Design/configuration/validation/testing teams, in collaboration with Cerner and subject matter experts from VCH, PHSA and PHC, are responsible for:
- working collaboratively with colleagues and other teams to gather and verify information;
- developing future state workflows that incorporate the clinical information system, streamline care and support delivery of safe patient care;
- defining requirements (clinical, functional and business) for the CST Cerner clinical information system;
- configuring content within the clinical information system based upon evidence and Canadian, regulatory and patient safety requirements;
- making design decisions related to configuration of functionality and tools within the clinical information system; and
- contributing to testing and training.
Each team includes a full-time manager or lead, full-time team members from VCH, PHSA, PHC and Cerner, and part-time subject matter experts.
- Acute Care
- This team is comprised of clinicians, support staff and information technology professionals from across VCH, PHSA and PHC. The Acute Care team is responsible for the way in which acute care clinicians (allied and nursing) will experience the clinical information system. This includes electronic clinical documentation, orders, electronic medication administration records (eMARs) and medication reconciliation. The team is responsible for ensuring that these elements and functionality are validated for use by clinicians, and for recommending and validating the best possible workflow to integrate them into clinicians' daily routines.
- This team is made up of clinicians, support staff and information technology professionals from across VCH, PHSA and PHC. Responsibilities include defining the unique requirements of ambulatory care. This includes ensuring real-time, simultaneous access to patient charts and automating processes for patient intake, registration, scheduling and clinical documentation. This will allow clinicians to better manage this high-volume patient population (often with complex needs) in a more effective manner.
- Coding and Informatics
- Coding and Informatics services analyze patient health information and assign standardized codes to create structured data. This data is used internally for decision-making, performance measurement and quality improvement; and externally for hospital funding, clinical research and national benchmarking.
The Health Information Management Coding team ensures that the mandatory reporting requirements of the Canadian Institute for Health Information (CIHI) and the Ministry of Health are fulfilled based on available patient documentation.
With expertise in nomenclature, classifications, clinical documentation improvement, data quality, data integrity, data mapping and analytics, the Coding team will provide support in these initiatives within the project.
- This team is made up of health informatics professionals and support staff from across VCH, PHSA and PHC.
Core is responsible for the foundational components of the Cerner build. The clinical design teams are dependent on these foundational components to facilitate and support them in building their own modules within the new clinical information system.
While Core is responsible for building the foundational components, other teams are responsible for the majority of the design, including design teams, technical teams and business areas within VCH, PHSA and PHC (e.g. finance). Core components are traditionally non-specific, which allows these configurations to encompass virtually all Cerner solutions enterprise-wide. Some Core build responsibilities include: Organizations and Locations, Alias Pools, Positions and Security, Provider Load, and the Event Set Hierarchy.
- This team is comprised of care providers, nurses, unit clerks and technical professionals from across VCH, PHSA and PHC.
The team works collaboratively with other CST teams to design and configure FirstNet, a Cerner module that automates a wide range of functions performed in the Emergency Department. These functions include - but are not limited to - registration, triage, patient tracking, assessments, orders and documentation.
This work will help to improve patient safety, and improve quality and continuity of care by enabling better integration with other departments and health care teams.
- Records Management/Document Scanning
- This team is made up of health information management and technical representatives from VCH, PHSA and PHC. Responsibilities include defining workflows for chart management, deficiency management and the release of patient information. This includes looking at chart generation processes, document deficiencies, transcription integration, legacy chart tracking, release of information requests, document scanning and integration of forms on demand. This work will ensure that clinicians can easily access complete and accurate information essential to patient care when necessary.
- This team is made up of lab technologists, support staff and information technology professionals from across VCH, PHSA and PHC. The Lab team is responsible for establishing the orders and results criteria for laboratory tests requested in the future-state system. This involves designing seamlessly integrated laboratory processes and workflows across the care continuum. This work will help ensure that providers and clinicians can submit lab orders with ease and receive accurate and timely results to enhance overall patient care.
- The Maternity team is made up of clinical analysts and application analysts from VCH, PHSA and PHC as well as Cerner consultants. The team is responsible for designing the content of the clinical information system for the entire maternity continuum. This includes antepartum, intrapartum, postpartum and newborn care. We will be implementing PowerChart Maternity and FetaLink applications, with tracking boards and centralized fetal monitoring. In addition to designing the maternity content, we are responsible for NICU content.
- Medical Imaging
- This team includes diagnostic imaging professionals, providers and technical representatives from VCH, PHSA and PHC. Responsibilities include defining diagnostic imaging-specific and intra- and inter-department workflows. This includes work list management and image and results distribution. This work will help ensure imaging results are automatically added to the patient record and visible by all clinicians, which will reduce time spent chasing test results.
