This practice was recognized as a LEADing Practice by Canada Health Infoway as part of the “Knowing is Better” education campaign, in partnership with Accreditation Canada

Advancing Professional Practice

The Ambulatory Care Clinics (ACC) implemented a number of electronic health systems and tools aimed at supporting quality improvements in patient care. The systems include electronic scheduling, automated patient reminders, clinical documentation, and customized reports through HSN’s Business Intelligence, which leverages clinical and demographic information to enhance clinical decision making.

The implementation of electronic health systems resulted in significantly more opportunities for achieving continuous quality improvement. For example:
• The scheduling system allows monitoring of resource utilization (e.g., clinic capacity) and patient scheduling trends (e.g., no shows, cancellations); and
• Evidence-based practice is enabled through the use of clinical decision support tools such as reminders and customizable reports.

“Most importantly, these electronic tools facilitate measuring what could not easily be measured previously. You cannot improve what you cannot measure, so this is where these tools provide the most value.” – Joanne Guizzo, Clinical Manager, Ambulatory Care Clinics

The ACC is also one of 22 facilities that have access to a shared electronic health record. The network of facilities is referred to as the North Eastern Ontario Network (NEON) and allows for seamless delivery of healthcare through Northeastern Ontario.

Improving Continuity of Care

The clinic’s electronic documentation system was designed to promote inter-professional care enabling clinical interventions to be completed, documented, and reviewed by all team members including primary care providers and specialists. For example, if a patient’s diabetes medication was recently adjusted, a physician or pharmacist in hospital or community will be aware of the change in the patient’s care plan and can adjust his/her treatment plan accordingly. In addition to having access to a shared electronic health record through NEON, clinicians are alerted when their patients visit the emergency department, or are admitted to an acute care site. These alerts permit clinicians to provide follow-up care in hospital, or immediately after discharge.

Impacting Providers and Patients

ACC is monitoring outcome measures to evaluate the impact of electronic health systems on care delivery; while in early stages of implementation, outcomes are positive:
• Access to a regional electronic health record improves communication and collaboration with inter-professional care teams across the care continuum;
• Electronic scheduling supports patient-centred care as it allows for synchronization of patients’ multiple appointments; and
• Automated patient reminders are reducing the number of appointment cancellations and no-shows and improving registration wait times.

The ACC team plans to assess the impact of the information system on acute care site admission/readmission data, patient enrolment and clinical outcomes among others.

Critical Success Factors and Lessons Learned

• ACC uses HSN’s LEAN philosophy to sustain existing electronic tools and implement new ones;
• The program trains “super users” to support the scheduling and documentation systems;
• ACC works closely with HSN’s Information Technology personnel to support the ongoing success of these tools, as well as identifying opportunities for enhanced implementation;
• Implementation of new technology has a considerable impact on programs and people therefore having someone with expertise in change management supports a smoother transition; and
• Underestimated the human and financial resources required to support successful design, training, implementation and sustainability.

For more information on Health Sciences North‘s LEADing Practice, contact Joanne Guizzo, Clinical Manager, Ambulatory care Clinics at or 705-671-6601 ext. 2971.

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