A new integrated health information system will enable more seamless care for patients and improved experiences for healthcare providers at Joseph Brant Hospital, whose CEO, Eric Vandewall, reveals more about the implementation of Epic.
PROJECT HARMONY
“Work is currently underway to implement a shared integrated health information system, an essential component of our digital transformation.”
Project Harmony reflects how Joseph Brant Hospital (JBH) is blending its proud history of compassionate care with the power of modern technology.
Located along the picturesque banks of Lake Ontario, JBH is a full-service academic community teaching hospital in Burlington, Canada that also serves the surrounding communities of Halton Region, Hamilton, Waterdown, Flamborough, and Stoney Creek – a referral population of around 250,000.
The modern, state-of-the-art facility proudly provides comprehensive care across a wide range of clinical programs and services, including emergency and critical care, mental health, oncology, diagnostic imaging, maternal, and childcare.
To digitize and modernize care across the entire hospital, JBH is working on Project Harmony in partnership with St. Joseph’s Healthcare Hamilton (St. Joe’s), a premier academic and research healthcare organization and leader in innovative technology implementation, to adopt their award-winning version of Epic, called Dovetale.
It represents a huge step forward in JBH’s digital journey, according to Eric Vandewall, President and CEO of JBH.
“This is a large-scale transformation that will connect our patients to the care they need, when they need it, and where they need it,” he adds.
“Work is underway, and we’re planning to go live with the new system in November this year.”
“This is a large-scale transformation that will connect our patients to the care they need, when they need it, and where they need it”
Eric Vandewall, President and CEO, Joseph Brant Hospital
SEAMLESS CARE
The partnership between JBH and St. Joe’s on a shared Epic platform will enable more seamless care for patients.
The implementation of Dovetale will provide patients with access to more of their health information through an online patient portal called MyDovetale.
“We mostly rely on paper patient records right now, so with Dovetale, we’re going to transition to a modern digital health information system,” notes Vandewall.
“Patients and their families are at the center of our care, yet when we’re working with a paper chart, they can’t always be a true partner in the process because they can’t readily see or access the same information as the care team,” he says.
“With this new system, patients will have access to parts of this information to support their decision-making.”
The partnership will also allow healthcare providers from each organization to better connect and collaborate with each other, as they will be able to easily access patients’ medical histories and ensure they are receiving the most appropriate care.
“For our healthcare providers, I think this will be truly transformational to their work because they will have more seamless access to patient records. This will result in more coordinated care, a far better provider experience, and clarity in terms of having one source of truth,” says Vandewall.
“Dovetale’s auto-cancel feature, for example, will reduce the likelihood of physicians ordering duplicate tests. It also has an electronic symptom management tool that will help oncologists track their patients’ symptoms over time without clinic visits.
“A lot of these built-in benefits will ultimately support providers in their care journey and result in better care and an improved experience for patients and their family members,” he adds.
PATIENT SAFETY
The new system will also strengthen JBH’s ability to create healthier communities.
According to Vandewall, Project Harmony is the largest quality improvement project that the hospital has ever undertaken.
“When a health information system such as Epic is introduced, we see measurements that predict safety and improvement, and we’re actively looking at those,” he says.
An important indicator of patient safety and the quality of care in Canadian hospitals such as JBH is the hospital standardized mortality ratio (HSMR).
The HSMR adjusts for factors that affect in-hospital mortality rates – such as age, sex, diagnosis, length of stay, comorbidities, and admission status – then compares the actual number of deaths in a hospital with the average Canadian experience.
The ratio provides a starting point to assess mortality rates and identify areas for improvement.
“An HSMR of 100 indicates the hospital’s mortality rate is no different to the national average in terms of the predicted number of deaths that would occur,” Vandewall explains.
“If it’s higher than 100, that suggests there are opportunities for the organization to improve in terms of patient safety, while an HSMR of less than 100 indicates that fewer deaths have occurred than expected.”
JBH has been monitoring its ratio for the past 10 years and has seen steady improvements, recording an HSMR of 72 in the last fiscal year.
“This is huge progress, and although we are already trending strongly, the introduction of Dovetale may open up opportunities for continued improvements in patient safety,” Vandewall says.
