Project REACH - Physician Informatics Leads Retreat

Your Guide to Project REACH
January 2025 - Physicians Informatics Leads Retreat
For internal purposes only

Your Guide to Project REACH
January 2025 - Physicians Informatics
Leads Retreat
01
Welcome to
Project REACH
5
02 Background 9
03
04
Education &
Resources
Our Engagement
Work
18
30
PROJECT REACH 3

01
Welcome to
Project REACH
A message from the
PROJECT REACH Team
Welcome to an exciting
phase in Sunnybrook’s
clinical transformation
journey.
As the organization moves towards a new single Health Information System, we recognize
that this will be no small undertaking. Over the course of the last few years, we have worked
to understand the needs of various clinical groups and we plan to continue this engagement
work throughout the implementation and optimization of the new system.
In this document, we will give you a history of the project, an overview of the work we’ve
done to date and some useful clinical informatics resources.
- The Project REACH Team
PROJECT REACH 5

01
Welcome to
Project REACH
PROJECT REACH LEADERSHIP
Our Sponsors
Rob Lee
VP Digital Health &
Chief Information Officer
Ru Taggar
EVP, Chief Nursing & Health
Professions Executive
Dan Cass
EVP Programs, Chief
Medical Executive
Our Project Team
Ilana Halperin
Chief Medical Information
Officer (CMIO)
Andrew Kennedy
Director of Clinical
Informatics
Julie Waspe
Interprofessional Clinical
Informatics Lead
We are currently building our team. There may be more key members of the project team not yet reflected at this time.
PROJECT REACH 7

02 Background
WHERE WE ARE
Our Journey to a New Health
Information System
Traditionally, our approach has been “best of breed” where each clinical area
selected the electronic tools that met their needs, and the IT department worked to
integrate the systems, as well as extract data for secondary use.
This approach has caused us to lag compared to our peer hospitals in key areas like structured clinical
documentation for nursing and allied health, as well as computerized prescriber order entry (CPOE), to
name a few. To meet the rapidly evolving needs of care delivery and research, a renewed and centralized
Health Information System (HIS) strategy is necessary. This will serve as a key enabler to invent the future
of health care at Sunnybrook and create a seamless experience for our providers, patients and community.
Many in the organization agree that Sunnybrook must move away from it’s current approach. As part of
a benchmarking exercise, in 2024 we partnered with independent healthcare IT insights company KLAS
Research (engage.klasresearch.com) to better understand the clinician experience with electronic health
records in it’s current state. Results from the survey showed that the overall electronic health records
experience at Sunnybrook is low and the most satisfied clinicians were the ones who were most deeply
digital and using the fewest number of systems. More details of the work with KLAS can be found in the
Engagement section of this document.
PROJECT REACH 9

02 Background
WHERE WE ARE
Project Timelines
Sunnybrook’s Health Information System transformation journey began in
the Fall of 2022 with a procurement project that followed the broader public
sector request for proposal guidelines.
With the ultimate goal of healthcare interoperability, we have engaged with stakeholders across the
organization at every stage of the process, and will continue to do so until we go-live. In the Spring of
2024, Oracle Health was determined to be the preferred proponent with the highest scoring in the RFP
evaluation. This included the combined scores of over 400 staff and physicians, who were consulted
as part of the process. You can read more about the multi-stage RFP process in the Engagement
section of this document.
PHASE 1
DEVELOP REQUIREMENTS AND INFORM PROCUREMENT APPROACH
(10 months)
➊
Procurement
Process Kick-Off
➌
Risk & Readiness
Assessment
➎
Financial Strategy
Development
Fall 2022
Winter 2022/23 Spring 2023
➋
Options Analysis
➍
Work Plan
Development
Milestone
Project REACH
announced to
Sunnybrook
(May 2023)
10 PROJECT REACH

PHASE 2
VENDOR SELECTION
(Approx. 20-23 months)
Milestone
➏
Milestone
RFP POSTING
(Aug 2023)
Summer 2023
Fall 2023
On-site demos for
final two vendors
conducted with staff
(Jan 2024)
Winter 2023/24
➑
Negotiating &
Contracting
Spring &
Summer 2024
Fall & Winter
2024/25
➐
Milestone
RFP Evaluation
Bids Close
(Oct 2023)
Milestone
Oracle Health
selected as
preferred
proponent/vendor
(May 2024)
Milestone
Implementation
Budget receives
Board approval
(Oct 2024)
PHASE 3
IMPLEMENTATION
(Approx. 18-24 months)
➒
Implementation
Process Kick-Off
⓫
Testing
⓭
Stabilization
Approx. 2-3 months
Spring 2025
Milestone
Negotiations
Finalized
(Mar 31 2025)
➓
⓬
Implementation Go Live!
⓮ Optimization
PROJECT REACH 11

