Case Studies Index

The Ottawa Hospital:
Transforming healthcare with mobile

Several years ago, The Ottawa Hospital determined that its traditional workflow process could not keep pace with today's medical advances and increasingly complex health conditions.

In addressing this need for change, the hospital and IBM codeveloped an innovative approach to Business Process Management (BPM) that puts mobility at the center of care. The team began its journey to transform the hospital into an mHealth operation, and set a new standard in healthcare with the eventual goal of becoming a top—10 percent performer in patient care and safety in North America.

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Challenge

An ailing patient care delivery system

Patient care teams were dealing with over-occupancy of up to 110 percent, inefficiencies associated with manual processes, limited access to patient information and open-ended communication methods. These issues led to care delays, a lack of team collaboration and inaccurate discharge scheduling, all comprimising the patient.

Solution

Empowerment through mobility

The Ottawa Hospital and IBM codeveloped a nimble, mobile-enabled care management platform to streamline workflow processes and create a “circle of care” around each patient. Care providers in the current scope of the mobility implementation have 24/7 access to patient information, collaboration tools and available hospital resources via a custom mobile app.

Results

Physician time reinvested in bedside care

With the platform, the hospital transformed its process infrastructure and standardized its delivery of care. The result? Easier access to patient information. Less paperwork. Improved workflow. Greater transparency. And more collaboration. Now doctors are able to spend two more hours per day at the bedside and delivering a higher quality of patient care overall.

The Challenge
To manage occupancy rates and patient care, The Ottawa Hospital changed how it works.

A need for change

The Ottawa Hospital was admitting a growing number of patients with complex conditions—many requiring attention from multiple clinicians, in different departments. Care teams of up to 50 members were struggling to communicate and collaborate effectively through manual processes and to access the vital patient information they needed to deliver the best care possible. These barriers contributed to delays in care and a less-than-ideal overall patient experience.

Dale Potter, then the hospital's chief information officer, had seen these types of issues in other industries where a lack of standardization in manual processes had created inefficiencies. Potter, now senior vice president of Strategy and Transformation, partnered with IBM to validate that BPM methodologies and technologies could work in healthcare.

Introducing BPM into healthcare

Addressing the challenge

When Potter started as CIO of The Ottawa Hospital, CEO Dr. Jack Kitts asked him to transform the hospital into a high-quality, patient-centric organization by “challenging traditional thinking in healthcare”—an ever greater challenge since Potter had no prior experience in the healthcare industry. Instead, he was equipped with experience from the manufacturing world on how to improve efficiencies through organizational processes.

By observing physicians at work, Potter saw that personal computers and other platforms were wasting clinicians’ time by disrupting workflows and keeping them away from the bedside. Clinicians were constantly shuttling between patients and PCs to make status updates, as well as to schedule surgeries, prescribe drugs, view X-rays and performing other tasks.

To address these workflow roadblocks and support the hospital's goal of providing a better experience for every patient, Potter envisioned a mobile approach for managing and automating the clinical process.

Delivering care to the bedside and being able to retrieve information in real-time wherever a physician happens to be are two elements that led us towards adopting mobile as aggressively as we did.

—Dale Potter, Senior Vice President–Strategy and Transformation, The Ottawa Hospital

Introducing BPM into healthcare

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We’re drawing what people do naturally, out of their heads, looking at best practices, trying to meld those together to be best practice.

—Dale Potter, SVP Strategy & Transformation

CPM—The right approach

Using the business process modeling solution IBM Blueworks Live™, The Ottawa Hospital team captured the hospital's processes and the clinicians' input and complete workflow in a matter of weeks—from basic administrative tasks to patient care procedures. Notably, the process modeling participants found Blueworks intuitive and easy to understand.

Another benefit of the CPM platform is the flexibility of the model created. The modeling process can be adapted across multiple departments in the hospital, and can be modified when workflow changes and communication gaps surface. The down-the-line advantage to this flexibility is the ability to maintain patient care at the highest possible standard.