“Another good example is the introduction of computerized prescriber order entry, which will reduce errors and enhance efficiency by allowing prescribers to submit orders electronically. This will mean faster receipt of patient care orders to multiple health care practitioners,” he adds.
“When Cambridge University in the UK introduced their Epic system, it also saw around 850 significant adverse reactions prevented each year thanks to electronic allergy-related prescribing alerts and a 42 percent reduction in sepsis mortality with electronic sepsis alerts built in, so we are super excited about the impact of Epic in terms of improvements to patient safety.”
ALIGNING BEST PRACTICES
The partnership between JBH and St. Joe’s is transformative because it goes beyond just helping JBH adopt Dovetale.
“This is a real opportunity we have with St. Joe’s in terms of aligning best practices and working together to improve the provider experience,” Vandewall says.
“It’s showcasing a new way for us to work together as two hospitals in Ontario. Their expertise and experience with Epic makes our implementation possible.”
JBH is among a small but growing number of hospitals in Canada adopting Epic using what it calls a Joint Connect Model. Once Dovetale is implemented at JBH, the two hospitals will continue to refine the shared system together and build enhancements as their needs evolve.
“Our partnership is especially meaningful because it’s a way for small to medium-sized hospitals to implement a digital health information system like Dovetale without having to shoulder the cost or infrastructure burden alone,” Vandewall emphasizes.
“We’ve heard from the Ontario government, and they’ve expressed their support for our approach because it offers a scalable and sustainable way to modernize health information systems across the province.
“We’re building a shared system, shaping a stronger patient and provider experience, and creating a model that others across Ontario can follow,” he tells us.
“We’re building a shared system, shaping a stronger patient and provider experience, and creating a model that others across Ontario can follow”
Eric Vandewall, President and CEO, Joseph Brant Hospital
TIGHT-KNIT CULTURE
One of JBH’s greatest strengths is its culture. When people at the hospital describe the organization as tight-knit, it’s not just a sentiment – it’s truly a lived experience.
“We know through research that the patient experience is directly tied to the provider and staff experience. If you have a vibrant, supportive culture and healthy workplace, that translates directly over to the patient experience,” Vandewall says.
“Our staff come to work every day with purpose, and our physicians and clinicians are devoted to exceptional care. Patients and their families trust us during some of their most important moments.”
When JBH launched Project Harmony, it was important to not lose sight of this identity.
While tools and technologies are changing, the hospital’s commitment to compassionate, high-quality care remains steadfast.
The project brings together JBH’s people-first culture and the innovative digital maturity of St. Joe’s.
“It’s not about becoming something entirely new – it’s about elevating who we already are and working alongside one of our partners to lift each other up and continuously improve,” says Vandewall.
“The collaboration with St. Joe’s allows us to integrate the best of both worlds – our deep community roots and people-first culture with their proven success, experience, and leadership in digital transformation.”
JBH and St. Joe’s will share a system that reflects not only the best practices of two respected organizations, but also the spirit of partnership, trust, and mutual respect that’s defined the project right from the very beginning.
“We’re moving into this next chapter in a way that honors where we’ve come from and confidently embracing where we’re going, and our culture is at the root of that success,” Vandewall asserts.
STANDARDIZED WORKFLOWS
Work on Project Harmony is progressing well ahead of the Dovetale system going live in November, with JBH currently in the building stage and standardizing workflows with St. Joe’s.
“We may have a workflow or best practice that St. Joe’s hasn’t adopted yet – and vice versa – so we’re asking, “Would this be of interest to our partner?”,” Vandewall says.
“Now that the project build is underway, we’re seeing this commonality of standard practices and workflows coming together. It’s a huge change, though, and I wouldn’t want that to be underestimated.”
Indeed, the digital platform will transform people’s work in a way that they haven’t been exposed to in the past at JBH.
“Some of our physicians have hospital privileges at St. Joe’s and have worked on the Dovetale system, and they can’t wait for it to become a reality here at JBH,” shares Vandewall.
“Having said that, there is a change process, so we’re spending a lot of time on change management and engaging our physicians and staff to mitigate the impacts as much as possible.
“What we put into it is what we get out of it, so our people are fully embracing what’s before them because they know the system is going to be with us for decades to come. Investing now will only serve everybody, including our patients, better as we go forward,” he concludes.
