1. I
mproving care delivery at the point-
of-care is a critical challenge for
healthcare organizations. Combining
pre-acute and post-acute processes
and technology, such as mobile
point-of-care and electronic visit verifica-
tion, will create a common approach to
electronic patient records and are critical to
the future success of our healthcare systems.
There is increasing evidence that mobile
technology and applications will transform
the industry and facilitate faster and better
communications. As well, they are able to
improve compliance and provide integrat-
ed outcome data to the front-line field staff.
For over 30 years, ParaMed Home
Health Care has delivered exceptional
healthcare to clients living in their homes.
Client-centered approaches to care and a
focus on client outcome achievement are
the foundations of care at ParaMed.
Using a care delivery model of Out-
come Based Care, a technology innovation
was collaboratively created by ParaMed
and CellTrak Technologies, Inc. Included
in the innovation are a clinical documen-
tation application that operates on a
mobile device, a healthcare team portal for
viewing and accessing electronic client
record data which is supported by formal
research partnerships.
Critical to the design of the application
was ensuring that the application followed
the nursing process. Health Outcomes for
Better Information for Care, nursing out-
come measurements, are embedded into
the system to ensure reliable and valid
measurement tools are used to assess
client status.
This innovation supports staff in deliv-
ering safe, quality care, supports improved
communication among the healthcare
team, integrates best practices, supports
best possible client outcomes and measur-
ability and maximizes decision-making at
the point-of-care. Data from the system is
transformed into actionable knowledge
and is used at the client, organization and
system level by each of the individual clin-
icians to transform practice and care.
Built upon a previously implemented
mobile healthcare technology platform
from CellTrak for automated service con-
firmation, ParaMed was able to take
advantage of advanced enterprise capabil-
ities to capture and analyze real-time data
and trends in home care with assurance
that health information security and con-
fidentiality were protected. This approach
to implementation supports integration
and sustainability.
Many technology solutions are built to
address business needs or automate poor-
ly operating care processes. However,
through the collaboration between Cell-
Trak and ParaMed, the solution aligned
with home healthcare industry require-
ments and blended business realities with
efficient and effective care delivery
processes and best practices.
Placing data into the hands of clini-
cians at the point-of-care has demonstrat-
ed that data can facilitate critical health
system transformation. A technology
enabled environment with the right appli-
cation and the right partners is really
making a difference to clients and their
care. Ease of access to information;
improved communication; real-time
monitoring of care and coaching of nurs-
es; along with efficient and effective tools
ParaMed deploys mobile solutions
to improve care to home-based clients
Reprinted from Canadian Healthcare Technology, October 2013 issue
www.canhealth.com
Using the new eOBC platform from CellTrak, ParaMed’s nursing team can quickly see and react to client outcomes data.

2. for care delivery and planning supports
clinicians in delivering the best possible
care to home care clients.
All of the clinical assessments in the
application include HOBIC nursing out-
come measures. The healthcare portal
allows viewing of electronic patient record
results by healthcare team members with-
in minutes of completion through a
secure visit manager web portal or via the
mobile device itself.
Here is what nurses at all levels of the
organization are saying about the system
and how it is making a difference to their
practice and care.
“For me as a Care and Services Manag-
er, eOBC is the window to client data
access. It allows me to monitor trends and
clients’ progress, gives me information for
on-call support and telephone advice, and
empowers me to do virtual supervision of
care whenever needed,”commented Agnes
Sibiga, RN.
“As a clinical leader I am able to review
the documentation practice of the nurse
and supervisory staff. Data is readily avail-
able to me so that I am able to measure
and respond to what the data is telling me.
This enables me to provide coaching and
mentoring support to staff so that I know
that the clients are receiving safe quality
care,” said Michelle Vesey, RN.
Cathy Campbell, RN Supervisor, added:
“It is great that it can be accessed remotely.”
Transforming supervision into real-
time concurrent practice has been a signif-
icant impact of this innovation imple-
mentation. Within 15 minutes of finishing
an assessment, nurses can receive feedback
from their supervisor on the quality of
their assessments and supervisors can eas-
ily see the assessment data and results for
their clients.
