INSIDE:

Telehealth in MontrealThe advanced Reacts telehealthplatform has been selected by ateam at McGill University HealthCentre to deliver improved remotecare to ventilated patients in thecommunity.Page 4

Managing heart failureIt’s believed that up to 60 percentof heart failure patients could besupported at home and kept fromreturning to hospital with betterremote management. The Medly

app has been designed for thispurpose, and more.Page 4

SoapBox for healthcareSaint Elizabeth Health Care, thehome care specialist, has imple-mented an innovative solution thatsolicits ideas for improvementfrom employees and determineswhich ones are most useful.Page 6

Secure textingClinicians are finding that texting isoften the most convenient way ofmessaging their peers. But textingmay include patient information,and colleagues may not respond in

a timely fashion. A solution fromPointClickCare is being used tosolve both challenges, providingsecure texts with follow-ups.Page 6

Pub

lication

s Mail A

greem

ent #

40018238

FEATURE REPORT: WIRELESS AND MOBILE SOLUTIONS – PAGE 12

CANADA’S MAGAZINE FOR MANAGERS AND USERS OF INFORMATION SYSTEMS IN HEALTHCARE VOL. 21, NO. 3 APRIL 2016

BY JERRY ZEIDENBERG

uebec is steaming ahead with its planto install an electronic health record,named Cristal-Net, in every hospitalacross the province.

The computerized system is already usedextensively by the CHU de Québec-Univer-sité Laval, which in early 2000 co-developedCristal-Net in conjunction with the CHU deGrenoble in France. In October 2015, theCHU de Québec-Université Laval obtainedthe complete rights to the system and is nowthe sole owner and developer.

Health Minister Gaetan Barrette, who haspublicly voiced his frustration with the in-ability of the patchwork of electronicrecords used in Quebec hospitals and clinicsto inter-connect, announced the plan tostandardize on Cristal-Net last December.

It came as a shock to many in the e-healthindustry, who assumed the move would dis-place the commercial systems being used inmany of Quebec’s hospitals – includingsome very new solutions with state-of-the-art software.

However, far from ripping-and-replacingthe clinical solutions that are already in-

stalled, the plan is to keep what’s workingwell, but to use Cristal-Net as a powerful in-tegration tool to view and complete theclinical data for the patient. It will tie to-gether existing systems that previouslycouldn’t communicate.

As well, “many of the hospitals still don’thave an electronic medical record, andCristal-Net will be used as the EMR inthose facilities,” said Louis-JacquesLalonde, Assistant-Director of Informa-tion Technology at the CHU de Québec-Université Laval.

He explained that Cristal-Net has numer-ous modules, including lab, pharmacy,Kardex, integration with the QHR (QuebecHealth Record), oncology, and the ability tointegrate with PACS and RIS.

“It has a lot of capabilities,” said Mr.Lalonde. It’s also user-friendly: “To createCristal-Net, we worked closely with the clin-icians, with doctors, pharmacists and nurses,to make the system useful to them.”

He pointed out, however, that it doesn’thave each and every capability – for exam-

Quebec hospitals to standardize on Cristal-Net EHR

CONTINUED ON PAGE 2

It’s the first major deployment of Watson Health in Canada, and research & development projects using its machine intelligence are ready fortake-off. Pictured at the launch event are: Ontario’s chief health innovation strategist, Bill Charnetski; Hamilton mayor Fred Eisenberger; pres-ident and CEO of Hamilton Health Sciences, Rob MacIsaac; and Dino Trevisani, president of IBM Canada. SEE STORY ON PAGE 5.

IBM brings Watson Health to Hamilton

PHO

TO:

CO

URT

ESY

OF

HA

MIL

TON

HEA

LTH

SC

IEN

CES

Existing, commercial EHRsystems that are working wellwill remain in place.

REPORT ONLONG-TERM CARE

PAGE 6

Q

ple, hospitals will still need to acquireimaging systems from outside suppliers.Other features that are add-ons includeorder sets and closed-loop medicationmanagement.

“We’re leaving that to outside vendors,”said Mr. Lalonde.

However, he noted that alerts and flagsfrom these systems will be integrated withCristal-Net, so that all clinicians will beable to see important patient informa-tion. “The idea is that you should neverhave to leave Cristal-Net to do your workif you don’t need an access to a specificclinical system.”

A team at the CHU de Québec-Uni-versité Laval is in charge of implement-ing Cristal-Net in hospitals across theprovince. It’s currently a group of 26,which will soon nearly double to 50.“Our team of 26 was serving the CHUQhospitals, but the game has changed now.We need more people to give quality ser-vices to the new users of Cristal-Net,”said Mr. Lalonde.

The new staff members will include not

just programmers and designers, but con-tent experts like nursing and pharmacyexperts. This way, they will be better ableto converse with clinicians, to explain thesystem to them and, conversely, to carryback their ideas and needs to the develop-ment team.

While the plan is to have Cristal-Netup-and-running in all Quebec hospitals by2019, there is a good deal of preliminarywork that first must be done. Mr. Lalondesaid that his team is creating a check-listfor all hospitals, to determine what theircurrent capabilities and needs are when itcomes to electronic records.

Organizations will need governancecommittees and groups to establish thebest workflows and standards. As an ex-ample, to promote interoperability withinhospitals, regions and across theprovince, common terminologies areneeded – for medications, tests, diagnosesand treatments.

As well, training will occur, to get theusers ready for Cristal-Net. “We’re going totrain the trainers,” said Mr. Lalonde. “Theyin turn will train their clinicians.”

While the team in Quebec City will be

training and supporting the users ofCristal-Net across the province, local hos-pitals and healthcare organizations willmaintain their own IT departments andwill stay in control of their systems.

Some hospitals are, of course, ahead of

others, and installations of Cristal-Net willbegin this year. “Everyone has alreadystarted, and some have more to do thanothers,” said Mr. Lalonde. “But by 2019,everyone will be using it.

“It is going to happen very fast.”The agenda for implementation is being

created by a committee that reports to theMinister of Health. The task has beenmade easier by the sweeping healthcare re-form that took place in Quebec in April2015, when 182 health organizations wereconsolidated into 34. “It makes it easier tocommunicate,” said Pascale St-Pierre, a

Communications Manager at CHU deQuébec-Université Laval.

Each of these provincial organizationswill be able to grant permissions to clini-cians to use Cristal-Net, and will be able tocontrol how much of the patient recordvarious care-givers can see. They will alsobe able to provide access to communityphysicians and clinicians, if they wish.

Mr. Lalonde, a software engineer bybackground, joined the Cristal-Net teamin 2010. He has helped bring commercialsoftware development techniques, like fast,agile production, into the organization.

The team now creates one major up-grade of Cristal-Net each year, with asmaller update each month. “That way, thechanges are gradual, and the users have lesstrouble adapting,” said Mr. Lalonde. Thecontinual updates, moreover, help ensurethe system is staying current with state-of-the-art technologies.

It also goes through rigorous testing.“In the last two years, we added more than8,000 automated tests that are runningeach day to make sure Cristal-Net is bug-free” he said.

He said the system has all of the latesttechnological features – it is fully web-en-abled, and authorized individuals can useit remotely, from anywhere when it’s re-quired in their job.

It also has innovative abilities when itcomes to integrating a wide variety of clin-ical information systems, and presentingthe relevant data to clinicians.

Mr. Lalonde said that many commer-cial, clinical systems are not “open”, and ithas proven difficult for hospitals to con-nect them together using their own re-sources. But Cristal-Net, he said, haspowerful tools for integrating to existingsystems.

The plan is to use Cristal-Net first toconnect systems and departments withinhospitals and to make the data easily view-able and usable to clinicians.

Next, Cristal-Net will be used to con-nect hospitals and health organizationsacross the province, so that clinicians inChicoutimi, for example, can see whathappened when their patients were treatedin Montreal or Quebec City.

Cristal-Net can do this, said Mr.Lalonde, without the need for centralizedrepositories that collect and house data.Instead, the system pulls what it needsfrom existing repositories. “We don’t wantto duplicate information,” said Mr.Lalonde. “We’re able to use the informa-tion that’s already stored.”

Other provinces that have had troubleconnecting their own clinical systems willbe watching Quebec closely, no doubt, tosee what can be learned.

CONTINUED FROM PAGE 1

Art DirectorWalter Caniparoliart@canhealth.com

Art AssistantJoanne Jubasjoanne@canhealth.com

CirculationMarla Singermarla@canhealth.com

Publisher & EditorJerry Zeidenbergjerryz@canhealth.com

Office ManagerNeil Zeidenbergneilz@canhealth.com

Address all correspondence to Canadian Healthcare Technology, 1118 Centre Street, Suite 207, Thornhill ON L4J 7R9 Canada. Telephone: (905) 709-2330.Fax: (905) 709-2258. Internet: www.canhealth.com. E-mail: info2@canhealth.com. Canadian Healthcare Technology will publish eight issues in 2016. Featureschedule and advertising kits available upon request. Canadian Healthcare Technology is sent free of charge to physicians and managers in hospitals, clinicsand nursing homes. All others: $67.80 per year ($60 + $7.80 HST). Registration number 899059430 RT. ©2016 by Canadian Healthcare Technology. Thecontent of Canadian Healthcare Technology is subject to copyright. Reproduction in whole or in part without prior written permission is strictly prohibited.Send all requests for permission to Jerry Zeidenberg, Publisher. Publications Mail Agreement No. 40018238. Return undeliverable Canadian addresses toCanadian Healthcare Technology, 1118 Centre Street, Suite 207, Thornhill ON L4J 7R9. E-mail: jerryz@canhealth.com. ISSN 1486-7133.

