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Presentation on theme: "PARTNERSHIP BETWEEN MANITOBA & BRITISH COLUMBIA FIRST NATIONS."— Presentation transcript:


2 MUSTIMUHW ( pronounced Moose tee mook )

3 NameMustimuhw cEMR VendorCowichan Tribes LocationDuncan, British Columbia InstallationsBC, SK, MB PlatformRuns on Windows ArchitectureClient Server or ASP model LicensingAnnual/per user Not for profit business model

4 A computerized medical record created specifically for First Nation community based health organizations Integrated use amongst multi- disciplinary & para-professional care teams Community, family & cultural focus Enabling client participation & empowerment Supporting the specific range of programs, services & workflow in FNs community based organizations

5 Mustimuhw meets the electronic charting needs of First Nation health centres and service providers Designed by First Nations for First Nations Charting designed for nurses Modules for First Nation health specific programs Reports designed to meet the funding requirements of Health Canada/INAC/P&T

6 Community Health Nursing Maternal Child Health Immunizations Chronic Disease Management Child Oral Health Initiative Mental Health Counseling Home and Community Care Patient Travel/Medical Transportation

7 Desktop application that runs under Windows Locally installed, or remote server version Designed to support multi-site practice groups remote locations mobile workers

8 Customizable charting templates Full disconnected use capability Lab result interfaces in British Columbia Home Care reporting interface for Health Canada Future integrations planned with Panorama and VIHA Pathways

9 Culturally appropriate, and strength-based, programs that address social determinants of health, are more successful in a FN context Mustimuhw cEMR provides a comprehensive record that members can relate to includes community teachings & sayings incorporates culturally appropriate language Contextualizes member records within their family & extended-family context Aboriginal – Status – On-Reserve/Off-Reserve classification

10 Service cultural of Members (clients) being part of health care team Goal-setting & Success monitoring tools for Members Member specific print-outs & summaries of various aspects of chart they can take away Providers record charting notes in conjunction with members Helps instill ownership over own health, & provide knowledge transfer & words to have in navigating broader health care system

11 Telehealth, EHRs & EMRs, Panorama Mustimuhw Pilot project Interim eHealth Advisory Partnership MFNs ICT Inventory MFNs Technology Council Building the MFNs Network Committee Youth ICT Committee Technology Development Committee Manitoba First Nations ICT Training Initiatives Inc. HISAP Readiness Assessments AFN National eHealth Advisory Committee (NeHAC) & AFN ICT Working Group

12 63 First Nations in Manitoba 125,000 plus registered Manitoba First Nation members 62% live on reserve 60% are under 30 yrs 6 of the 20 largest First Nation communities in Canada are located in Manitoba

13 50% (32) of Manitoba First Nations are northern and/or isolated communities 36% (23) are not accessible by all- weather roads Dene Cree OjiCree Ojibway Dakota

14 The goal of the MFNPWTG project was to reduce the significant impacts of foot ulcers & amputations through the development of a wait time guarantee for the prevention, care & treatment of diabetic foot ulcers in Manitoba First Nations (MFNs) communities. The MFNPWTG project researched options & invested in hardware & software for 6 pilot sites. The initial goal was to implement in 8 sites, however jurisdictional issues led to 2 sites being eliminated.

15 INPUTS Funding Health Canada- wait times envelope national office Separate envelope, not FN envelope Sustainability funding from 2008 to current from FNIH MB Stakeholder partnership MFNs AMC Federal Government Provincial Government Clear Concepts Saint Elizabeth Health Care Cowichan Tribes

16 ACTIVITIES IT infrastructure - Connectivity - Hardware - Software Preplanning visit Making Mustimuhw Your Own Community level training Technical and Mustimuhw support OUTPUTS IT equipment purchased based on needs Preplanning visit & Assessment Customization, privacy policy & other information issues addressed Capacity building carried out at the community level to build competency in software usage On-going technical and Mustimuhw support made available to the communities

17 SHORT-TERM OUTCOMES Health Canada reports at the touch of a button Compliance with reporting requirements Easy scheduling & tracking Can add current health forms directly into the cEMR On-line charting and easy access to growth charts Screening people with diabetes for risk of foot complications Stores digital photographs of wounds Right information at right time LONG-TERM OUTCOMES Integrated case mgmt & holistic care Vaccine preventable communicable disease control Community empowerment Portability Accountability & efficiency Useful tool for health care providers to help improve health status of FNs Increased job satisfaction among nurses & healthcare providers Safe, reliable, quality care

18 AMC acquired financial contributions from FNIH-MB for Fiscal Years to aid with project management, administration, communication & collaboration with MFNs, Cowichan Tribes, etc. In March 2008 AMC took the Systems Champions to Cowichan to show their commitment to the partnership, as they continued to take Mustimuhw to its next level of functionality, security, implementation & support.


20 AMC continues to develop a business model & funding plan to allow for all interested MFNs to implement Mustimuhw. A Mustimuhw Evaluation Plan was undertaken by AMC as part of Health Infostructure funding, to collaborate lessons learned & validate the upcoming business plan.

21 Pilot evaluation helped inform our future efforts Evaluation input from 5 of the six FNs

22 Difficulty / Complexity for end-user: The majority (77%) of Health Centre end-users found it a friendly and easy to use application.

