VCH, PHC and PHSA and other labs around the province into CST Cerner has been a complex undertaking. This project-within-a-project, which began in 2019, is now complete thanks to the hard work of the CST project’s technical teams, led by CST Technical Director, Amr Kabesh.
“A lot of patients, especially those with chronic diseases, get their requisitions and go to LifeLabs or other health authorities to get their tests done,” says Amr. “Before now, clinicians would receive those lab results on paper and many results were manually transcribed into CST Cerner. Sometimes, results could be missed or not delivered.”
Now, physicians who use CST Cerner can view their patients’ province-wide lab results [in most instances], whether from a VCH, PHSA or PHC site that is not yet using CST Cerner, or any provincial lab partner within the system. Gradually, over the next year, notifications of lab results will be made available to all providers who use the system via the Cerner Message Centre tool.
Benefits to patients and physicians
For physicians like Dr. Grafstein, access to better information enables better care.
“For ambulatory clinics that see patients from all over the province, like BC Cancer or some of our transplant clinics, this integration greatly improves the flow of information to physicians. It creates better safety for patients who will have their lab results all in one place.”
Dr. Alain Gagnon, CST Chief Medical Information Officer for the Provincial Health Services Authority, says this pioneering lab project is integral to his practice at BC Women’s Hospital + Health Centre.
“Having results – performed almost anywhere in the province – accessible in the CST Cerner chart makes it possible to review and take action right away. It also makes results easily available when I see patients in the clinic or virtually and it reduces duplicate testing [for patients] in a scenario where results are not easy to locate.”
This effort is in-line with the Ministry objective for lab medicine to have coordinated, cross-sector provincial plans and it demonstrates the value of working collaboratively to improve the quality of health care services for B.C. residents.
Another first: New agreement paves the way
The CST project worked closely with all health authorities and the Ministry of Health to develop a Common Integrated Program Agreement. This formal legal agreement provides the legal authority for these lab results to flow through the External Lab Messaging Service (ELMS) into CST Cerner.
“This agreement lays the groundwork for other health authorities and Excelleris to be able to leverage this solution to appropriately share lab results amongst each other,” says Amr.
The number of CST Cerner users is set to increase from ~30,000 to ~40,000 over the next few years with the CST project rolling out to more than 70 facilities across VCH, PHSA or PHC. Learn more: cstproject.ca