Designing the Fraser Health Patient Education Resources system

by Kathy Bryce Wednesday, November 28, 2012 3:36 PM

In 2010 Andornot was approached to develop a system to manage the patient education materials produced and recommended by Fraser Health Authority (FHA) staff. FHA serves over 1.6 million people and employs 26,000 staff spread out over 12 acute care hospitals and numerous other facilities.

The challenge was to identify and review all existing patient education resources both in hard copy and electronic formats. Types of material included general informational pamphlets or posters on topics such as smoking cessation or breastfeeding, plus procedure-based factsheets and discharge instructions. Add in to the mix the multiple language versions created to cater to the large Asian, Indo-Canadian, Korean, and Filipino populations, and the fact that there were multiple similar pamphlets on popular topics, as many hospitals had developed these on their own.

Andornot provides similar patient education resources systems to Vancouver Coastal Health and McGill University Health Centre and so had considerable experience in the workflow associated with managing these types of publication.

FH Patient Education search results

We chose to emulate various well-respected websites for patient health information and index every item by multiple categories, including Disorders & Conditions, Body Location and Demographic, as well as an uncontrolled Keywords field and MESH headings. In addition, fields were added for FHA Program information and site locations. Considerable planning went into the choice and values for each category in order to create facets to allow users to easily limit or expand their searches.

We prototyped the catalog aspect of the system using Inmagic DB/TextWorks, and a library technician with a medical transcriptionist background was hired to do the first pass of data entry. DB/TextWorks is a great tool for this, as inevitably the scope changed during the project as different types of resources were uncovered, and integration with the FHA Print Shop was added to facilitate the ordering of multiple copies. 

Once a thousand or so items had been catalogued and the system parameters finalized, we transitioned to a SQL Server database with a Solr based front end search using our Andornot Discovery Interface (AnDI). This allows us to better specify relationships between documents, i.e. for multiple language versions, plus it supports versioning.    Searching for medical terms can be challenging with acronyms and abbreviations, as as well as problems with correct spelling.

Apart from the refine by facets capability, the new system features automatic truncation and a Did You Mean capability, so for example if a user types “anasthesia” they will be directed to the correct spelling. Did You Mean example

The collection includes full-text documents created by healthcare professionals in FHA, plus links to the URLS’s of full-text documents created by other reliable organizations. FHA professionals are reviewing each publication for appropriate content in compliance with plain language and formatting standards.

An authentication system is in place to limit who can see what, and from where, depending on the Status field of each item.  Many of the resources are best viewed with a health care professional, so access to these will be limited to PC’s within the IP ranges of the FHA facilities. The aim is that in 2013, the catalogue will also be made available to the public through a link from the FHA website. In the meantime this direct link shows just a small subset of materials already approved for the public at large. The default AnDI search results are displayed by relevance but we were able to boost certain parameters to display the active and English language items first.FH Admin

FHA staff are able to submit new patient education resources for evaluation using the resource submission function. These show up immediately with an In Process status so that other FHA staff can see whether a similar publication already exists or is under development.

Behind the scenes is an extensive administrative interface to allow FHA authorized staff to edit records, make batch changes to lookup fields and export reports of downloads for statistical analysis. The system has only been launched officially to the ER departments but it already provides a fascinating snapshot of the most in demand resources, thus helping guide ongoing review and translation priorities.

“Emergency departments in FH are now able to access the patient education catalogue to download patient discharge instructions as they send patients home. Plus they are able to capture reports showing how regularly each specific item is utilized. FH physicians, staff and volunteers are looking forward to accessing and sharing their patient education materials from across the health authority, to enhance the experience of patients, clients, residents and the public served by FH.  [Kathy Scarborough, MSN, RN, Clinical Practice Consultant, Professional Practice and Integration, Fraser Health.]

This new system showcases Andornot’s expertise in both designing and implementing a custom, complex web application over a multi year period.

Please contact us to discuss how we can help you develop a similar patient education system or for any other projects.

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