CANADA’S MAGAZINE FOR MANAGERS AND USERS OF INFORMATION TECHNOLOGY IN HEALTHCARE

Volume 21, Number 3 April 2016

Contributing EditorsDr. Sunny MalhotraTwitter: @drsunnymalhotra

Dianne Danieldianne.daniel@cogeco.ca

Richard Irving, PhDrirving@schulich.yorku.ca

Rosie Lombardirosielombardi@hotmail.com

Andy Shawandy56@telus.net

Quebec hospitals moving to install Cristal-Net EMR province-wide

2 C A N A D I A N H E A L T H C A R E T E C H N O L O G Y A P R I L 2 0 1 6 h t t p : / / w w w . c a n h e a l t h . c o m

The Quebec City team producesa major upgrade of Cristal-Neteach year, and smaller updatesare made each month.

N E W S A N D T R E N D S

h t t p : / / w w w . c a n h e a l t h . c o m4 C A N A D I A N H E A L T H C A R E T E C H N O L O G Y A P R I L 2 0 1 6

BY JERRY ZEIDENBERG

TORONTO – The Centre forGlobal eHealth Innovation ison the verge of releasing a newversion of its Medly app thatcan monitor patients with two

or more chronic conditions. Medly wasfirst designed and released for heart fail-ure patients.

However, the system was designed as ageneral platform, and a single Medly appwill soon be able to support patients withmultiple chronic conditions, includingchronic obstructive pulmonary disease,diabetes, hypertension, and chronic kid-ney disease.

“We know that over 50 percent of peo-ple who are 65 and older have two or morechronic conditions,” said Emily Seto, an as-sistant professor at the University ofToronto, who chaired the Mobile HealthSummit in January. The conference washeld in Toronto and was organized by theStrategy Institute.

Seto works closely with the Centre forGlobal eHealth, and described some of thework being done there on monitoringchronic care patients through the use ofapps to improve outcomes and to reducecosts and pressure on acute-care hospitals.

Patients using the apps typically takereadings of various vital signs; in some in-stances, such as when they step on a Blue-tooth weight-scale in the morning, thedata is automatically uploaded via Blue-tooth to the patient’s smartphone. Datafrom the smartphone is then uploaded toservers.

In the randomized controlled trial,alerts about abnormal readings were sentdirectly to the patient’s cardiologist via e-mail. The message included the patient’sphone number, so the physician couldsimply click on the phone number toquickly get in touch.

“We didn’t want them to have to openthe electronic patient record to startsearching additional clinical informationand for phone numbers,” said Seto.

A six-month randomized controlledtrial of the Medly app that involved 100patients was a major success. The patientswere all enrolled in the University HealthNetwork’s (UHN’s) heart function clinic,

and compliance with the program wasvery high.

One patient even went to Florida forfour of the six months and still took hismeasurements and uploaded them.

In the trial, many of the patientslearned to modify their own diets and ex-ercise. Some learned, for example, not todrink too much water, as it is not healthyfor heart failure patients.

Overall, said Seto, the patients experi-enced improvements in quality of life andself-care. BNP fell significantly, and LVEFlevels increased by notable amounts asfound through a sub-group analysis.

BNP is a substance secreted from theventricles or lower chambers of the heartin response to changes in pressure that oc-cur when heart failure develops and wors-ens. The level of BNP in the blood in-creases when heart failure symptomsworsen, and decreases when the heart fail-ure condition is stable.

Left ventricular ejection fraction(LVEF) is the measurement of how muchblood is being pumped out of the left ven-tricle of the heart (the main pumpingchamber) with each contraction.

Seto said that one reason the clinicaltrial was successful was that it had thebacking of a clinical champion. Dr.Heather Ross, who heads the heart failure

clinic, is a proponent of the Medly app andits benefits for patients and the hospital.

By keeping closer tabs on HF patients athome, Dr. Ross and the creators of Medlybelieve they can keep them out of hospital.

Indeed, the most common reason forhospitalization in Canada and the UnitedStates is heart failure. There are 500,000HF patients in Canada, and about 5 mil-lion in the U.S.

Moreover, up to 60 percent of the hos-pitalizations are preventable, with betterpatient management, said Seto.

While the clinical trial, with its 50 clinicpatients, sent alerts right to the smartphones

of cardiologists, it’s unlikely that physicianswill be ready and able to field these alertsand make call-backs in the future.

That’s because the plan is expand theuse of Medly to thousands of patients, andto other hospitals. In fact, a remote moni-toring program using Medly will belaunched as standard of care to UHN heartfailure patients in Spring 2016. An analo-gous remote monitoring program will alsobe launched this year to UHN chronic kid-ney disease patients.

“We envision a shift to nurse practition-ers supervising the alerts,” said Seto. Nursepractitioners will in some cases be able tohandle the alerts on their own. They willalso know when to escalate the problem toa physician.

The Centre for Global eHealth Innova-tion is now testing new ways of expandingthe use of telemetry, apps and smartphonesinto the community. It is in partnershipwith Paramed, a visiting nurse and com-munity healthcare company, and CellTrak,which devises software for visiting nurses.

However, it has proven harder to recruitpatients in the community than at theUHN’s hospital clinic. As well, nurses arenot currently able to bill for their ‘telephonevisits’ which is a barrier to implementation.

Nurses that did participate in a fieldtrial of Medly in the community found, inaddition, that it was difficult to get intouch with patient’s physician when addi-tional advice was required. “Physicianswere often off duty, or busy with other pa-tients,” said Seto.

Seto and her colleagues are working onsolutions to these problems. In the near fu-ture, the remote monitoring system maybe more useful for patients tied to hospitalcardiac clinics, especially those whose clin-icians are salaried.

Still, the continually falling cost of med-ical equipment and phones makes remotemanagement of chronic care patients eas-ily affordable.

Moreover, new sensors are being devel-oped that will make remote monitoringeven more effective. Seto described abandaid-like sensor that can be placed onthe chest to take ECG readings. A head-band that can monitor EEG waves is alsobeing tested.

But Seto said that when it comes toapps and remote monitoring, technologyis the easy part. “Implementation of thetechnology including finding fundingmodels and managing workflow is thehard part,” she said.

Reacts deployed by MUHC to improve the lives of ventilation-assisted

MONTREAL – Reacts has been se-lected by the McGill UniversityHealth Centre’s National Pro-

gram for Home Ventilatory Assistance(NPHVA), to enhance its overall tele-health services and improve remote sup-port for its home-based ventilation-as-sisted clientele.

The NPHVA team is composed of ul-tra-specialized professionals who sup-port patients and their families in theirhome settings, while complementingvarious local and regional healthcareprofessionals through a range of clinical,technical and training services.

In order to optimize the team’s ef-

forts, the McGill University Health Cen-tre (MUHC) decided to replace their oldtelehealth platform with Reacts, a versa-tile technological solution providingunique interactivity.

“Reacts allows us to provide innova-tive remote support and care for patientsin the comfort of their own homes, nomatter where they are,” says Lyne Noel,Coordinator of Respiratory Services,Adult Sites, MUHC. “With this digitalvideo collaboration platform, we can re-ally make a difference in the quality oflife of patients and their families.”

With Reacts, the NPHVA’s profession-als can use their own computers or mo-

bile devices to interact with patients andcaregivers, regardless of location. Theycan propose virtual home visits, organizecollaborative sessions between healthcare

professionals, provide remote training topatients and providers, all thanks to a va-riety of features such as audio-video ex-changes, remote auscultation, and secure

file transfers – such as respirator data.“The Reacts platform is easy to use,

secure and focuses on collaboration, su-pervision, education and remote assis-tance,” says its founder, Dr. YanickBeaulieu. “It therefore meets the NPHVAteam’s many needs, and more impor-tantly brings healthcare professionalsand their patients closer together.”

The NPHVA team introduced Reactsto its service delivery model in Januaryof 2016. Implementation at the provin-cial level will continue throughout 2016.For more information about the Reactstelehealth platform, see:https://www.iitreacts.com/

Seto: Finding funding models and managing workflow is the hard part of implementing remote monitoring.

The Reacts telehealthplatform makes use of newtechnologies and runs on avariety of devices.

Medly app shows success in monitoring health of heart failure patients

It’s believed that up to 60percent of heart failure patientscould be kept out of hospitalwith better management.

N E W S A N D T R E N D S

BY JERRY ZEIDENBERG

HAMILTON, ONT. – HamiltonHealth Sciences and IBMCanada are partnering tolaunch a healthcare innovation

centre in the downtown core of the city – amove that will help with Hamilton’s trans-formation from Steel City into a high-techhub. Teams from both organizations willsoon move into what used to be a Stelcooffice building that’s located in the down-town core.

“We’re re-inventing Hamilton throughhealthcare,” said Dino Trevisani, presidentof IBM Canada, who is himself originallyfrom Hamilton. “We’re going to make thisa centre of excellence in Canada and forthe world.” Trevisani spoke at a well-at-tended event, held at Hamilton Health Sci-ences, to publicize the announcement.

Significantly, researchers at the new col-laboration centre will be the first in Canadato make extensive use of IBM’s Watson ar-tificial intelligence software for healthcare.

Watson gained instant fame in 2011when it trounced the reigning Jeopardychampion, Ken Jennings, in two televisedmatches. At that time, Watson required 10racks of computers that filled a room; today,Watson software requires only a singleserver that’s the size of the vegetable drawerin your refrigerator. And because of stream-lined software, it runs 24x faster than before.