23 Key positive outcomes identified by Health Centre respondents: Access to Information Time-saver Easier reporting Increased information security / confidentiality


25 Interoperability = ability of electronic medical systems to interface, or connect, to talk to each other GOAL of project = develop & demonstrate interoperability between Mustimuhw (cEMR) & a primary care clinical information system (EMR), i.e. within same community or with primary care service providers outside the community, but who provide service to the on-reserve population. MUSTIMUHW cEMR II PROPOSAL Developing Interoperability for Manitoba First Nations

26 Expansion of Mustimuhw cEMR to 3 MFN communities Community Selections & Readiness Assessments Project Advisory Committee CTFoH Project management team Project Liaison, ICT Network Liaison, Interoperability Team housed at Manitoba eHealth & AMC eHealth report directly to AMC eHealth = Project Management Office CANADA HEALTH INFOWAY Mustimuhw cEMR Phase II Project

27 Application principles: Improve patient wait times & healthcare through technology Prevent disease & its complications, in particular Diabetes Outcomes: Contribute to meeting the objectives of the MFNTC Resolution & contribute to building the future Centre of Excellence Increase ICT capacity in communities & community level decision-making, including business opportunities

28 Deliverables-based funding: receive $$ after completion & approval of documents, for example: Project Charter & Project Procurement Plan Project Sponsorship & Advisory Committees Formation Master Project Plan & Change Management Plan Community Site Selection & Engagement Reports Service Delivery Model: Current & Future


30 The 1 st FNs in Canada to receive funding from Infoway for community EMRs! June 2011 Proposal Submitted January 2012 Legal Agreement complete Project Commencement February 2012 Staff Procurement January 2012 Press conference announcing project June 2013 Project end


32 Community Info Largest First Nation community in Manitoba, with a population of approximately 9042 people of Ojibway & Cree descent. Located 190 km north of Winnipeg, MB, and has an area of 75,749.2 acres.

33 With the support of MFN PWTG Pilot Project we were given tools to enhance our current diabetes program: Mustimuhw install Training, foot care instruments, dremels, doppler, printer and a digital camera to help enhance our community program

34 Medical Transportation Program Visiting Mental Health Therapists General Dentist - Dental Therapist &COHI Home and Community Care Program Aboriginal Diabetes Initiative Program Water Quality Program Traditional Healing Program NNADAP Program Public Health – Baby Clinic - Immunizations Footcare Program Health & Wellness Program Maternal Child Health Vision Care Program Canadian Prenatal Nutrition Program

35 Benefits to Clients Enhanced internal case-management & communication – continuity of care with follow ups Standardized templates for service encounter charting Benefits to Staff Job satisfaction Automatic data collection for reporting (efficiency) Client wait times are decreased through faster charting

36 Benefits to Management Facilitates compliance with reporting requirements Facilitates quality assurance Facilitates employee activity monitoring Increased capacity for change Data collection evidence-based programming evaluation advocacy

37 The Mustimuhw program makes charting much more easy and efficient to use. It decreases a lot of time charting in between clients, improving the level of service. Home and Community Care Program I find the use of the program extremely beneficial in that it cuts the time for charting. The reports function make the month end reports a lot more easy to compile. I like that the system gives reminders for certain activities, Ie: foot screening, etc. The spell check function also makes for an easier task, an I will continue to use the program. Public Health Nurse

38 Community Info Current Leadership – Chief Frank Brown, Councillor Mervin Demas, Councillor Gerald Sandy Canupawakpa Dakota Nation, non-Treaty Located in southwestern Manitoba One of 5 Dakota Bands in Manitoba Population of 600+, on reserve 300+ Language spoken – Dakota

39 Community Health Promotion & Injury/Illness Prevention, Public Health Protection Communicable Disease Control & Management, Home & Community Care CHNs, HCCNs, Health Care Aides, In Home Care Support, CHRs, Community Diabetes Worker, Visiting Dietician, Foot Care Nurse, Nurse Practitioner Medical Transportation Community Wellness Addictions & Solvent Abuse, Mental Health, Crisis Intervention, Parenting Skills, Injury Prevention, Healthy Babies & Child Development,

40 The Mustimuhw Program has been great for our Community. The nurses can provide better continuity of care. The Mustimuhw program is excellent for case management, you can easily see which programs have been involved with the client. I cant imagine running my program without it. Shelley Kirkup, HCCNM The Mustimuhw program is member focused, he/she can monitor their own strength of wellness. Mental Health Coordinator We wish our health centre had the program, Sioux Valley considers CDN to be very fortunate to have the program. Neighboring community, Sioux Valley Nurses

41 Continue the partnership & collaboration with all project partners Establish a linkage to the Manitoba Regional Health Authorities electronic health systems. Establish linkage to FNIHs other electronic programs, e.g. CRWs program – Medical Transportation Program Sustainability & capacity building for IT support & costs associated with Mustimuhw program.

42 Sustainability costs AMC – continued advocacy IT Capacity Clear Concepts – support & capacity building eHealth development Cowichan Tribes – product enhancements Maintenance & Maximization Community champions network Cowichan Tribes - Software support

43 Wopida – Ekosani – Miigwech – Mahsi – Huy ch qu – Thank You Lisa Clarke– eHealth-Technology Coordinator Assembly of Manitoba Chiefs 2 nd Floor Portage Avenue Winnipeg, MB R3B 2B3 Phone: Fax: Steve Sagodi – Mustimuhw Solutions Architect Tsewulhtun Health, Cowichan Tribes 5760 Allenby Rd. Duncan, BC V9L 5J1 Phone: Fax: Terry Wilson – Medical Transportation Coordinator Peguis First Nation Box 88 Peguis, MB R0C 3J0 Phone: Fax: Wanda Sandy – Health Director Canupawakpa Dakota Nation PO Box 11 Pipestone, MB R0M 1T0 Tel: (204) Fax: (204)


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