View the project timeline with key collaboration milestones.

To scroll through the project milestones, click on the arrow at the bottom right.

To scroll through the project milestones, use your touch screen or tap the arrow at the bottom right.

  • MAR 2010

    Envisioning a mobile strategy
    CIO Dale Potter distributes iPads to the hospital’s staff.
  • JUL 2010

    Clinical Mobile App development begins
    App to display relevant patient information for physicians
  • NOV 2010

    Clinical Mobile App pilot begins
    More than 40 clinicians at the hospital participate in the pilot program.
  • FEB 2011

    BPM for healthcare
    Partners explore Business Process Management strategies to apply to the health field.
  • APR 2011

    Developing health-records function
    IBM BPM specialists develop the scope for this feature of the Clinical Mobile App.
  • APR-JUN 2011

    IBM engages Industry Business Value Assessment experts
    Partners recommend a pilot project for the Health Records app.
  • JUL-OCT 2011

    Health Records app pilot launch
    The program demonstrates value of BPM and mobile channel and reduces missing files from 4,000 per month to 20 per month.
  • JUL 2011

    Hospital-wide Industry Business Value Assessment (IBVA) implemented
    IBVA begins, revealing BPM’s value and benefits, and identifying processes in need of improvement.
  • JUL-AUG 2011

    IBM engages its global BPM experts
    IBM’s BPM experts redefine BPM for healthcare as Care Process Management and recommend full-scale BPM project.
  • SEP-OCT 2011

    Partners develop CPM platform roadmap
    In this eight-month plan, the first phase addresses patient flow, safety, quality of care and patient experience.
  • SEP-OCT 2011

    On-the-ground development team
    This phase engages 40 care team stakeholders across all hospital disciplines.
  • SEP-OCT 2011

    Collaboration amongst stakeholders
    One-on-one interviews highlight stakeholders’ pain points so they can be addressed in changes to the existing processes.
  • NOV 2011

    Roadmap to implementation
    IBM and hospital agree to an 18-month project roadmap including Business Value Analysis, BPM, a mobile dashboard and new process optimization.
  • MAR 2012

    Computerized Physician Order Entry goes live
    The CPOE iPad app goes live—a first for any hospital worldwide—letting physicians place 90 percent of patient orders, up from 20 percent before the app.
  • OCT 2012

    Clinical Mobile App goes live
    The CMA launches with Circle of Care, MDAP dashboard and closed-loop comms functionality, saving physicians two hours per day.
  • FEB 2013

    Discharge Readiness Planning enhanced
    CPM evolved to electronic whiteboard patient discharge display
  • JUN 2013

    Mobile Reconciliation on mobility platform
    Rolled out at the Civic Campus Hospital
  • JUL 2013

    Emergency Department Consults
    CPM optimized for Emergency Department. Closed loop request with automated notification, Pilot Project for Medicine Consults
  • OCT 2013

    Mobile Reconciliation on mobility platform
    Rolled out at the Civic Campus Hospital
  • NOV 2013

    CPOE and Mobile ED tracking rolled out
    Computerized Physician Order Entry and Mobile ED Tracking implemented
  • MAY-JUN 2014

    CPM model to be adapted to all The Ottawa Hospital units
    Discharge Readiness Planning Model extended to other TOH units; all hospital's processes being standardized.
  • SEP 2014

    Continued adoption of CPM model
    An additional 2,000 iPads plannd for deployment to the hospital, brining the total iPads in use to 6,000.
  • NOV-DEC 2014

    IBM predictive analytics to be implemented
    IBM predictive analytics to improve resource planning, patient/treatment flow and the overall patient experience.

IBM

IBM & The Ottawa Hospital

The Ottawa Hospital

Inspiration from outside of healthcare

Potter had a unique perspective on the hospital's problems. Knowing these issues were not specific to healthcare, he sought inspiration on business process modeling from other industries.

