Clinicians at the new Northeast Urgent and Primary Care Centre (NE UPCC), which opened on February 16, 2021, are now using CST Cerner — a shared system designed to help improve the safety, quality and consistency of patient care in British Columbia.
This new clinical information system is already in use by nearly 11,000 users at four Vancouver Coastal Health (VCH) hospitals and health centres, three Providence Health Care (PHC) hospitals and dozens of related ambulatory clinics, 10 COVID-19 test collection centres and more.
The NE UPCC is the first community-based site to use the system, which is being rolled out across VCH, Provincial Health Services Authority (PHSA) and PHC facilities as part of the Clinical & Systems Transformation (CST) project.
“The NE UPCC represents steps by VCH to link community with acute care services,” says Dr. Eric Grafstein, CST’s Chief Medical Information Officer for VCH and PHC. “There will be full information sharing between the UPCC and acute care hospitals, where these patients might require care. This ‘knowing’ about a patient means we’re dramatically improving the overall quality of care in the region.”
So why did VCH want this to happen? And why now?
Improving the safety, quality and consistency of patient care
The use of CST Cerner within the NE UPCC ensures the easy exchange of electronic information, with hospitals like Lions Gate and St. Paul’s, if a client is moved to a hospital. This reduces the need to ask patients repeat questions, do duplicate tests or search for missing information. It also ensures family doctors can receive consult reports, discharge summaries and other reports through Excelleris, a system already used by many VCH physicians.
Jeb Dykema, Director of Clinical Informatics Community for VCH, and his team worked alongside key governance groups, including the VCH Regional Primary Care and the eCommunity Steering Committee, to determine that CST Cerner was the best solution for VCH’s new urgent care model.
“Firstly, the system supports workflows that are unique to urgent care,” says Jeb. “We have patients arriving without appointments and then seen based on their clinical priority; physicians using computerized provider order entry, which is widely considered best practice; and evidence-based functionality, like electronic order sets, to help make patient care safer and more consistent.”
“The Vancouver community team has been so willing, engaged and genuinely excited by what CST Cerner can offer, which makes it fun to work with them,” says CST Director, Brenda Hearn, who was instrumental in helping VCH roll out CST Cerner at several COVID-19 testing sites. “We’ve brought this system outside of acute and ambulatory care settings for the first time, which has been a really great opportunity. I think we’re all excited to see the benefits for clinicians and their patients.”
NE UPCC serves as model for future CST Cerner use
After receiving approval to move forward with the new system in summer 2020, now the team intends to use this implementation process for additional UPCCs, and there have been many requests already. The CST team has trained the community informatics team, who will work with the UPCC planning teams to implement and support rollouts at future UPCCs. This support relies heavily on peer mentors, who work at the site and learn the new system and workflows early on.
“Systems are often an afterthought, but that’s changed in recent years and especially with the CST project,” says Jeb. “Now, you design with CST Cerner in mind because it’s driving that workflow. It’s not just after-the-fact documentation. It’s been an opportunity for us to think differently about how we use systems and related processes.”