That, in itself, is an indication of howquickly computer technology is advancing.Hamilton Health Sciences, for its part, is apowerhouse in health technology and haspioneered, among other things, advancedapplications in region-wide, patient deci-sion support and a predictive analytics sys-tem called HEWS. This latter solutiongathers data from patient monitors andmedical devices and provides early warningof when a patient is running into trouble.

It’s these two applications that will bethe starting points for the teams fromHHS and IBM. They will further developthe systems, both for use at HamiltonHealth Sciences and for commercializationin Canada and around the world.

“With the integrated data system, sixLHINs are already feeding data into the so-lution,” said Mark Farrow, HHS’s vicepresident of information technology andCIO. “We can see how patients are usingthe healthcare system. Now, we can take itto the next level using Watson.”

The system could be a boon to man-agers and planners, enabling them to bet-ter match the resources that are needed athealthcare facilities with real-time demandfrom patients.

Similarly, the intelligence of Watsonwill be tied to the early warning system,further improving the predictive capabili-ties of the solution.

The president and CEO of HamiltonHealth Sciences, Rob MacIsaac, noted thenew centre will be both a physical and vir-tual work space. Through the web andteleconferencing, patients, start-up busi-nesses and R&D staff at large corporationscan all interact with technology developersat the downtown facility in Hamilton.

In addition to IBM’s Watson Health,the team in Hamilton will also have ac-cess to IBM’s expertise in cloud comput-

ing, super-computing, and many othertechnologies.

Researchers from nearby Mohawk Col-lege and McMaster University will also beparticipating in the project and will bringtheir own expertise and interests.

The innovation centre is designed to

spur the development of spin-off compa-nies and will act as a business incubator.The province of Ontario is involved in thecentre through its chief health innovationstrategist, Bill Charnetski, who helped bro-ker the deal and make the project happen.Charnetski said the goal is not only to pro-

duce start-ups, but to see them grow to 10,100 and 1,000 employees.

Barry Burk, IBM Canada’s vice presidentof health, noted the new centre in Hamiltonwill be the first in Canada “where we’ve de-ployed Watson for human healthcare in ameaningful way.”

IBM brings Watson to Canada in partnership with Hamilton Health Sciences

A gateway to integrated careWith the Agfa HealthCare Portal, hospitals can offer care providers, referring physicians and patients “anywhere, anytime” access to the patient’s health information, even from different sources. Taking the knowledge and experience it has built up with proven solutions that share images and other data, Agfa HealthCare is now extending it beyond the hospital walls, to eventually integrate all players in healthcare delivery.

To nd out more, visit www.agfahealthcare.com.

IT’S ALL WITHIN YOUR REACH…

h t t p : / / w w w . c a n h e a l t h . c o m A P R I L 2 0 1 6 C A N A D I A N H E A L T H C A R E T E C H N O L O G Y 5

For more than 15 years, Toronto-based Responsive Health Man-agement Inc. has sought waysto advance resident care andstaff operations through inte-

gration of healthcare technology and mo-bile solutions.

Last year, the organization was facedwith the challenge of ensuring secure,timely staff text-message communicationbetween nurses and physicians in one ofits homes. Responsive hadn’t discouragedsending text messages in the past, butrather was looking for ways to make thataction more secure and productive.

Senior Nurse Consultant MarionGodoy said that data security was a bigconcern; nurses were using unsecure tex-ting to convey information to staff physi-cians in the Mill Creek Care Centre, wherethe average staff age is 28.

Moreover, when using conventional on-phone SMS texting apps, informationwould not always reach a physician ornurse in a timely manner, which occasion-ally led to delayed orders.

“For example, a nurse would send anemail earlier in the day and have left workby the time the physician was able to re-spond,” Godoy said. “And the eveningnurse would not be aware of this messagebecause it had been sent to a personalwork email or phone.”

Responsive implemented PointClick-Care Secure Conversations, a medical-grade messaging application enabling

healthcare professionals to create theirown protected messaging network. Re-sponsive has been using PointClickCareelectronic health record (EHR) technologysince 1995.

Secure Conversations helps about 100staff members and clinicians at MillCreek Care Centre securely communicatetime-sensitive messages regarding labora-tory results, medical histories, practi-tioner on-call notifications and resident-related questions.

By facilitating direct interaction be-tween doctors and nurses at the Mill CreekCare Centre, PointClickCare Secure Con-versations ensures better communicationsand response time and accurate decision-making. This, in turn, leads to quicker andmore precise interventions and ultimatelyimproved resident outcomes.

“The application is easy to use and thestaff can securely communicate residentand non-resident information without thechallenge of waiting for a call back,” Godoysaid. “Since most of the staff memberswere already very familiar with texting,they adapted well to this technology.”

“Secure Conversations software has im-proved efficiency among physicians andeliminated delayed responses from them asphysician mobile phones are now alertedwhen they receive a new text message,”Godoy added.

Physician order transcription has alsoimproved due to there being a record of aconversation and order. With the

PointClickCare Secure Conversationssoftware, nurses and physicians at MillCreek Care Centre can also track conver-sations on the facility’s PointClickCareEHR home page and decide if a conversa-tion needs to be part of the progress notessection of the EHR.

This avoids time-intensive duplicatecharting for clinicians that is the case withsmartphones’ native SMS apps. Nurses can

send pictures to the EHR via the software,a particularly useful benefit for when anurse is describing a wound for treatment.

“Responsive staff can see a record oftext communications from beginning toend,” said Godoy. “This reduces errors andpotential miscommunication betweenclinicians. We are seeing fewer errors onorders, fewer missed orders and staff isable to address the health concerns of resi-dents in a more timely fashion.”

Responsive initially implementedPointClickCare Secure Conversations withits registered nurses, management andphysicians, but has since realized securetexting would be a tremendous benefit forthe organization’s personal support work-ers, especially because they carry iPods fordocumentation.

Godoy believes this will help stream-line reporting, corresponding, notifyingand exchanging resident and healthcare-related information. Once the implemen-tation occurs, these workers will be ableto use PointClickCare Secure Conversa-tions to alert one another to help with aresident transfer and be better equippedto address early sign and symptomchanges in residents.

“Like its EHR, PointClickCare’s SecureConversations software has proved to bevery useful in getting key information toappropriate staff in a timely manner,” saidGodoy. “This means care can be deliveredto the right person at the right time andright place, and in a secure way.”

R E P O R T O N L T C

PointClickCare Secure Conversations ensures clinicians receive messages

Saint Elizabeth uses SoapBox to spur innovation from employees BY JESSICA WEISZ

Saint Elizabeth is leveraging its8,000 employees to help driveinnovation and improvehealthcare delivery for themore than 18,000 people itvisits daily. The social enter-

prise has become the first Canadianhealthcare company to adopt SoapBox, aSaaS platform that flattens organizationsby connecting leaders with the best ideasfrom frontline workers.

“Our front-line home care employeeshave the very best ideas for makingthings better for clients. SoapBox allowsthese ideas to come to life,” said ShirleeSharkey, President and CEO of SaintElizabeth. “On the site, the ideas arebroadly shared in real-time within theorganization and because of our virtualwork, this allows staff to collaborate withcolleagues everywhere – many of whom,they never see in person.”

The way that Saint Elizabeth handlesSoapBox ideas cuts through the typicalorganizational challenges that get inthe way of implementation and ex-pands the innovation capacity of theorganization.

“Ideas are framed around the clientexperience, which aligns to Saint Eliza-beth’s top priorities” said Sharkey.

When an employee shares an idea onSoapBox, their peers can view, com-

ment, and vote on it. Once the idea re-ceives 25 or more positive votes, a teamof Innovation Partners at Saint Eliza-beth review, evaluate, and respond tothe idea by providing an “Official Re-sponse”, a statement from the leadersthat shares the status on the idea andnext steps.

According to Brennan McEachran,CEO and co-founder of SoapBox, “officialresponses are critical to sustaining and in-creasing engagement in the community,as they close the feedback loop anddemonstrate that leaders are listening.”

As Saint Elizabeth is working to lever-age technology in a number of ways,they were able to integrate ideas fromSoapBox into their technology and mo-bile strategy. The organization recentlyinitiated a major rollout of new tabletsand smartphones to team membersacross the country.

For the first year of the rollout, SaintElizabeth engaged its workforce tocome up with ideas to derive valuefrom their new devices. The ideas andsuggestions led to optimization of thefeatures, customizations, and whichapps were most helpful.

As one example, SoapBox has been asignificant source of insight into SaintElizabeth’s bereavement strategy. SaintElizabeth uses SoapBox to tap into em-ployee insights around bereavement andsupportive conversations. More than 100

employees have commented, voted, andshared techniques and best practicesfrom across the country to help supportboth the family of the client and mem-bers of the healthcare team.

Recently, best practices generated inSoapBox around bereavement were in-corporated into a guideline to supportnurses with bereavement visits and alsohelped to inform program enhance-ments. Saint Elizabeth re-launched thebereavement visit process for nurses, as

well as a Guide for Leaders on support-ing staff with grief.

When Saint Elizabeth launched Elizz,a new brand dedicated to all things care-giving, the company leveraged SoapBoxand the wisdom of its employees to in-form the development of new servicesand resources for caregivers.

As home care providers, Saint Eliza-beth staff work alongside family care-givers every day and bring a unique un-derstanding of their challenges andneeds. The Family Caregiver Challengegenerated more than 100 ideas aboutways to support caregivers and make a

difference in their lives. For example,suggestions regarding a virtual socialnetwork where caregivers could anony-mously share their experiences and con-nect with others in similar situations arebeing brought to life through ElizzGroup Support.

In 2016, Saint Elizabeth plans to fur-ther engage its workforce with an excit-ing roster of Challenges. These Chal-lenges will focus on tying ideation tostrategic projects or initiatives the or-ganization is working on from the earlyplanning stages, so that the employeevoice can really have an impact on execution.

