Summary
The Manitoba eRenal Implementation and Transformation (MeRIT) Project is introducing an electronic patient management system for the Manitoba Renal Program (MRP) that will centralize key information collected as patients receive kidney care in the province. The system, the electronic kidney health record (eKHR), will be delivered in three phases over the next two years.

The eKHR will gather patients' clinical assessments, lab and other test results, dialysis* treatment information and medical history from various programs and sites. The information will be accessible to health-care providers as they deliver kidney care in 20 sites across the province. Hemodialysis* and clinical assessment scheduling will also be integrated and housed in the system.

The eKHR will replace a variety of methods currently being used to gather this information for the MRP. These vary by site and region, are typically manual and contain errors and duplications.

A user advisory group comprised of 23 multidisciplinary program roles provides consultation services to the project. This group is regularly consulted to ensure the system and associated workflows are appropriate for users.

The Manitoba Renal Program is working in collaboration with the British Columbia Provincial Renal Agency, which built and owns the application, to customize and implement the system.

Components

Stage 1 of the eKHR includes patient scheduling and registration.

Scheduling
The system will link hemodialysis scheduling across the province. Appointments for clinical assessments will also be created and housed in the system.

Patient registration
The system will capture demographic patient information and, in stage two, connect it with the clinical information.

Stage 2 of the eKHR includes clinical data capture.

Clinical information
Clinical assessment, medical history and care information from the interdisciplinary team will be captured and housed in the system. Prescriptions will be written in the system and a prescription history saved for every patient. Health-care providers will have immediate access to lab and other test results. System reports will be available to help identify potential candidates for specific preventative therapies.

Benefits

Patient benefits

• Patients will receive better continuity of care in a timelier manner as they receive renal treatment throughout the province.
• Patients requiring hemodialysis may receive treatment sooner, as available dialysis treatment sites will be assessed in real time across the province.

Clinical Benefits

• Health-care providers will have immediate access to key patient information, enabling them to make informed, timely patient care decisions.
• Manual transcription will be reduced, decreasing errors.
• Improved access to patients' lab and other test results will reduce duplicate testing.

Administrative Benefits

• Accurate, up-to-date patient data can be used for clinical research, reporting to other organizations and monitoring of renal cases in the province.
• Manitoba Renal Program will be able to make more accurate budget and planning decisions based on timely and accurate patient data.
• More accurate patient hemodialysis schedules will allow the hemodialysis machines to be scheduled to capacity.
• Billing will be automated, which will reduce billing time and errors.

Major Milestones/ Schedule

• Spring 2012: Stage 1 - Hemodialysis scheduling and patient registration to be implemented at Health Sciences Centre, St. Boniface Hospital and Seven Oaks General Hospital (WRHA MRP sites).
• Summer 2012: Planning, analysis and design for Stage 2 to begin.
• Winter 2012: Clinical Scheduling, balance of eKHR functionality and workflows and interfaces implemented for WRHA MRP sites.
• Summer 2013: eKHR implemented for MRP sites throughout Manitoba.
• Fall 2013: Project completion and closure.

Glossary
*Dialysis – The medical treatment that performs the regular function of healthy kidneys by cleaning blood and removing wastes and excess water from the body. There are two kinds of dialysis: hemodialysis and peritoneal dialysis.

**Hemodialysis – A process where a person's blood is cleaned outside the body through a machine.