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Improvements made

CHEO expands MyChart two-way communications

 

Dr. Ellen Goldbloom in her office at CHEO. To the left of the photo is a computer screen showing MyChart. On the right is Dr. Goldbloom, looking at the camera and smiling.

 

CHEO continues to expand the reach of MyChart two-way communications, a powerful application that give families direct access to their CHEO health record.

“When I first learned about MyChart, I was interested in how it could improve my partnership with the children and youth in my care,” says Dr. Ellen Goldbloom, CHEO endocrinologist. “I underestimated the positive impact it would have on my relationship with families.”

MyChart is a secure, online patient portal that connects children, youth and families to parts of their CHEO electronic health record, either with a computer or a mobile device. They can see a summary of past visits, receive appointment reminders, review health issues, allergies, medications, lab test results, medical imaging, growth chart information, and more — anytime and anywhere. 

“When I bring Paige to see Dr. Goldbloom, we are already up to date with all her blood test results so we get to spend all of our one-on-one time with our doctor on the issues that are most important to us,” says Amy Michaud, eight-year-old Paige’s mom. “If I need to double-check what I should be doing in between appointments or call up something to show my husband for those times when he cannot attend her appointments, it’s all there to review.”

In addition to the basic MyChart features, over a third of CHEO Ambulatory Care clinics now offer two-way communications, allowing families to send messages directly to their health-care team to ask questions and get answers in a convenient and efficient way – often replacing the “telephone tag” that would otherwise be necessary. 

“I cannot tell you how important two-way communications is to our family,” says Michael Patterson, two-year-old Zoë-Anne’s dad. “I can think of a time when we were 95% sure that we knew the answer to a question about Zoë-Anne’s health but we did not want to take the 5% risk. We sent a message. We got an answer. We were relieved. Without MyChart it would have meant a lot of back and forth phone calls or maybe even a trip to the hospital and likely would have taken up our entire day just to get the reassurance.”

For Leanne Findlay, MyChart two-way communications has been extraordinarily helpful. Her son Cameron, 8, has Russell-Silver Syndrome, a rare genetic disorder associated with short stature. Annually, at a conference in Chicago, Dr. Madeline Harbison, one of the world’s foremost Russell-Silver experts consults with families at no charge. Findlay usually takes Cameron for this consultation every second year. 

“Last year we were anxious about something that was going on with Cameron,” says Findlay. “We were considering going to the conference even though it was an off year for us. I sent the endocrinology team at CHEO a message. Dr. Goldbloom sent us for extra blood tests, and then she was able to reassure us that there was nothing out of the ordinary. We didn’t even come in for an appointment and we saved thousands of dollars by not attending a conference that we didn’t need to.”

Feedback from CHEO families using MyChart has been overwhelmingly positive.

“Now when I review lab results,” says Goldbloom, “I take a few seconds to attach a comment like, ‘everything looks good.’ Families are reassured and don’t have to assume that no news is good news. MyChart has added more human touch in the doctor-patient partnership.”

Sign up for MyChart.  

CHEO Intensive Care Unit improving pain management for children and youth

A head and shoulders picture of Dr. Tatiana Sampaio, smiling, standing in front of a bulletin board in a hospital hallway.

“We found that over 40% of children on ventilators in our Intensive Care Units (ICU) would have withdrawal from pain medication. Among patients who are ventilated for five days or more, this number was over 80%,” says Dr. Tatiana Sampaio.

Dr. Sampaio is leading the ICUs in instituting several initiatives, including measuring pain and agitation with better tools more frequently.

As many of the children in ICU are too young and sick to be able tell their health-care team about the severity of their pain, a scale which can be applied by every nurse to every child is important.

When a child or youth’s pain is frequently and correctly measured, the right amount of medication is used which minimizes pain and agitation, and lowers the risk and severity of withdrawal.

“Regular, standardized pain assessment is helping us keep children more comfortable when they are in ICU.” says Dr. Sampaio.

Nurses use FLACC (face, legs, activity, cry, consolability) to measure a child’s pain. Each letter represents an area that is assigned a score from 0 – 2. All five are added together get a score out of 10.

This measurement is vital as it helps to efficiently adjust pain medication. As the child’s pain decreases, dosage is quickly reduced and withdrawal is minimized. As the pain increases, so dose dosage, efficiently reducing the child’s pain and agitation.

There is clear evidence that pain and agitation in CHEO ICUs is decreasing — children on ventilators are more comfortable.

“Our initial results show that our withdrawal rates dropped to less than 30% after instituting this program. In addition to reducing withdrawal rates, we are noticing that even when patients experience withdrawal, they are having less symptoms,” says Dr. Sampaio. “This is just the beginning. More improvements are on the way and we are confident that this number will drop even lower.”

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