The organization is also teaming upwith Radboudumc’s REshape Center tolaunch a SoapBox to their network ofglobal health care innovators. Their ob-jective is to create a people-poweredhealthcare system, improve the method-ology of healthcare innovation, and toidentify and break down challenges toinnovation in healthcare

“At Saint Elizabeth, we see possibilityeverywhere,” said Sharkey. “With ouremployee SoapBox, our aim is to harnessthe passion and imagination of our mo-bile, national workforce – all eight thou-sand of them.”

Jessica Weisz is Chief, Client Success Of-fice, at Soapbox. Please visit the website:https://soapboxhq.com/

In one instance, SaintElizabeth used Soapbox torefine its delivery ofbereavement support.

Senior Nurse Consultant Marion Godoy.

h t t p : / / w w w . c a n h e a l t h . c o m6 C A N A D I A N H E A L T H C A R E T E C H N O L O G Y A P R I L 2 0 1 6

N E W S A N D T R E N D S

LAS VEGAS, NEV. – A U.S.-Israeli start-up company – with substantialCanadian ties – has created theworld’s first “personalized health

information service.” The web-based solu-tion pushes information about the latestmedical research and treatments to sub-scribers and tailors that information tomatch their particular medical conditions.

Called Medivizor, the system combs awide variety of sources, including medicaljournals, for the most recent research find-ings, and also alerts subscribers to clinicaltrials that may interest them.

In March, Medivizor exhibited at theHIMSS conference in Las Vegas, which at-tracted over 35,000 attendees from aroundthe world.

If you have certain type of skin cancer,for example, Medivizor will keep youposted – weekly or even daily – on the lat-est medical findings and treatments. Andknowing your approximate location, it willalso tell you about the newest clinical trialsin your area.

“It’s perplexing that health informationhas not been personalized before,” said TalGivoly, CEO and co-founder of the com-pany, which has been offering its servicefor the past two years. “We’re all unique,shouldn’t our health information be?”

Indeed, the more detailed the informa-tion that a subscriber provides Medivizorabout the person whom is coping with ill-ness, the more precise and pertinent theresulting information will be.

And while some might be put off by thethought of entering highly personal infor-mation, no names or personal identifiersare required. “You don’t need to enter aname, address or phone number – all youneed is an e-mail, so we can send you theupdates,” said Givoly. Subscribers are ableto use email addresses that have no per-sonal identifiers in them.

So far, tens of thousands of subscribershave signed on, said Givoly, who prefersnot to divulge precise numbers.

At the moment, the service is availableonly in English, and it has become popularin the United States, Canada, the U.K., Ire-land, Australia and New Zealand. Thecompany is mulling its next languages, andsays it is deciding between Spanish andMandarin Chinese.

A large portion of software develop-ment for Medivizor is conducted in Van-couver. Overall, the company is a globalenterprise – its headquarters are in Israeland New York, software development isconcentrated in Vancouver, business devel-opment is in Atlanta, it’s lead bloggerworks in Boston, and dozens of contribu-tors are located in a variety of countries,including Ireland and the U.K., in additionto Canada and the United States.

While most medical research papers arewritten for medical professionals and con-tain highly technical language, Medivizor’steam of contributors around the worldconvert them into easily readable Englishfor the layperson.

“They’re digestible, 300-word sum-maries,” said Kim Carbonara, director ofbusiness development. “Medical papers areincomprehensible to most people, so weturn them into readable summaries, likeCliff ’s Notes.”

Finding and converting the papers intoaccessible English is accomplished through amixture of computer algorithms and hu-man effort. Carbonara said the company hasseveral dozen reviewers around the world.“Each adheres to the same editing and writ-ing process,” she said. “We call it ‘one voice.’”

Medivizor is a free resource for individ-uals, but it is also being marketed tohealthcare organizations, who pay a feeand can then provide it to patients, doc-tors, and staff.

In these cases, the system can be con-nected to the facility’s electronic health

record, which then populates the Medivi-zor record. In that way, the informationsent to the individual become highly rele-vant and specialized.

The platform can also aid pharmaceuti-cal companies find patients who might beideal participants for clinical trials.

Web innovator offers unique, personalized health information

© 2016 Cerner Corporation

To learn more go to www.cerner.ca

Cerner’s health information technologies connect people, information and systems, putting information where it’s needed most.

Together with our clients, we are committed to improving the health of individuals and communities.

Working together for a healthier tomorrow today.

h t t p : / / w w w . c a n h e a l t h . c o m A P R I L 2 0 1 6 C A N A D I A N H E A L T H C A R E T E C H N O L O G Y 7

ADVANCE PATIENT CARE WITH MOBILE HEALTHCARE TECHNOLOGY. WE GET IT.

Call your CDW healthcare solutions specialist today.1.Surface Pen comes with Surface Book and Surface Pro 4 and sold separately with Surface 3. 2.

Lenovo IdeaPad® Miix 700

Starting at

$1149.00

Surface Pro 4

Starting at

$1179.00

HP ElitePad Healthcare Tablet

Starting at

$1649.00

Source:technology investment well into the future.

ENHANCING QUALITY OF CARE AND PATIENT SATISFACTION

INFORMATION TECHNOLOGY PLAYS A KEY ROLE

needed to work more efficiently and enhance the patient

specifically for clinical settings.

hospital walls.

Surface empowers healthcare providers with instant access to the information

1

information secure

DOM

A

EHBILEO

CNAVVAD

TIENCTHLLTAEH

AATE PPA

REETREAC

ACNT

ITHLOHNCE

E W

OGY

OWM

HITETGE

BILEO

C.T

THLLTAEH

ETREAC

LOHNCE

.OGY

.00$1649g atStartin

aad HealthcePHP Elit

ablete TTaar

allspecific

oneeded t

gs.al settinor clinicly f

e te efficiently and enhancork moro w

the patient

.00$1149g atStartin

Mi®ado IdeaPvenoL

ix 700

hospital w

alls.w

g atStartin

o 4e PracSurf

e emacSurf

viders with inoe prarers healthcwmpo

1

ormationo the infess tcnstant ac

CAFFASTIAATTIENT SAATPPALAUG QINCNANHE

.00$1179

NOCTINDAREACFLITY O

KENFI

ormatioinf

LEOREY OHNCETNOTIAATMROF

eon secur

ASYAAYOGY PLL

llC

W h l hDC

oell intestment wvy ingechnolot

l i

e.o the futur

di li

ecSour

e:

all yComeen ce PacSurf1.

W healthcDour Cyelyato 4 and sold separe Prace Book and Surfaces with Surf

e solutions sparc2.e 3. acy with Surf

y.odapecialist t

CDW.ca/healthcare | 800.493.7651

Logitech GROUP Video Conferencing System with Logitech Expansion Microphones

$1749.99

Epson WorkForce DS-40 - sheetfed scanner

$165.99

implement and support effective solutions

Ergotron StyleView Laptop and Tablet Carts

the right height for whatever task is at hand.

CALL FOR PRICING

adapt online health care systems which connect physicians and other medical specialists to patients and their caregivers via “telemedicine”

standing use

management suite included

driver supported

initiate treatment without having the patient make a trip

Instant Savings of $34 until April 30th 2016

2

on StyleVotrErg

artsablet Cop and TTaaptw LieV

g usestandin

N

ororkFEpson W

ICIR PORFLCAL

oght fght heithe ri

NG

annered scS-40 - sheetfe Dcr

er task is at hand.veor what

$165until April 30th

gsvinInstant Sa

.9952016

2

s of $34

eder supportvdri

e includedement suitgmana

.9$1749

ech Egitowith LUOech GRgitoL

patients and theirsicians and otyph

adapt online healt

99

ophonesExpansion Micremstg Syencineronfideo CUP V

elemedicine” ers via “tvegiarr coal specialists tther mediconnectems which cstye sarth c

g vineatment without hae trinitiat

e a trip the patient mak

i l t d t

l titiff

DC

ara/healthc.cWD

implement and support e

e | 800.493.765r

e solutionsvectieff

1

BY DR . SUNNY MALHOTRA

Diagnostic imaging has always beena key part of making a medical di-agnosis. Constantly improvingmedical imaging has enabled med-ical students and practitioners togain a wider and deeper under-

standing of the human body. The technology hasalso improved workflow and productivity, allowingphysicians to make accurate and earlier diagnoses.Lastly, it has enabled the sharing of important infor-mation among healthcare professionals.

Medical students are steadily increasing their useof technology for studying and learning the intricatedetails of human anatomy.

The use of 3D technology in anatomy classes andself-directed studying has disrupted the traditionalmedical education format. There are multiple plat-forms and companies that have developed 3D tech-nology for medical students through the use of appsand practical classes.

Commonly used apps that can be downloaded onApple and Android devices are Human Anatomy At-las, Essential Anatomy 5 and BioDigital Human. Thesocial use of mobile apps includes such products asFigure 1 and InsightMedi to display medical imagesfor educational purposes.

BioDigital Systems, a visualization firm based inNew York City, created BioDigital Human. BioDigi-tal creates virtual human replicas of multiple bodysystems for anatomy education, and includes simu-lated diseases and conditions.

The founder of BioDigital, John Qualter, hopesthat one day this technology can also be used in aclinical setting to help physicians illustrate condi-tions to their patients. Recently, BioDigital used theirtechnology at New York University School of Medi-

cine in their anatomy labs to give students a 3D in-teractive experience.

With the use of 3-D glasses created by a com-pany called Nvidia, BioDigital was able to cre-ate a simulated human body that studentscould dissect by giving a unique perspectiveinto living human anatomy in a way that dis-secting cadavers fails to do.

