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Pam Nolan (Garden River Wellness)
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Pam Nolan (Garden River Wellness)


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  • 1. Garden River Wellness Centre’s Electronic Record
  • 2. Our Community
    • Garden River First Nation is a Transfer Community with a population of 1,200 on reserve;
    • GRWC delivers Health & Social Services from Provincial & Federal Government Sources;
      • activities to promote wellness;
      • child and family services;
      • children’s oral health services;
      • chiropody / foot care;
      • chronic disease management (i.e. Diabetes);
      • crisis intervention & referral for sexual abuse, addictions etc…
      • cultural awareness and services;
      • dietary services;
      • emergency preparedness; (cont’d)
  • 3. Our Community (cont’d)
    • GRWC delivers Health & Social Services from Provincial & Federal Government Sources; (cont’d)
      • environmental health;
      • homecare for elderly & disabled;
      • non-insured health benefits;
      • occupational therapy;
      • physiotherapy;
      • prenatal and postnatal care and activities;
      • prevention programs i.e. harm, sickness and disease;
      • primary health care; physician, nurse practitioner;
      • representation in court for child welfare matters;
      • speech and language services; and
      • traditional and contemporary mental health services.
  • 4. Problem Areas
    • Client care was compromised,
      • information was not being shared between providers within and outside the community i.e., immunizations, promotion and prevention interventions, etc
    • Reporting requirements were unmanageable, unorganized, time consuming (manual) and uncoordinated
      • No one person held all the information. We had to go to different people to get the information;
    • Statistics collected were incomplete and inaccurate therefore unreliable for program planning;
  • 5. Background
    • In 2000, we began to explore the world of electronic charting looking at it’s
      • Different types of systems
      • Benefits
      • Funding sources
      • Other users/resources
    • In 2004, we submitted funding proposals
  • 6. Background
    • In 2006, we received funding
      • Purchased software and hardware;
        • i.e. 20” monitors, new CPU’s
      • Developed a Change Management strategy;
        • Staff practiced and developed more computer skills;
        • Staff began compiling the statistics they needed to capture i.e. Diabetes, Health Canada Annual Report etc…
      • Developed an Implementation Plan;
        • Communication Plan, Process Mapping; Forms Analysis etc…
      • Developed policies and procedures
        • i.e. Privacy, Security etc…
  • 7. Uniqueness
    • Our interpretation of the meaning of “client centered care”
    • Our electronic record needed to be able to meet our needs and incorporate our holistic view
    • We soon came to realize that we had more work ahead of us than originally anticipated because,
      • Could not buy out of the box – it is not an out of the box solution;
      • Every provider counted – health & social
      • One record, one client
      • Customization of software – more time, more money
  • 8. Electronic Wellness Record
    • To implement a Patient Registration, Scheduling and Electronic Wellness Record for all clinical and non-clinical programs/services provided at the Garden River Wellness Centre.
  • 9. E.D.S C.P.N.P Psychologist H.B.H.C. Traditional Mental Health ICDP GRWC’s Electronic Wellness Record NIHB Addictions Health Services Community Outreach Speech Language
  • 10. Customization
    • Mapping roles and responsibilities was crucial given the fact that both clinical and non-clinical staff were charting in both the health and social field;
    • Unique Status Number needed to be displayed in demographic screen;
    • Added traditional medicines to list of over the counter medications for the Traditional Healer.
      • In order for the traditional healer to chart, we needed to look at how he delivers services that are different than the typical provider. i.e. customized drop down lists had to be created;
            • (cont’d)
  • 11. Customization
    • Designed forms to meet OUR needs and Health Canada requirements;
    • We used different parts of the software in unique ways such as Dr. Bill to capture statistics for Health Canada Reporting; Sign-offs were used for Financial versus Clinical purposes etc…
    • Naming of the Electronic Record – typical Medical, Health did not define our needs - hence the “Electronic Wellness Record”
  • 12. EWR Project Outcomes
    • A holistic approach to patient care;
    • All patient/client information is located in one secure place;
    • Centralized patient/client registration;
    • Improved communication between staff;
    • Reduced use of paper for patient/client charts, prescriptions, laboratory services etc…;
  • 13. EWR Project Outcomes
    • Improved overall clinical and non-clinical documentation and processes based on best practice i.e. Diabetes Management, Foot Care, Non-Insured Health Benefits; Outreach programs/services;
    • Simplified and streamlined comprehensive reporting;
    • Accurate and reliable statistics; and
    • A model for other First Nations.
  • 14. Where we plan to go next
    • Our future goal is to share client information such as immunization and communicable disease data electronically with local providers off-reserve and between other First Nation communities;
    • Developments to date
      • I am happy to report discussions have started with Algoma Public Health and Group Health Centre to look at what needs to be done to make this happen i.e. sharing agreements, client consent; and
      • 14 First Nation communities throughout the North Shore and Manitoulin are currently working together to develop their electronic record systems and
        • (cont’d)
  • 15. Where we plan to go next
      • Developments to date
      • LHIN E-health strategy intent is to improve access for all Ontarians. As a member on this committee and because of the work we have done to date, I provide feedback from a First Nations perspective; and
      • As a member of the Panorama Tri-partite working group for Ontario, work is on-going between Federal, Provincial and First Nations to share immunization.