Addressing Wait Times with Information Technology

Report 2

Submitted To: Dr. Brian Postl
Submitted By: Canada Health Infoway
Date: March 21, 2006

Executive Summary

Timely access to care is critical to optimizing health, health outcomes, and improving patient satisfaction. With increasing wait times for many health care services, monitoring and management of wait times has become a focus for governments in Canada and internationally.

Wait time initiatives in Canada have varied from the web-based reporting of wait times in selected surgical and diagnostic procedures to more focused investments in increasing capacity and redesigning system processes. Information and communication technologies have demonstrated value in many of the efforts to date and will increasingly become crucial to supporting clinicians providing timely and equitable access to quality health care for Canadians.

This document frames the wait time issue in terms of a patient's journey through the health care system. The use of information and communication technologies will result in the following benefits:

Access

• Support timely delivery of care - solutions to improve referral and scheduling processes and overall case management will help providers decrease the overall time between identification of need and treatment.
• Support equitable distribution of care - solutions for prioritization of resource usage will help ensure that care is delivered appropriately on the basis of need.

Quality

• Improve appropriateness of care - standardized assessment and wait time prioritization will help providers ensure that the wait time is appropriate for the patient.
• Improve effectiveness of care - more timely access to physicians, specialists, diagnostic tests, surgical procedures, as well as after care services will provide for improved health outcome and reduced pressure on the system.

Productivity

• Improve provider productivity - information technology will impact provider productivity in many ways, from ease of access to information to improved efficiencies (e.g. reduced call backs, reduced duplicate tests).
• More efficient resource use - solutions for scheduling will help managers optimize the use of scarce human and physical resources.
• Improve coordination of care - case management will allow a virtual team of providers to more easily coordinate the successful completion of a patient's treatment plan.

In order to capitalize on these benefits there is need to leverage and integrate information and communication technologies for wait time management with the pan-Canadian electronic health record infostructure currently being implemented across the country.

The additional information and communication technologies envisioned to better manage wait times will require investment in referral management, scheduling, case management and wait time monitoring and reporting systems as well as additional investment in location registry, physician electronic medical records and patient portal technologies. The pan-Canadian costs for wait time related information and communication technologies are estimated at approximately $400 million, and the physician electronic medical record and patient portal costs are estimated at approximately an additional $2.0 billion.

Table of Contents

• 1 Introduction
  • 1.1 The Challenge of Health Care Renewal
  • 1.2 Managing Wait Times is Very Complex
• 2 The Patient Journey and Wait Time Improvement Opportunities
  • 2.1 A Hip Replacement Scenario
  • 2.2 Standardized Assessment Tools
  • 2.3 Order Entry and Results Reporting Tools
  • 2.4 Advanced Scheduling Tools
  • 2.5 Electronic Referral Tools
  • 2.6 Case Management Tools
  • 2.7 Provider Electronic Health Record Tools
  • 2.8 Patient Electronic Health Record Tools
  • 2.9 Wait Time Monitoring and Reporting Tools
• 3 The Information Technology Solution
• 4 The Implementation Strategy
  • 4.1 Implementation Staging
  • 4.2 Other Implementation Considerations
  • 4.3 Costs
• 5 Benefits from a Wait Time Management Solution
  • 5.1 Access
  • 5.2 Quality
  • 5.3 Productivity
• Appendix A - Patient Journey Scenario
• Appendix B - Patient Journey Flowchart