Similarly, developing companies such as 7DSurgical Navigation and Ourotech have begunto create real-time 3D images that can be used

in hospitals during operations and surgeries. The com-panies hope this technology will aid surgeons in oper-ating theatres and make surgeries more time efficient.

The use of medical imaging in cardiology has al-ways been crucial to make a rapid and accurate diag-nosis. In electrophysiology, imaging the inside of theatria has been done with less fluoroscopy over theyears to reduce radiation exposure. “Cardiac Map-ping” is like a GPS system to navigate the inside ofthe heart and find dangerous heart rhythms. ToperaMedical is a system with a Rhythmview workstationand FIRMap catheter that opens up with a wired ballwith sensing electrodes along its surface.

Carto and ESI are systems that use endocardialelectrograms to correlate with local electrogram and

cardiac anatomy. Progress is also being made in tele-echocardio-

graphy. Tele-echocardiography allows formedical professionals to work alongsidecardiologists to gain a specialist reading ontheir patient’s echocardiograms throughimaging firms such as USARAD.com, An-gus Radiology and Real Time Radiology. Tele-echocardiography allows for rapid

sharing and collaboration among healthprofessionals, and facilitates rapid interpre-

tation of echocardiograms. This is espe-cially useful for clinics and hospitals

in remote locations that couldnot have echocardiogramreadings done immedi-ately on location due tolimited staff.

VI

EW

PO

IN

T

Virtual reality is being used to teach anatomy, improving upon the traditional methods.

3D apps for diagnostic imaging improvemedical education and patient care

Dr. Sunny Malhotra is a US trained cardiologistworking at AdvantageCare Physicians. He isan entrepreneur and health technologyinvestor. He is the winner of Bestin Healthcare – Notable YoungProfessional 2014 and thenational Governor General’sCaring Canadian Award 2015.

The use of 3D technology in anatomyclasses and self-directed study hasdisrupted the traditional medicaleducation format.

Healthcare apps should be treated like over-the-counter medsBY PUNEET SETH, MD

AND DORIAN MURARIU, MSC

It can be daunting for clinicians,who are already overwhelmedwith patient-care responsibilities,

to now screen and manage an en-tirely new modality – the mobile‘apps’ that run on smartphones andtablet computers.

However, the potential for im-proving outcomes and reducing sys-tem costs is significant through theuse of mHealth apps. On the otherhand, patient harm is also a realpossibility, through inappropriateuse or through the use of apps withfalse claims. With the presence ofmobile devices in society increasingand the growing number ofmHealth consumer apps, clinicianswill inevitably be crossing pathswith patients who seek advice aboutmHealth apps.

How then, should physicians in-teract with patients using or askingabout apps? What approach shouldthey take to learning about the bestor most appropriate apps? We pre-

sent some solutions in this article.mHealth apps can be categorized

based on the intended user, beinghealthcare providers and patients(who are termed as ‘consumers’ ofmHealth apps). With respect to con-sumer mHealth apps, a survey of2000 app developers from aroundthe world found these applicationsare being used diversely to monitorfitness data (e.g., steps, speed, HR,hydration, calories, mood), patientvitals (e.g., BP, blood oxygen, glu-cose, temp, medicine adherence,brain waves, posture), and medicalexams (e.g., respiratory rate, EEG,ECG, blood test, US, urine test.)

Fitness and wellness apps are cur-rently the most commonly used, butdevelopers agree that apps targetingchronic illnesses will gain a largershare of the market in coming years.

Among the most common disease-specific apps are those targeting dia-betes, obesity, hypertension and coro-nary heart disease, and to a lesser ex-tent asthma, depression, and cancer.

Surveys of healthcare providersand industry developers have re-

vealed a sense of optimism about thepotential of mHealth apps to changehealthcare for the better. Many in-dustry developers believe thatmHealth apps show great promiseand potential for improving health-care delivery and health outcomes.

According to one survey, the ma-jor ways in which this will happeninclude improved prevention and ed-ucation, reduced or slowing down of

healthcare costs, and improved inter-action between patients and doctors.

As the demand for health infor-mation and health services increases,mobile health apps will take a moreprominent place in healthcare. How-ever, this demand should be metwith some sort of regulatory or cer-tifying body in order to protect con-sumers, and, on the other end, to al-

low physicians to be aware of whichapps to comfortably recommend totheir patients.

Before apps are adopted in prac-tice it is necessary to determine theirsafety and effectiveness. According toone industry report, over 300 clinicaltrials using mHealth apps were regis-tered on ClinicalTrials.gov in 2015,representing a huge leap forward intheir validation.

Regulatory bodies such as the USFDA will play an important role intesting these apps by definingwhether they are “medical” or “well-ness” apps (the latter will be exemptfrom some regulations). Similarly,Health Canada has expressed intentto have a regulatory process for“higher risk” medical apps; howeverwhat defines this remains to be seenand only a handful of mHealth appscan be found through HealthCanada’s website.

The Canadian Medical Associationin 2015 released a policy report tohelp guide physicians on recommend-ing mobile health apps to patients.

CONTINUED ON PAGE 15

Just as they are askingabout over-the-countermeds, patients will quizdoctors about apps.

h t t p : / / w w w . c a n h e a l t h . c o m1 0 C A N A D I A N H E A L T H C A R E T E C H N O L O G Y A P R I L 2 0 1 6

V I E W P O I N T

BY JERRY ZEIDENBERG

LAS VEGAS – At the latest HIMSS con-ference, in early March, one majortheme was artificial intelligence andits application to healthcare.

A session on The Rise of Machine Intel-ligence in Healthcare, led by KennethKleinberg, discussed how far artificial in-telligence has come and speculated on howmuch better it will probably get.

We’re now seeing smart anesthesiologysystems that can replace anesthesiologists.There are robots, like the guided vehicles atHumber River Hospital, in Toronto, thatcan carry medications, open elevators andwarn people to stand back. And soon,there will be radiology and pathology sys-tems that can spot diseases as well as hu-man doctors.

“The world is far from prepared for whatis going to happen,” said Kleinberg, who hasmonitored AI and machine intelligence fordecades.

One indication of this occurred whenthe floor was opened to questions andcomments. One participant told the audi-ence that he foresees the day when robotswill demand their own equal rightsamendment. Instead of Isaac Asimov’sthree rules of robotics, which protect hu-mans, robots and computers may developthe consciousness needed to demand pro-tection for themselves.

One of the leaders in machine intelli-gence is IBM. Who would have thoughtthat it could build a computer that woulddefeat two Jeopardy champions? Execu-tives at IBM came up with the notion in2006, and for the first few years, the resultswere abysmal. But after stumbling, rapidprogress was made. By 2011, they had ahigh-functioning system called Watsonthat trounced the Jeopardy champs.

And that’s a microcosm of what’s oc-curring, in general, in machine intelli-gence. A kind of self-sustaining take-offhas happened, where very quick progress isbeing made. That’s why Kleinberg sayswe’re unprepared for the future.

At HIMSS, the IBM Watson Healthgroup showed the work it is doing on sev-eral projects. One of them, code-namedIaso, is looking through the medicalrecords of patients to discover which oftheir conditions were unreported. Whenthe unreported pieces are put together,they can paint a picture of a serious condi-tion – like an aneurysm.

Radiologists or cardiologists, whenlooking for specific conditions in diagnos-tic images, may not report ancillary prob-lems. Or they might simply miss them.

“Unfortunately, this happens more thanyou might think,” said Dr. Tanveer Syeda-Mahmood, Chief Scientist for the MedicalSieve Radiology Grand Challenge projectin IBM Research. Iaso, however, can spotthese conditions in records and images. Itcan then create a more comprehensive re-port – one that could save your life.

Right now, Iaso is a work-in-progress,but IBM plans to soon apply for regulatoryapprovals in the U.S.

Another Watson project, code-namedQibo, can act as a physician’s assistant byautomatically combing through diag-nostic images and records to produce a

summary of the most important piecesof information.

This task is sometimes assigned to resi-dents, and it may take 15 minutes or moreto compile. Qibo, by contrast, can do it inseconds.

“It acts like a smart assistant,” said Syeda-

Mahmood. Qibo extracts structured andunstructured reports, and can use patternanalysis on numerous types of imagingstudies, such as echocardiograms and CTscans. Iaso and Qibo are meant to be usedas tools in the hands of physicians. Theyare not designed to replace physicians, but

rather, to enhance the accuracy and speedof the physician’s work.

“If I had a serious illness, I’d alwayswant a doctor looking after me, with Wat-son as an assistant,” said Robert Merkel,Healthcare & Life Sciences Leader withinIBM Watson Group.

Expect more intelligent machines and smart computers in healthcare

Clinical logistics solution External & internal transport

Patients

Blood samples

Attendants

Organ transports

Isolation precautions

Medical equipment

REDUCECosts

Accidents

Length of stay (JIT)

Cancelled transports

Spoiled Samples

INCREASE

Productivity

Control and reporting

Patient satisfaction

Savings up to 25%

For more information, please contact your sales representative at 1 888 882 8898 Christieinnomed.com

© Christie Group Inc. Company.

h t t p : / / w w w . c a n h e a l t h . c o m A P R I L 2 0 1 6 C A N A D I A N H E A L T H C A R E T E C H N O L O G Y 1 1

BY DIANNE DANIEL

You may think you’ve invented the nextgreat, transformative healthcare app.And maybe you have. But when it comestime to move your idea beyond your testgroup so the entire hospital, commu-nity, province or country can benefit,

what then? Do you have the foundation and resourcesto navigate your way through the complexities of secu-rity, privacy and interoperability that follow?