The manufacturing model

“Lean manufacturing” is an industry concept that aims for value creation in every dollar spent in the manufacturing process. Being familiar with this construct, Potter recognized inefficiencies in wasted physician time: high-value staff performing low-value tasks, such as transcribing information. Engagement in manual, low-value tasks also prevented physicians from accessing real-time patient information.

The banking model

In banking, an online transaction passes through as many as 15 systems before it reaches a customer. A similar process was happening in the hospital with resource assignment requests. Following the bank’s example, Potter introduced a system that sent physicians’ resource requests directly to the right specialist group—replacing an inefficient, error-prone process using phones and faxes.

The transportation model

Looking outside the healthcare industry for process management success, Potter learned from a global transportation company whose key priorities for an airport ground-control solution were flow, security and safety. The hospital's senior management also focused on those factors to develop its process model, improving accuracy in discharge scheduling, patient data security and error reduction.

Why IBM Mobile?

The Ottawa Hospital identified its most significant barriers to consistent patient care as

  • Delays in the flow and exchange of patient information
  • The inability of clinicians to communicate in real time.

Physicians were spending too much time at their PCs retrieving and manually inputting information, instead of being at patients’ bedsides.

The solution: The hospital partnered with IBM for its Mobile Business Intelligence, an integrated mobile-centric platform that could develop and seamlessly integrate into the hospital’s existing infrastructure. IBM designed the mobile solution to deliver near-real-time patient information, enhanced clinical collaboration, faster response times and improved patient safety and care outcomes.

When we adopted mobility, we were able to bring care back to the bedside. One of the most interesting outcomes is that at a bedside, there's an exchange, a dialogue, and the patient will ask questions. Four years ago, if the patient asked a question about something, the physician would have to leave to get that information, then come back to continue the conversation.

—Dale Potter, Senior Vice President–Strategy and Transformation, The Ottawa Hospital

The Solution
Linking its care management platform with a clinical mobile app for a “circle of care.”

A platform for visibility

The Ottawa Hospital was in need of transparency—access to hospital systems, patient information and staff availability. The team delivered this transparency by combining the care management platform with the Clinical Mobile App on more than 3,400 iPads, with a patient circle of care, with a Multi-Disciplinary Activity Plan and with closed-loop communications capabilities. Physicians could work with patients at their bedsides using up-to-the-minute information and collaborate with colleagues without being tethered to their desktops.

The Circle of Care is a simple visual interface that gives caregivers the ability to view and manage the Clinical Mobile Application. It's designed to give care team members an understanding in real time of who and which services are part of the patient's care. It also facilitates communication and collaboration between the caregivers.

The Circle of Care

The “Circle of Care” is a simple visual interface that gives caregivers the ability to view and manage the Clinical Mobile Application. It’s designed to give care team members an understanding in real time of which caregivers and which services are involved in the patient’s care. It also facilitates communication and collaboration among the caregivers.

Watch how mobility brought the Circle of Care to life

 

A Multi-Disciplinary Activity Plan

A Multi-Disciplinary Activity Plan gives care providers the ability to assign tasks, monitor activities and offer a complete view of the care process for each patient. It also saves time by allowing physicians to enter electronic orders from anywhere, at any time.

Closed-loop communications

Closed-loop communications capabilities ensure that all in-process care team communications are sent, received and executed. Clinicians can input consult requests, response tracking, escalation procedures—even requests to caregivers outside the hospital—without pagers or phones.

Mobility is enabling social collaboration among the team players who deliver care by allowing the sharing patient data, aggregate patient data and outcome of performance data in real time.

— Dr. Michael Fung Kee Fung, Head of Surgical Oncology and Medical Director for Strategy and Transformation, The Ottawa Hospital

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The Results
Offering better care—and a better patient experience—through a new mobile platform.

The transformation: Healthier outcomes at Ottawa

The Ottawa Hospital was transformed. Its resources are now better used. Discharge scheduling is more accurate. Physicians' time is better spent. And best of all, patient care is consistent, making for a much improved patient experience.

