What's the best part of working at North York General Hospital (NYGH)?
I get to work with my wife! My wife, Dr. Joyce Lee, is actually a geriatric specialist here. It's a true NYGH love story — we started dating when I was here in 2003 doing a training elective in gastroenterology.
What is a chief medical information officer?
Well, in a hospital like ours, a chief medical information officer or CMIO is someone with a frontline health care background, often a physician, who works with clinical information services staff to provide input into the design and use of health technology in a hospital.
In this role, I help to set the direction for our health informatics projects, and I am a support for our clinical informatics specialists and frontline staff and physicians. As a practicing Gastroenterologist, I get to be both a customer and designer of our electronic tools. I understand and believe in the benefits of health technology, while keeping in mind that technology is only successful when it is carefully designed to enhance the daily work of clinicians and the care they provide for their patients.
|Dr. Jeremy Theal, Chief Medical Information Officer and Gastroenterologist|
I actually know Dr. Peter Rossos well; he was a mentor of mine. Many gastroenterologists choose this specialty because of the mix of patients you see. Some patients are dealing with chronic illnesses like inflammatory bowel disease, so you develop a therapeutic relationship with them as you work together to treat their illness. Then there are patients who come in with a symptom that you can fix quickly, with a procedure like a gastroscopy or colonoscopy.
This is similar to being a CMIO; some of the projects we work on are more cerebral, requiring a lot of thinking and teamwork to achieve results, and other times I can help find a simple “quick win” solution that makes it easier for a physician or nurse to care for their patients.
What makes you proud of working at NYGH?
North York General is a great hospital; there are many things that make me proud to work here. We have had a lot of successes; we were the first community teaching hospital in Canada to achieve HIMSS Stage 6, which means our electronic medical record system is able to support electronic orders for clinicians, leading-edge medication safety protocols, and evidence-based reminders to our physicians as they enter electronic orders for patients.
In 2006 when we were using paper-based patient orders, only about 35% of hospital admissions were initiated using an evidence-based standardized protocol. Today, using our computerized provider order entry (CPOE) system, that number is over 97%. This means nearly all hospital admission orders are based on the most up-to-date, evidence-based treatment. We have conducted studies showing that by putting these computerized systems in place, we have been able to improve patient safety, evidence-based practice, and even save lives!
Could computers ever replace doctors and nurses?
No – not at all! The computer systems we are using are invaluable in that a computer has a much greater ability to store and remember information than any one physician or nurse, and these days clinicians have to grapple with massive amounts of information in their daily work. But the human factor is irreplaceable. Health care professionals' work is changing, and I think for the better. Electronic systems can actually act as a partner in helping clinicians and staff at NYGH to have the latest information at hand in real time, allowing them to provide even better care for our patients.
What's next for health technology at NYGH?
To bring the quality and safety benefits of a seamless electronic record across the hospital, we plan to implement our system in the two remaining paper-based areas. As part of this effort, we plan to achieve HIMSS Stage 7, which is when a hospital has zero paper-based patient charts. In the later part of the summer we will be releasing the Implementation Guide portion of the Canadian CPOE Toolkit, which is a Canada-wide collaborative led by NYGH, designed to freely share knowledge and electronic order sets for the implementation of computerized provider order entry.
Dr. Jeremy Theal is a recognized expert in the design and implementation of advanced electronic medical record systems to improve the quality and safety of patient care. As a key opinion leader on quality improvement using Computerized Provider Order Entry (CPOE) and Clinical Decision Support (CDS), he has served as an advisor to over 50 hospitals as well as several public health authorities and private companies both in Canada and internationally.