As easy as it is to build mobile health products andservices, scaling them is an entirely different storysays Raymond Shih, co-founder and president ofToronto-based QoC Health.

“Every week you see or hear about a pilot app be-ing tested at a hospital and there’s always the promisethat if it’s validated, and people use it across thehealthcare system, it’s going to save money,” saysShih. “But very rarely do you see that article a yearlater that says everybody’s using it.”

One of the first healthcare-related companies tojoin the growing global community of Certified BCorporations, sustainable companies in business forthe greater social good, QoC Health is on a mis-sion to change that scenario. Founded in 2010,the fast-growing company is bridging the gapbetween innovation and scalable products for adiverse group of healthcare clients.

Leveraging a highly skilled in-house team ofhealthcare experts, IT professionals and entre-preneurs, QoC Health has developed a cloud-based platform it says provides all of the func-tionality required to rapidly prototype mobilehealthcare solutions. It also provides the under-lying infrastructure to scale those solutionsacross multiple stakeholder groups and jurisdic-tions, all for the purpose of supporting others.

As Shih explains, the company isn’t in thebusiness of coming up with game-changingideas. Rather, its job is to ensure those ideasdon’t end up on a shelf, collecting dust.

“We don’t want to be a healthcare companythat’s just making money,” he says. “We reallywant to be a company that tries to improve theoverall quality of care in the system.”

Obtaining B Corp certification is one way todemonstrate that commitment. B Corp compa-nies are routinely evaluated on many levels to en-sure they meet rigorous standards of social andenvironmental performance, accountability andtransparency. One of the core principles is that aB Corp is “purpose-driven and creates benefit forall stakeholders, not just shareholders.”

Collectively, B Corporations are leading agrowing global movement of “people usingbusiness as a force for good.” Individually, each oneaspires to use its business power to solve social andenvironmental problems.

QoC Health’s self-declared B Corp mission is to re-imagine the patient care experience by shifting care tothe community, reducing healthcare costs and im-proving access to care. Its cloud-based platform-as-a-service and infrastructure-as-a-service offerings dothat by helping to create and grow electronic circles ofcare, applying the company’s technology to securelyconnect patients, providers and other communitysupport services in a way that fosters stronger collab-oration and ultimately improves patient outcomes.

Healthcare apps spring to life in a variety of places.It might be a researcher in a lab, a physician in a clini-cal setting or a service provider in the community whocomes up with the notion; no matter where the ideaoriginates, the creators eventually reach a point wheretheir idea is proven in a small test group or pilot pro-ject and it’s time to roll out to a wider population.

That’s when the complexities of privacy manage-ment, interfacing to legacy systems, seamlessly inte-grating with an electronic medical record (EMR) oradhering to strict regulations can prove challenging.

“There’s a temptation to go it alone and that typ-ically doesn’t end well,” says Shih, noting that eachjurisdiction has its own set of requirements.

That’s where QoC Health steps in, partneringwith innovators to expand their ideas by adding thefoundational layer beneath. “We provide all of the

components out of the box so that healthcareproviders are spending their time, effort and re-sources on improving their tool, doing rapid itera-tions and testing rather than spending a year build-ing something that’s already been built,” he explains.

Some of the core components provided by QoCHealth’s Cloud Connected Platform include profilemanagement, multi-directional collaboration,HIPAA/PHIPA compliance, analytics and businessintelligence, and turnkey EMR integration.

Each building block is white labelled, meaninghow a customer applies the technology will beunique to their solution. The underlying infrastruc-

ture required to scale, supported by secure data cen-tres in Canada, the U.S. and U.K., is already in placeand managed by QoC Health.

By leveraging that foundation, customers are freeto focus on what their app might look like and whoit might connect, says QoC Health co-founder SarahSharpe, who is responsible for Healthcare Analyticsand Quality Improvement and works hands-on withclients to evolve their ideas. “What we try to do inany discovery process is to imagine the ideal scenariobecause it actually may be possible,” says Sharpe.

For most clients, the starting point involves concep-tualizing a circle of care: Who needs to be connected towho and what do they need to do? From there, QoCHealth helps to establish a framework for moving for-ward, including objectives, timeline and cost. Severaldevelopment methodologies are used, from experi-ence-based co-design to research-based design.

“We can look at any scenario and say, ‘Here’swhere you need help. Here are the points whereyou’re strong. Here’s where we can step in and actu-ally help you through the journey of actually devel-oping an app, making sure it’s evaluated and sustain-able,’” explains Sharpe.

Sometimes the electronic circle of care is alreadywell established and the mobile app isproven. All that’s required from QoC Healthis the expertise to grow.Robyn Henderson, founder and CEO of TheUncomplicated Family, a progressive organi-zation based in Alberta, approached QoCHealth in the fall of 2015. Her company’s rev-olutionary technology called Teleroo, devel-

oped in 2011, is a collaboration tooldesigned to create efficiencies in the

way essential services are managed anddelivered to children with complex needs.

“Our goal is to un-complicate things so thatpeople can enjoy the best quality of life,”says Henderson, who at the time, was look-ing for a technology partner to help scalethe product.The idea for Teleroo was born from Hen-derson’s desire to make a difference in thelives of families. The mobile app is permis-sion based and designed to be used by any-one in a child’s circle of care, including par-ents, speech/language pathologists, occupa-tional therapists, physical therapists, behav-ioural consultants, physicians or teachers.One of the most engaging features is a videolibrary that enables users to capture and se-curely store behaviours or events on a mo-bile device as they occur in a child’s naturalenvironment. The company has written aground-breaking algorithm to blur every-

one else out of the frame so that the videos can beshared without compromising privacy.

For example, one family used Teleroo to film a pe-culiarity in their child’s gait. After waiting six monthsto see a specialist, when the appointment finallycame, the doctor was unable to assess the child dueto behavioural issues. Using Teleroo, the parentsshared the video that had been captured and the doc-tor was able to provide treatment.

“The whole point is to build local capacity,” saysHenderson. “If a speech/language pathologist has anexcellent idea for how to work with a particular child

FE

AT

UR

E

RE

PO

RT

The company is working with creators in the public and private sectors in Canada and abroad.

QoC helps healthcare innovators turn ideas for apps into real-world solutions

ILLU

STRA

TIO

N:

LIN

DA

WEI

SS

CONTINUED ON PAGE 15

h t t p : / / w w w . c a n h e a l t h . c o m1 2 C A N A D I A N H E A L T H C A R E T E C H N O L O G Y A P R I L 2 0 1 6

Read allabout it.

SUBSCRIBEELECTRONICALLYVISIT OUR WEBSITEwww.canhealth.com

Signature required for authenticity purposes only. All data must be supplied for subscription to beprocessed. Publisher reserves the right to determine qualification. Valid only in Canada.

C O M P L I M E N T A R Y S U B S C R I P T I O N R E Q U E S T

Your organization’s business or industry?

Hospital

Health region

Long-term care institution

Home care

Clinic

Government

University

Computer or software vendor

Telecommunications vendor

Medical device vendor

VAR or systems integrator

Education

Finance/insurance

Consulting/legal

Public relations

Other

If you are employed by a hospital,which of the following categorieswould best apply to you?

CEO/President/VP/Executive Director

Finance

MIS

Medical Director

Physician

Purchasing

Nursing

Pharmacy

Radiology

Pathology & Laboratory

Human resources

Health records

Public relations

Quality assurance

Other

(PLEASE PRINT)

Name

Title

Company

Address

City

Province Postal Code

Telephone

Fax

E-mail

Signature Date

Canadian Healthcare Technology, published eight times peryear, is sent free of charge to managers of hospitals andclinics, and executives in nursing homes and home-careorganizations. Qualified subscribers need only periodicallyrenew their subscription information to ensure continueddelivery of the magazine. Please take a minute to completeyour renewal and make sure Canadian Healthcare Technologykeeps coming to you – absolutely free.

THERE ARE TWO WAYS YOU CAN SUBSCRIBE:FILL OUT AND SUBMIT THE FORM ONLINE AT www.canhealth.com/subscribe.html

or FILL OUT THE FORM BELOW AND FAX IT TO 905-709-2258

YES, I want to receive/continue to receive Canadian Healthcare Technology magazine.

IF YOU HAVE SUBMITTED A SUBSCRIPTION REQUEST IN THE PAST 12 MONTHS, EITHER ONLINE OR BY FAX, PLEASE DISREGARD THIS NOTICE.

Q U E S T I O N P E R I O D

Dr. Tepper is a Toronto physi-cian who still practices whenaway from his quality im-provement agency’s desk –both with the St. Michael’s

family health team and in the North YorkGeneral Hospital’s emergency department.But he also bristles with high level healthcare management smarts and wide experi-ence including a stint as the province’s firstassistant deputy minister responsible forproviding Ontarians with the right mix ofhealth care providers. Keen on marginal-ized populations, Dr. Tepper has been ac-tive with groups addressing inner cityhealth and rural healthcare. His academiccredentials include a degree in public pol-icy from Duke University, an MBA fromWestern University, and a Master of PublicHealth from Harvard. Dr. Tepper spoke re-cently with CHT contributor Andy Shaw.

CHT: Dr. Tepper, we’re always curious toknow how the medical leaders we talk togot to where they are now. So what led youto being Health Quality Ontario’s leader?

Dr. Tepper: I think it was the chance to com-bine my frontline experiences as a physicianand take a system level approach to address-ing better quality care. You know, every dayhundreds of thousands of people go to workin the healthcare system with a deep com-mitment to providing the best possible carefor their patients. So the mandate of HealthQuality Ontario is to give those people bet-ter support in doing their work. For me, it isa very important opportunity.

