April 14, 2020

Nurses explore new ways of delivering patient care using I.T.

Innovating since the days of Florence Nightingale, nurses continue to strive to deliver better patient care. However, this does not necessarily mean in a healthcare facility or at the patient bedside. With the increase in the use of digital technology to manage patient information and care, many nurses have transitioned into the realm of information management and technology. Following is an opportunity to meet some of the leaders at Nova Scotia Health Authority’s Information Management and Technology (NSHA IM/IT).

Andrew Nemirovsky, RN, Senior Director, NSHA IM/IT, Chief Information Officer
As the senior director of NSHA IM/IT and the provincial health authority’s chief information officer, Andrew Nemirovsky is challenging traditional ideas of the role of nurses. For example, he is among a growing number of men entering nursing, which, in the past, has been primarily dominated by women. In fact, over a recent five-year period the growth in the number of male nurses in Canada was three times that of female nurses, according to CIHI statistics.

Nemirovsky’s experience both at the patient bedside and in various clinical health informatics positions throughout his 14-year career have positioned him for success in his current role. Andrew brings a combination of clinical and IT perspectives to ensure clinician workflows and improvements to patient care are paramount in the design and delivery of any new clinical IT systems. Nemirovsky has contributed to local and national digital health associations in relation to conference planning, the writing of white papers and mentorship opportunities for new health IT professionals. He is currently in his last term of his Masters in Health Informatics as he recognizes the value that clinical informatics brings to the healthcare continuum.

IM/IT employs 15 registered nurses/LPN who support and inform the delivery of healthcare through clinical applications and systems, virtual care technology and health informatics. “Technology is critical to the modernization, sustainability and ability to provide the best care to patients,” says Nemirovsky.

Annie Gillis, RN, IM/IT Virtual Care Lead, Nova Scotia Health Authority
As a registered nurse with over 30 years’ experience, Annie Gillis brings a unique clinical perspective to her role as the virtual care lead for the province’s Virtual Care team at Nova Scotia Health Authority’s St. Martha’s Regional Hospital in Antigonish.

Gillis is a champion of the team’s vision to bring patient care closer to home, using audio and video technology to connect patients with healthcare providers in other locations and improving access to quality, person-centred care.

Gillis provides a bridge between clinicians and the IM/IT team. She engages with healthcare providers to support them in navigating the virtual care environment and understanding the effect that using remote technologies will have on their clinical practice and workflow and the patient at the local healthcare facility or site. As a former Telehealth site coordinator, Gillis has a strong understanding of the patient’s virtual care experience at the local healthcare facility. She connects healthcare providers with the nurse at the patient site and provides support to the nurse on how to participate in a virtual appointment and how best to support the patient. Many health service areas across the province’s two health authorities, NSHA and the IWK Health Centre are offering patients the opportunity to participate in virtual care appointments, including: mental health and addictions, orthopedics, neurology, chronic pain, among many others.

At the local regional hospital in Sydney, Cape Breton, Virtual Care is being used to deliver wound care services to patients. After one year, the number of patient appointments, on average, tripled from four in-person visits to 12 virtual appointments during the weekly clinic – a 300% increase. Virtual technology enabled patients to be seen more quickly and reduced the need for lengthy, uncomfortable ambulance trips from the patients’ home communities. Between 2018 and 2019, virtual clinical appointments increased from 5,606 to 7,966 – a rise of 42 percent (read the case study about wound care here). Virtual Care has been available in Nova Scotia since 1998 and in recent years has been expanded to include a desktop application for NSHA and IWK Health Centre healthcare providers (HCPs).

The following virtual care (video conferencing) technology is available in Nova Scotia:

  • Telehealth Unit: A facility-based piece of equipment used for video conferencing. Available at all NSHA healthcare centres and some community partner locations. Facility-based telehealth units can connect to each other as well as to RealPresence desktop/mobile users.
  • RealPresence: Video conferencing software is available for install on NSHA devices. Connects with telehealth units and/or other RealPresence desktop/ mobile users.
  • Virtual Visit: A patient appointment using a web-based videoconferencing solution to connect healthcare providers with patients in their homes, or other location of their choice, using an electronic device.

Nova Scotia’s Virtual Care team is continuing to collaborate with clinicians and other partners to increase the number of services that use remote technologies to enhance both the patient experience and health outcomes. The team is also continuing to explore ways to leverage new and existing technologies to enable the expansion of virtual care across Nova Scotia.

Mary Eileen MacPhail, RN, Clinical Informatics Lead, One Person One Record – Clinical Information Systems Program, Nova Scotia Health Authority
Mary Eileen MacPhail is a Registered Nurse and informatician with NSHA in Halifax. Throughout her nearly 30-year career in healthcare, she has had a passion for health informatics.

Mary Eileen has been an integral member of the Nova Scotia Nursing Informatics Group (NSNIG) for the past 20 years and is also an active member of the Canadian Nursing Informatics Association. Nova Scotia’s Nursing Informatics Group describes nursing informatics as how all nurses manage the information they collect so that it is meaningful and contributes to quality patient care (reference). “By developing nursing informatics networks, we are building on the work of other nursing informaticians to develop standards both locally and nationally,” says MacPhail.

In her role as a clinical informatics lead, Mary Eileen supports the integration of technology into practice. From design to education to delivery and evaluation, she is the liaison between NSHA’s clinical and technical worlds. Her goal is to ensure changes bring process improvement whether through better and/or easier data capture, improved patient care, access to clinical information or improved reporting. In her role with the One Person One Record (OPOR) Clinical Information Systems Program, Mary Eileen supports an interprofessional team and numerous working groups responsible for the development, adjudication and implementation of governance, evidence-informed best practice and standardization within the OPOR Program.

To increase awareness among clinicians and other stakeholders about the benefits that technology and health informatics can have on the delivery of care and patient health outcomes, Mary Eileen hosts a monthly Let’s Talk Informatics series. These workshops build a culture of evidence-informed decision making within Nova Scotia’s healthcare system and are accessible to attend either on-line or in person.

Technology is a key enabler in the delivery of patient care by supporting healthcare providers, ensuring they have the information they need to make patient care decisions. Having access to timely, comprehensive information that provides more of a complete picture of a patient’s health history, symptoms and test results can lead to better patient health outcomes. For more information about Nova Scotia Health Authority, visit www.nshealth.ca.

Lauren MacDougall is a Senior Advisor with the Nova Scotia Health Authority, a valued Digital Health Canada member. Download a PDF copy of this article hereThis article was originally published in Canadian Healthcare Technology.