Physicians —efficiencies enable better patient care decisions and saves time that can be reinvested at the bedside.

Patients —with direct access to test results and doctors at the bedside, patients have a better understanding of their condition, diagnosis and treatment plan and can communicate more effectively with their clinicians

Hospital administrators —coordinated processes and improved patient flow means shorter hospital stays, reduced operational costs and better patient outcomes.

IBM gave us something that has changed the way we practice medicine.

—Dale Potter, Senior Vice President–Strategy and Transformation, The Ottawa Hospital

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What next?

The Ottawa Hospital mHealth story doesn't end here. The Ottawa-IBM team continues to collaborate and develop strategies to adapt the CPM platform across all of its departments. Soon, by using predictive analytics, the team will be able to plan its resources weeks in advance, speed up patient flow and treatment, and subsequently standardize all in- and outpatient processes. The ongoing impact? Hospital-wide operational efficiencies, better quality care and most importantly, optimal patient experiences.

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Key learnings

Potter and his extended internal and IBM team succeeded in standardizing patient care, improving workflows, saving physician time and improving discharge scheduling. Potter's key insights into building a mobile strategy and developing a mobile application include:

  • Involve end users as stakeholders early on and focus on needs before technology.
  • Position the solution to demonstrate value. The CPM platform is a capability—a way of working—not just another system.
  • Change your culture. With BPM, you're making your culture process aware.
  • Expect modifications. Build in the ability to adapt to user requests and feedback.
  • Track compliance and measure success. Share data and trends to continuously optimize.

In terms of advice for other leaders, my core advice is if you see a need for mobility in the type of operations you run, go for it; you’ll find that the change process will
just happen.

—Dale Potter, Senior Vice President–Strategy and Transformation, The Ottawa Hospital

Who's who

Dale Potter

Senior Vice President–Strategy and Transformation, The Ottawa Hospital

Potter joined The Ottawa Hospital, one of Canada's largest academic health science centers, in 2008. He has served as CIO of Alcan Engineered Products in Paris and Bombardier Transportation in Berlin.

Dr. Glen Geiger

Chief Medical Information Officer, The Ottawa Hospital

Geiger, a practicing general internal medicine specialist, has overseen electronic patient record systems for more than a decade. He has a masters in biomedical engineering from the University of Toronto.

Valerie Gamache-O'Leary

Chief Information Officer, the Ottawa Hospital

Gamache-O’Leary is a Business and Information Systems Executive with a track record of delivering effective business solutions that leverage state-of-the-art technology in the Healthcare IT space. Val also has more than 10 years experience leading large, complex Regional and Provincial Healthcare IT projects.

Stephen Brickell

IBM Smarter Healthcare

Brickell leads the IBM software team in Ontario, Canada, to help transform the publicly funded provincial healthcare system. The team has had success in world leading technology wins in province wide Health Information Access Layer, Social Business for Patient Care and Health Analytics to increase hospital operations.

Products and Services

IBM Business Process Manager

Optimize business processes to reduce complexity and improve productivity and collaboration. IBM® Business Process Manager products give you visibility into and enable management of your business processes.

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IBM BlueWorks Live™

IBM Blueworks Live™ is a cloud-based business process modeling tool that lets you discover, design, automate, and manage business processes for your organization.

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IBM WebSphere® Operational Decision Manager

IBM® Operational Decision Manager provides an elegant development environment, along with dedicated, business user interfaces, for automating and governing frequently occurring, repeatable business decisions across processes and applications.

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IBM Integration Bus Advanced

IBM® Integration Bus Advanced formerly known as WebSphere® Message Broker is an enterprise service bus (ESB) providing connectivity and universal data transformation for service-oriented architecture (SOA) and non-SOA environments.

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About The Ottawa Hospital

The Ottawa Hospital is one of the largest academic teaching hospitals in Canada. With four campuses throughout the city, the hospital has 1,200 beds, 1,500 physicians and 3,400 nurses (12,000 employees total) and serves 1.2 million people across eastern Ontario.