CHT: As I understand it, you provide sup-port largely in the form of more and betterinformation, so you are essentially an advi-sory agency. But do you ever wish youcould instead just crack a whip over peo-ple’s heads and say, “Do quality improve-ment this way, now!”?

Dr. Tepper: Well, one of the things we knowfrom our experience is that we are tacklingvery difficult quality issues every day. Wealso know that people are working hard atthem already. So, I really believe it’s best tosupport them by giving them better infor-mation, but also better tools by creating‘communities of practice’. Overall our ap-proach is to support people where they al-ready have a strong desire to go in providingthe highest quality of care. I don’t hear any-one in healthcare, saying, “We don’t want toparticipate in better quality care.” Rather wehear, “Can you help me get there?”

CHT: You have had just over two yearsleading Health Quality Ontario. How welldo you think you’ve done so far?

Dr. Tepper: First, it’s not about what I havedone but rather about what the remark-able group of people here at Health Qual-ity Ontario and the many partners wework with in the healthcare system havedone. Quality is, after all, a ‘team game’.

But I do think there are areas whereHealth Quality Ontario has demonstratedsuccess. In the area of surgery, for example,we are helping Ontario to adopt the Na-tional Surgical Quality Improvement Pro-gram (NSQIP). We are also working hard tosupport primary care-givers. To do that, we

take measures of their key clinical practiceand every few months send them a confi-dential personalized report showing themhow their performance compares to theirpeers. We also combine that with givingthem practice tips and tools they can adoptif they see from our reports that there is aparticular area they can improve on.

As well, are very pleased to be co-lead-ing a program called Adopting Research toImprove Care (ARTIC). This programtakes proven examples of best practice inone part of the system and helps other or-ganizations adopt the same approach.

As you may know, the Ontario Ministryof Health and Long-Term Care has devel-oped something called Health Links,which are virtual communities of practice,focused on quality improvement and tar-geting that one percent of the populationthat is the most unwell. Health QualityOntario provides support to more than 80such Health Links across the province.

Finally, every year we collect formal‘Quality Improvement Plans’ from morethan 1,200 healthcare organizations acrossthe system. We then provide feedback andshare the ideas of new and innovative waysof doing things that we spot in those plans.This initiative started with about 160 hos-pitals, but now we also have participationfrom primary care, home care, and long-term care facilities. So it’s fair to say thatQuality Improvement Plans have really hadan impact on our provincial healthcare

CHT: How do those Quality ImprovementPlans get shared?

Dr. Tepper: One way is that we post allthose plans on our (hqontario.ca) website.The second way is to re-shape the plansinto broader themes and findings reports,

which we send back out to the managersand caregivers on the front lines. And, ofcourse, many healthcare organizations puttheir Quality Improvement Plans on theirown websites.

CHT: Are there other models for you any-where else, or is what you are doing at HealthQuality Ontario pretty much unique?

Dr. Tepper: There are other health qualitycouncils in Canada and other parts of theworld. Each one is a bit different in howthey are structured and their mandates. Butwhat truly sets us apart is we have a man-date to look carefully at the evidence sur-rounding new interventions and technol-ogy in healthcare, and then make recom-mendations to government about fundingthem. We’re very aware that just becausesomething’s new and shiny doesn’t neces-sarily mean it works well or is cost effective.

Also, on February 10, we launched ournew Quality Standards program. We areworking with experts, providers, patients andfamilies to create a set of concise standardsfor the best evidence-based care possiblegiven to patients with selected conditions.

CHT: Is there one thing among HealthQuality Ontario’s accomplishments underyour direction that you are most proud of?

Dr. Tepper: I think that people in the or-ganization take pride in the very broadrange of accomplishments that occur eachyear. However, one new area of activitythat I think has been critically importantin our work is the way we involve the fullspectrum of patients, families, caregivers,and the public.

CHT: How do you involve patients, exactly?

Dr. Tepper: First, we make sure that wehave patients on our committees; theyshare their experiences in our reports; andthey give us guidance on what we shouldlook at next. We also have caregivers onour Board and have set up a provincial Pa-tient and Family Advisory Council (PFAC)as well as a wider reaching Patient andFamily Advisory Network (PFAN). So, in-creasingly patients and care providers areactive participants in our work. That’s apivotal shift which has been really good forus. If what you are about is improving thequality of patient care as we are, then youneed to involve patients in order to benefitfrom their experience and wisdom.

CHT: So what now are your priorities go-ing forward through the rest of 2016 andbeyond?

Dr. Tepper: We are committed to keep onimproving our reporting activities at theprovincial, regional, facility and even –where appropriate and possible – the indi-vidual level. This information sharing is acritical part of quality improvement. Peo-ple and organizations need to know howthey are doing and how their performanceis improving over time. Accordingly, weare looking to significantly enhance ouronline reporting and allow people to findinformation more easily.

We’ve also launched a new 2016-2019strategic plan for Health Quality Ontario –Better Has No Limit: Partnering for aQuality Health System – which sets out ourpriorities and goals for the next three years.

CHT: In that plan do you address such top-of-mind healthcare quality issues as high

rates of drug, surgical and other medicalerrors? And what about innovative toolssuch as checklists? Can they reduce errors?

Dr. Tepper: Last year, we participated in anational report called ‘Never Events for Hos-pital Care in Canada’. It was the first report ofits kind in Canada on things that shouldnever happen in Canadian hospitals. Work-ing with the Canadian Patient Safety Insti-tute we developed a ‘never’ events list that in-cludes errors like doing surgery on thewrong body part, or on the wrong patient;conducting the wrong procedure, or givingwrong tissue, biological implant or bloodproduct to a patient, or leaving behind anunintended foreign object in a patient.

As for checklists, yes, there’s a largebody of evidence showing that checklistscan be remarkably effective in increasingpatient safety. There’s also evidence show-ing that checklists are no more than a tooland not a ‘magic bullet’ or solution. Assuch, they have limits. You need to embedthem in a larger effort of cultural andstructural change. Just dropping in check-lists into the healthcare system will notnecessarily lead to improvement.

CHT: Aside from greater patient involve-ment, what are the other human factors atplay in quality improvement?

Dr. Tepper: Collaboration and teamworkare paramount. We tend to think of thingslike medical errors and safety as being verylocal and specific to one hospital. But whatthing we need to do is think more broadlyand collaborate regionally, provinciallyand even nationally on these issues be-cause the same challenges are everywhere.

The other opportunity for teamwork isto focus on local systems and the entire carejourney a patient might experience. Qualityrisks and gaps occur most often when peo-ple are moving between sectors: from hos-pital, to homecare, to primary care, to com-munity services, to rehabilitation hospitalsand back. We need a better integrated sys-tem for all that movement and you need ef-fective teamwork to produce it.

CHT: Getting back to your 2016-2019strategic plan, how will you measure HealthQuality Ontario’s own performance?

Dr. Tepper: I think it’s very important thatwe just don’t report on other parts of thehealthcare system but also hold ourselvesaccountable. So we have developed a num-ber of performance indicators that mea-sure our own ability to deliver on ourstrategy. Once they are finalized we willshare them publicly.

CHT: Is there anything about quality im-provement that maybe we haven’t touchedon, Dr. Tepper – something you would likeour readers to take away with them?

Dr. Tepper: Yes, and it’s this: quality im-provement should never be about blamingand shaming. Rather it should be about cre-ating a culture in which everybody is com-mitted to providing excellent care today andthen committed to finding a way to be a lit-tle better tomorrow. Quality improvement isabout creating a culture that improves carecontinuously. We want the highest qualitycare to be the job, not just part of the job.

Teamwork key to improved quality of care, especially with patient hand-offs

Tepper: providers want to know how to improve.

h t t p : / / w w w . c a n h e a l t h . c o m1 4 C A N A D I A N H E A L T H C A R E T E C H N O L O G Y A P R I L 2 0 1 6

Adopting Research to ImproveCare (ARTIC) takes provenexamples of best practices andhelps with their adoption.

LAS VEGAS – Sansoro Health, ofMinneapolis, Minn., has beennamed the winner of the 10th an-nual Venture+ Forum pitch com-

petition for startup companies in thehealthcare technology industry as part ofthe 2016 Healthcare Information andManagement Systems Society (HIMSS)Annual Conference & Exhibition.

“The HIMSS Venture+ judges pickedSansoro for its innovative solution,strong business plan, and value proposi-tion for customers and investors,” saidVenture+ Forum Founder and Modera-tor Howard Burde, Principal of HowardBurde Health Law, LLC.

“Sansoro represents the leading edge of

EMR integration,” continued Burde. “Thecommitment of the U.S. Department ofHealth and Human Services and majorelectronic medical record vendors to openApplication Program Interfaces (APIs)represented an important announcement.More important, Sansoro does that hardwork now. We believe it earned the HIMSSVenture+ Forum victory by providing thesolution that meets the commitment.”

Sansoro Health’s innovative software,Emissary connects any software to an EMRthrough an open API model. Using thisrapid, scalable, and secure approach,health system customers easily deploy con-solidated patient records from multipleEMRs, mobile healthcare applications for

physicians, real-time analytics tools, andimproved patient medical record portals.

Third-party developers benefit fromEmissary’s standardization by avoiding the

complications of integrating with multipleEMR systems.

“The Venture+ Forum award recog-nizes Sansoro as an innovator in the dy-namic healthcare IT startup community,”

said Jeremy Edes Pierotti, CEO of SansoroHealth. “We are thrilled to be seen as oneof the most promising investments that ahealthcare customer or healthcare IT in-vestor might make. That reflects thestrength of Sansoro’s business plan, ourvision for seamless EMR integration, andof course the outstanding work of our en-tire team.”