- Medication Management
- This team is comprised of pharmacists, nurses, support staff and technology professionals from across VCH, PHSA, PHC and FHA. This team will ensure that the design of the clinical information system and associated workflows support best practices for medication ordering, verification and dispensing. Key elements of this work include developing the processes for: ordering, verifying and dispensing medications; formulary and medication order catalogue design; medication barcoding; medication reconciliation; and clinical pharmacy workflows. This work will contribute to the prevention of medication errors.
- Oncology and Clinical Trials
- This team includes clinicians, support staff and technology professionals from across VCH, PHSA and PHC. Responsibilities include ensuring the unique requirements of oncology are met. This includes articulating requirements to support screening, referrals, diagnostic services, treatment plans, medication, and patient follow-up services, as well as education related to prevention. This will allow clinicians to better manage their patients, who have complex needs and require high utilization of health care services.
- Order Sets
- This team has a mix of nurses, a business analyst and an application analyst, from VCH, PHSA and PHC. They are responsible for developing the computerized provider order entry (CPOE) order sets, based on the best evidence available. This will help to minimize misinterpretation of handwritten orders, dosage errors and adverse drug interactions; and to ensure high-quality, safe patient care.
- Patient Registration
- The Patient Registration team comprises of Business Analysts, Application Analysts, and Cerner consultants. Working in close collaboration with the Registration Standards team, registration staff, and Subject Matter Experts across health authorities and various design teams within the CST project, the team gathers and validates patient registration requirements, standardizes patient registration processes, and designs enterprise registration workflows. The team also supports integrated workflows with other clinical areas across the enterprise system to streamline and enhance patient care. The Registration team is responsible for designing, building, and testing system functionalities in the Cerner Registration application, PM Office, to support the workflows.
Positive patient identification is the backbone of every clinical information system and by following the Registration best practices we ensure that accurate registration information is captured within the clinical information system and flows to various applications and downstream systems.
- Patient Scheduling
- The Patient Scheduling team is working to standardize scheduling activities within the Cerner Scheduling Application. Their focus is on enhancing access and flow for patients, providers, and health care professionals within the overall clinical and systems transformation.
This team is made up of business analysts, application analysts, and Cerner experts.
The team is responsible for defining scheduling needs in relation to new and existing patients. This includes establishing the processes for new requests, wait list management and prioritization, scheduling, and effective coordination. This will improve communication and ensure accurate patient scheduling and the appropriate use of resources to reduce bottlenecks and downtime.
Additional team responsibilities include finalizing scheduling workflows and integrating functionality with the Oncology and Ambulatory solutions.
- Pharmacy Infrastructure
- This team is made up of pharmacists, pharmacy technicians/assistants, nurses, analysts and project/change managers from across VCH, PHSA and PHC. The team is responsible for ensuring that equipment and processes are in place to support a closed loop medication management system, which is a foundational component of CST and will reduce medication administration errors, improving patient safety.
- Pharmacy Supply Chain
- This team is made up of pharmacy, finance, purchasing, clinical and logistics professionals from across Lower Mainland Consolidated Services pharmacy partners.
This team is responsible for designing a single integrated supply chain system that supports efficient management of pharmacy inventory. This involves procurement of medication inventory; real-time inventory management including production, preparation and packaging of medications; dispensing logistics and distribution; and integration with financial systems. This work will ensure that we achieve improved medication safety objectives and efficiency goals.
- Provider Experience
- The Provider Experience team works with providers and CST design teams to ensure that workflows using the new clinical information system will meet the needs of providers (physicians, nurse practitioners, midwives, clinical pharmacists and dentists).
The team is responsible for enabling efficient, useful electronic providerworkflows appropriate to all specialties, by designing playbooks that cover documentation, ordering, patient access, and more. The team works with the Emergency, Maternity, Oncology and Clinical Trials, Ambulatory and Surgery and Anesthesia teams to ensure that they are following consistent standards for the provider user interface.
- This team is made up of a business analyst, report developers and a tester.
The Reporting team works closely with other CST design teams to identify the needs for operational reports that need to be accessed from the new clinical information system. The team is responsible for developing custom outputs from the clinical information system, identified by different CST design teams, which include the following: Custom reports, extracts, labels, queries and requisitions.
- Surgery and Anesthesia
- This team is made up of surgeons, anesthesiologists, nursing and allied health professionals, unit clerks, and technical professionals from across VCH, PHSA and PHC.
They are defining the perioperative workflow, including surgical bookings, pre-operative consultation, surgery and post-anesthetic care. This includes waitlist management and tracking, case scheduling, pre-operative assessments, emergency cases, patient transfers, intra-operative documentation and orders as well as inventory management. This will create efficiencies by improving communication and ensuring the relevant steps are taken to improve patient flow.