“eOBC enables me to collaborate with
my supervision and nursing teams in the
identification of trends at the point-of-
care and in real-time, thus enabling us to
either provide evidence of achieving posi-
tive health outcomes or to initiate quality
improvement activities when indicated,”
commented Tracey Stevenson, RN.
Carol Fitzgibbons, RN, said that “as a
supervisor for nursing, eOBC allows me to
review the quality of the assessments con-
ducted by our nurses to ensure they are
keeping to the standards required by the
College of Nurses. These assessments ulti-
mately provide our clients with the foun-
dation for improved outcomes as other
nurses who are assigned to see the clients
are able to review previous assessments
and as a result are better prepared to pro-
vide the quality of care required.”
Ensuring effective communication is
critical to client consistency and continu-
ity of care, noted Chantale Hebert, RN,
and Sue Gauvin, RPN. “Using the elec-
tronic outcome-based charting has pro-
vided me with the tools to complete a
comprehensive assessment of my clients.
It has helped me in designing care plans
focused on their needs in a more efficient
manner,” said Hebert.
“eOBC has provided the front-line
nurses with access to the clients’ complete
histories at the push of a button,” said
Gauvin. “The ease in which it allows us to
quickly put all the pieces together is what
I think has been, by far, how eOBC has
changed my practice.”
With knowledge-creation accelerating
quickly, it is critical that ways to effective-
ly integrate that evidence into the prac-
tice are found. This innovation has facili-
tated that integration in a positive and
seamless way. Kelly Negrin, RN, BSN,
MSN, said: “I have been a nurse and
nurse educator for 25 years. I really
appreciate using the CellTrak eOBC solu-
tion for nursing assessments in my role as
a visit nurse. This technology supports
my evidence-informed practice, which
helps to ensure I am meeting the stan-
dards for a professional nurse.”
Case management and preparedness
when working in a community context
can be challenging. Tasma Baxendale, RN,
said that “communication is the key to
community nursing. Given the nature of
the job, the eOBC portal is an excellent
resource for all nurses to get information
and updates on any client they may be see-
ing for the first time, and therefore pro-
vide appropriate care with a professional
approach.”
For her part, Bessie Snow, RN, said: “I
check the eClient portal for information
on each client. It makes assessment easier,
therefore making the client more comfort-
able because I am familiar with their med-
ical issues. I have had comments like, ‘I
have never seen you before, and you
already know so much about me.’”
Jessica O’Driscoll said that “being pre-
pared and having client details before a
visit provides both reassurance and trust
to a client and their loved ones.”
At a corporate level, aggregated reports
and dashboards received by professional
practice consultants increases the trans-
parency and identification of trends in
groups of clients regarding outcome
achievement. This data is used to respond
upstream to potential system issues and
shape the company policy and education
that may be required. Use of data in trans-
formation of practice is a fundamental
impact of the system’s implementation.
This new application is critical to pro-
viding nurses with the tools and support
they need to deliver the best possible care
to their clients. Cheryl Reid-Haughian,
RN, MHScN, and Director, Professional
Practice, Knowledge and Innovation, said:
The magic of a system like this is seeing
how at every level of the organization
nurses are using the health outcomes data
to shape care at the client, organizational
and system level. Nurses can see, in real-
time, health outcomes data to make
informed clinical decisions for care plan-
ning and care delivery and can reflect on
data to inform nursing practice change.
This innovation enables collaborative,
coordinated healthcare in home care, pro-
vides access to timely data to be more effec-
tive and connects previously unconnected
systems, while transforming paper process-
es. The work to date enables the organiza-
tion to deliver the best possible care and
lays a foundation for connecting to a future
Pan-Canadian electronic health record.
According to Michael K. Wons, presi-
dent and CEO of CellTrak, “working with
industry leader ParaMed has been at the
cornerstone of the continued innovation
for the industry. For home and communi-
ty care, technology will continue to shape
the future of point-of-care service and
compliance. No matter what technology
appears next, the most important return is
in the quality of care for the clients. The
foremost goals in any home healthcare
agency adding on a technology solution
will remain the same: to manage costs,
improve the quality of care and achieve
the best possible outcomes, and to give the
client services that they need within the
home and community-care setting.”
Within 15 minutes of finishing
an assessment, nurses can
receive feedback on the quality
of their work.