“Experts and leaders all across our in-dustry, from federal government to theprivate sector, have highlighted the needfor open APIs to share EMR data. SansoroHealth’s Emissary software fulfills thatneed today by providing open APIs thatare both proven and deployed acrosshealth systems, creating better experiencesand outcomes for physicians and pa-tients,” said Dave Levin, MD, CMO ofSansoro Health.

Sansoro Health’s team includes experi-enced health IT executives, EMR experts,and sought-after software engineers. Thecompany’s Emissary software is currentlyused at some of the leading healthcare sys-tems across the United States, and is con-tinuing to expand its presence.

The Venture+ Forum spotlights top in-novative early and growth-stage compa-nies and provides business-building edu-cational resources and networking oppor-tunities for innovators with leading deal-makers, investors and health industrypartners. Over 60 companies applied toparticipate in the Venture+ pitch competi-tion. Sansoro Health was selected as thewinner from the final four companies thathad delivered live presentations to an ex-pert panel of healthcare industry leadersand investors.

According to the company, SansoroHealth transforms healthcare informationtechnology by providing robust web ser-vices integration across the major elec-tronic medical record (EMR) platforms.The Minneapolis-based company’s award-winning software, Emissary, embraces arapid, scalable, and secure approach toprovide a bi-directional, proven set ofEMR-agnostic, open APIs.

Sansoro’s solution helps withinteroperability betweensystems. HIMSS has highlightedthis as a major issue.

– or even across children – it can be sharedwith all practitioners, for example.”

Kids with autism make up 80 percent ofTeleroo’s current user base in Alberta. Thecompany has successfully demonstratedimproved efficiencies in its local commu-nity and is now widening its reach to spanacross Canada and the U.S. Earlier thisyear, it received an education grant fromthe Ohio Department of Education to rollout a cloud-based version of Teleroo tobenefit hundreds of thousands of schoolchildren in the Ohio area. QoC Health isplaying an instrumental role in makingsure the technology will scale as needed.

“We had been vetting different plat-forms to help us achieve that goal and theywere just a beautiful fit for us,” says Hen-derson, noting that the two companies arewell aligned. “We’re not just building cooltechnology. It needs to be built based onwhat kids and families need.”

The Uncomplicated Family is an exam-ple of how a private sector company is ben-efitting from QoC Health’s scalable plat-form and white-label approach to buildingmobile solutions. Innovations from thepublic sector also stand to benefit.

One example is the Women’s MentalHealth Program at Toronto’s Women’sCollege Hospital, where psychiatrist Dr. Si-mone Vigod has launched an importantdecision aid for women faced with decid-ing whether or not to use anti-depressantsduring pregnancy. Roughly one in 10 preg-nant women will suffer from depression.While there can be a negative impact whenthe illness is left untreated, since it oftenleads to drinking, smoking or general dis-regard for personal care, there are also the-oretical risks to the baby when medicationis prescribed.

“That really leaves women in a Catch-22 and some of our earlier work hadshown that even when these women comefrom specialized clinical care, they stilldon’t know what to do about this situa-tion,” says Dr. Vigod.

As lead for the hospital’s ReproductiveLife Stages Program, Dr. Vigod decided tocreate a patient decision aid to assistwomen in making the best decision fortheir own set of circumstances. Prior toreaching out to QoC Health, she per-formed a comprehensive needs assessmentto first validate that pregnant women fac-ing the choice of whether or not to take

antidepressants do indeed have very highlevels of decisional conflict, and second, tobetter understand the barriers to makingan informed decision.

Dr. Vigod could have gone the route ofdeveloping a paper-based decision aid, butin today’s connected world, an electronicsolution made more sense. Once her re-search was complete, she partnered withQoC to start development.

She says QoC Health was able to workwithin the boundaries of strict Interna-

tional Patient Decision Aids Standards andoffered impressive ideas to help grow theproduct. “In a lot of ways, they gave us aleg up because by the time we applied forfunding, we had a prototype,” says Dr.Vigod. “We couldn’t have done it on ourown. We provided the content, the patientsteering committee to go over the various

iterations; they were the ones who pro-vided the frame for doing that.”

The resulting decision aid is accessible byphone, tablet or PC, and accessed via a se-cure login.

Users peruse information about why orwhy not to take antidepressants, what othertreatment options are available, and anoverview of the risks associated with treat-ment versus non-treatment. As they readeach benefit or risk, they assign it a ranking.In the end, they are presented with a sum-mary that reviews everything they read,how they valued it and what pieces they feelthey’re struggling with.

“The idea is they go back to their doctorand sit, having done this, and make a moretimely and effective decision,” says Dr.Vigod. “Because it’s one of those situationswhere as a physician, I can’t say for surethat it will be better if you take antidepres-sants than if you don’t.”

Dr. Vigod’s patient decision aid is cur-rently being piloted by a group of 50women. It has also gained the attention ofthe National Health Service in the U.K. andQoC Health is helping to scale a versionthat is applicable to women there as well.

CONTINUED FROM PAGE 12

QoC helps innovators turn ideas into real-world solutions

Public and private organizationsoften have good ideas for apps.The challenge is in creatingthem and scaling up.

Sansoro Health wins Venture+ Forum pitch competition at HIMSS16

The document, however, provides onlybasic high-level recommendations andlacks a useable approach that can be ap-plied to practice.

Navigating the ever-evolving space ofmHealth apps can be a challenge forboth the clinician and the patient alike.As patients further turn to their health-care providers for advice and informa-tion regarding the use of such tools, itwill become critical for providers to havea practical approach towards makingsuch recommendations. This is particu-larly true in this transition period wherethere is no centralized regulation or eval-uation of these applications.We proposethat clinicians evaluate and treatmHealth apps with a very similar frame-work to the way OTC (over-the-counter)medications are treated. Conceptually,both groups of “interventions” sharemany similarities: they don’t need a pre-scription for usage; patients will still ap-proach clinicians and other healthcare

providers for advice on their use; theycarry potential risks and benefits thatneed to be weighed to the individual pa-tients and there is a broad selection ofuses, as well as a growing market ofcompanies selling the products that canmake selection difficult.

Just as a clinician may have a pre-ferred choice of over-the-counter med-ications that they may recommend, clin-icians through experience, research and

sharing within their networks can beginto develop a list of their “preferredapps” for specific therapeutic conditionsand purposes.

There needs to be more work at mul-tiple levels of the healthcare system toapproach this topic.

Medical associations and the Min-istry of Health need to continue to de-

velop a robust and agile framework forscreening and categorizing such apps,and provide material to educate bothpatients and healthcare providers alike.

Medical schools and residency pro-grams need to incorporate topicsaround health information privacy andmobile health applications as a standardpractice. Until then, frontline cliniciansmust take the responsibility for develop-ing their own lists of ‘preferred apps’and sharing them within their networksand associations, and ensuring time isallocated to discussing this importanttopic with patients.

Puneet Seth, MD, is a practicing physicianin Ontario and is Chief Medical Officer ofInputHealth, an award-winning digitalhealth company connecting patients andproviders through the Collaborative HealthRecord. You can follow him on twitter@psethmd. Dorian Murariu, MSc, is aClinical Research Coordinator in Ontarioand a co-investigator on clinical studies indiverse fields including head and necksurgery, cardiology, medical education, andglobal health.

Healthcare appsCONTINUED FROM PAGE 10

Clinicians can begin todevelop a list of theirpreferred apps for specifictherapeutic purposes.

h t t p : / / w w w . c a n h e a l t h . c o m A P R I L 2 0 1 6 C A N A D I A N H E A L T H C A R E T E C H N O L O G Y 1 5

In their day to day clinical environment, health careprofessionals constantly need to interact with their patients and colleagues, wherever they may be. They need to shareknowledge and expertise, reassure their patients, train and assessthe competency of their students. What they need is a tool thatallows them to remotely interact in a dynamic, engaging and user-friendly way. Reacts was created with this perspective in mind.

Reacts (“Remote Education Augmented Communication, Training,Supervision”) helps improve access to care, decreases costs, andimproves efficiency and satisfaction among both patients andhealth care professionals. It has been designed to meet the highestperformance and security standards of the medical industry.

Reacts is a feature rich, integrated solution that allows you to:

• Communicate face-to-face using high quality secured video calls, either peer-to-peer or between multiple remote sites

• Share virtual pointers to direct attention to anything on live streams

• Connect and stream multiple video feeds simultaneously, using any medical device that has a video output

• Securely share your applications or your desktop screen

• Share instant messages, files and documents easily and securely

• Manage your files and multimedia elements from your Reacts library

• Store and retrieve files centrally, with 2 GB of cloud storage per licence

• Perform virtual guidance by superimposing semi-transparent images, 3D objects, or live video streams onto a remote user’s live stream

• Take snapshots or video recordings, and add annotations to any image, video, or asset

• Create checklist and report templates to ensure a standardized approach to care or to document your virtual encounters

• Use Reacts in simulation sessions to capture and record multiple video feeds that can then be reviewed offline for briefing / debriefing purposes

Reacts goes beyond the medical world. It can be used in several other fields such as education, field services,public safety, business, and any other area in which interactive, multimedia collaboration is needed.

Reacts provides a highly secured virtual environment and allows you to interact with colleagues, patients,clients or friends in an unparalleled way. It will make you rethink the way you communicate.

Welcome to hyperpresence.

Reacts – a digital collaborative platformthat brings remote interaction to thenext level through “hyperpresence”.

www.iitreacts.com Telephone: 514-223-1717 • Toll free: 1-844-423-1717 • Email: info@iitreacts.com