Imagine if:

• A patient’s file indicates that he has been receiving treatment and a team is handling his follow-up care – fourteen months after he died.
• You see patients’ names on a waiting list when, in fact, they are being seen on a regular basis.
• Other patients’ files show them as being in follow-up, but their case manager and physician’s names are not shown in their records.

In this day and age, it’s hard to believe that such situations can occur; but they have—and right here at the Douglas Institute. 


A study conducted recently in the United States revealed that health care errors are the eighth most common cause of death.  “This highly worrisome finding applies equally to Canada and emphasizes the urgent need to implement strategies that will significantly improve patient safety and the quality of care” stated Jean-Bernard Trudeau, M.D., Director of Professional and Hospital Services. The Douglas Institute has decided to tackle this challenge head-on by developing an electronic patient record system.

The Douglas: Pioneering e-health technology
The Electronic Patient Record (EPR), featuring the Oacis platform from TELUS Health Solutions, is in the process of being implemented in many Montreal healthcare institutions. The Douglas Institute has signed a partnership agreement with TELUS to design and develop the mental health component – one of several components being drafted simultaneously for the Oacis system.

Douglas clinicians, together with technical and administrative teams, have been working for the past 18 months to perfect this component, which will be integrated into the Oacis patient record.

“It is essential for clinics to create electronic patient records— I would even go so far as to say it is a necessity, if only to ensure patient safety. We are convinced that computerized information will bring significant improvements to the quality of mental and psychiatric health care and patient safety,” Dr. Jean-Bernard Trudeau said.

Patient information updated 24/7/365
Come 2012, it will no longer be possible to mistakenly assume that an old lab result is the most recent, simply because it is the first document in the file. Following the five-year implementation period of the EPR system, authorized personnel will be able to access a patient’s entire file, 24 hours a day, 7 days a week, 365 days a year, from any computer on campus. “The key quality of the EPR is to provide instant access to information, in real time, to authorized personnel. We will be able to obtain patient information, whenever we need it, from any one of our 32 buildings on the Douglas campus,” explained Michel Dalton, Director of Financial and Informational Resources. He added: “Better still, the EPR will allow data to be transferred between institutions with the appropriate authorizations. It can be difficult to extract all the necessary information from a patient with mental health concerns who ends up in an emergency room. With the EPR, the ER team may eventually access the information it needs to provide the appropriate level of care.”

What will the EPR look like?
The electronic patient record draws on the combined expertise and know-how of clinicians and computer specialists. “It will be simple and user-friendly, two key aspects that are invaluable to clinical staff to speed up the learning process and provide proper patient care,” asserted Kathleen Madden, Analyst and EPR Project Manager. “Clinicians will derive tangible benefits from the EPR system, once it’s up and running. For instance, with just a few clicks of the mouse, they can retrieve a consultation from a list of default values or prescribe medication.”

Some of the EPR’s benefits
With its user-friendly interface, the EPR will help clinical staff be more efficient by providing:

• Quick access to patient data
• Test results more rapidly
• Specifics on predispositions (metabolic, etc.)
• Details on prescriptions
• Information on drug-drug interactions, etc.

"Studies have clearly shown a marked improvement in the quality of medical services provided, even by highly experienced clinicians, thanks to computerized equipment and decision aids,” Trudeau noted. “Patients will also experience the advantages of the EPR, since it will reduce medical errors and wait times. Ultimately, all these enhancements may well increase the patient’s life expectancy. In the end, it becomes a win-win situation for everyone, because it will improve social productivity.”

Lastly, the advantages of the EPR go beyond strictly helping clinicians and patients. From an administrative point of view, an EPR system will allow better use of human and material resources at the Douglas by: 

• Eliminating multiple files for one patient, located in different sites
• Reducing administrative tasks, from filing to archiving.

The EPR champions
A multidisciplinary team has been working relentlessly for nearly 18 months on the implementation of the EPR at the Douglas. At the moment, the team is made up of some fifteen professionals—a number that will surely swell—from the DACTCE, the Medical Records Department, the Prevention and Early Intervention Program for Psychoses (PEPP-Montréal), the Info-Centre and the IT Department, as well as advisors from all sectors of the hospital.