02 Background
OUR GOVERNANCE STRUCTURE
Sunnybrook’s Clinical
Informatics Governance
Governance structures are key for project progression ensuring key stakeholders are
included in decisions, and identifying escalation path for issues, risks, and delays.
Below is the proposed governance structure for Project REACH that leverages current Sunnybrook
structures. It is subject to change and may be impacted by the vendor negotiations.
Board of
Directors 1 *
Senior
Leadership
Team*
Project REACH Steering
Committee
Advisory
Committees: *
• IQC
• OLAF
• MAC
• HPLC
• PNC
• REC
• Patient
Experience
Clinical Informatics Council*
Project REACH Integrated
Working Group 2
Project REACH Functional
Working Groups 3
Project
Management
Support *
*Denotes governance structures that are already working or advising on the project
1
This includes the Board in general, and the HIS Subcommittee and Finance & Common Audit Committee in particular
2
This group will have sub-committees that will include Clinical Documentation, Scheduling and Order Sets
3
This will be made up of specialty working groups from across the programs
PROJECT REACH 13

02 Background
OUR GOVERNANCE STRUCTURE
What role do each of these
groups play?
FUNCTION RESPONSIBILITIES MEMBERSHIP GOVERNANCE
Steering Committee
• Provides highest level
of risk escalation and
mitigation oversight on
the progress of the HIS
program
• Coordinates overall
alignment with the HIS
sub-committee of the
Board
• Acts as the highest level
of program governance
at the operational level
for all escalations and
dispute resolution
• Approves major program
decisions related to
scope, resourcing, and
timeline
• Provide updates to SLT
and HIS sub-committee
of the Board
• Project Sponsors
• CFO
• Legal Counsel
• Project Management
Support
• Reports from CMIO,
Project Director and
Director of Clinical
Informatics
• Final level of project
governance
• Accountable to SLT and
HIS sub-committee of
the Board
Clinical Informatics Council (CIC)
• Provides overall
leadership and direction
on the HIS program
• Ensures that clinical and
technical requirements
are integrated within the
program enabling safe,
high-quality patient care
• Oversees program
management, benefits
realization, as well as
risk management at the
operational level
• Overarching policy,
clinical practice
standards, procedures,
processes, and
organizational structure
to the HIS program team
and / or governance, with
appropriate approval(s)
from advisory council(s)
(e.g. MAC, IQC)
• CIO Leadership Team
• Director & Medical
Director of Quality
• Director
-Interprofessional
Practice
• Director - Decision
Support
• Operations Directors
• Project Management
Support
• Escalate issues to
Steering Committee
• Share policies and
guidance to Integrated
and Functional Working
Groups
14 PROJECT REACH

FUNCTION RESPONSIBILITIES MEMBERSHIP GOVERNANCE
Integrated Working Group
• Achieves standardization
and alignment of
stakeholders across
Functional Working
Groups on matters with
enterprise impacts
• Supports Working
Groups in achieving
cross-functional
alignment/
standardization
• Issues recommendations
for conflict related
to cross-functional
alignment
• Ensures evidence-based
leading practices and
corporate standards
• Physician Informatics
Leads
• Interprofessional Clinical
Informatics Lead
• Clinical Informatics
Specialists
• Project Management
Support
• ORACLE Representative
• Chairs of Functional
Working Groups
• Escalates issues to CIC
• Push decisions down to
the Working Groups
• Escalates unresolvable
issues to CIC
Functional Working Groups
• Achieves standardization
and alignment of
stakeholders across
Functional Working
Groups on matters with
enterprise impacts
• Supports Working
Groups in achieving
cross-functional
alignment/
standardization
• Issues recommendations
for conflict related
to cross-functional
alignment
• Ensures evidence-based
leading practices and
corporate standards
• Physician Informatics
Leads
• Interprofessional Clinical
Informatics Lead
• Clinical Informatics
Specialists
• Project Management
Support
• ORACLE Representative
• Chairs of Functional
Working Groups
• Escalates issues to CIC
• Push decisions down to
the Working Groups
• Escalates unresolvable
issues to CIC
Project Management Support
• Provides guidance,
tools, and resources
to ensure project
planning, execution,
and completion are
efficient, on time, within
budget, and aligned with
organizational goals
• Coordinates overall
alignment with the HIS
sub-committee of the
Board
• Facilitates
communication
• Risk management
• Reporting and metrics
• Develops project
management frameworks
• Monitors project
performance
• Supports all layers of the
project
• Project Managers
• Business Analyst
• Project Coordinators
• Embedded at all levels of
Governance
PROJECT REACH 15

02 Background
KEY ROLES
Sunnybrook Clinical
Informatics Roles
What will the Clinical Informatics positions at Sunnybrook look like? Some of
the existing and future clinician roles that will support Project REACH and the
transition to the new HIS are listed below.
➊ Project Directors – Work Streams
Reporting to the leadership under the Chief Information Officer’s portfolio, they will be the central point of
contact to validate design decisions are being made in a timely manner, data collection is being completed
to Sunnybrook’s standards, and risks and issues are being logged and mitigated appropriately.
➋ Physician Informatics Leads
They will represent key medical departments and/or programs. The Physician Informatics Leads will sit at
the Integrated Working Group and are responsible for design decisions that will impact physician workflows
across the organization. They will help to identify and coordinate the work of the Project REACH Physician
Subject Matter Experts (Physician SMEs). Although they are accountable for the build and implementation
of the system as it impacts physicians, they will also work collaboratively with other team members to
ensure a seamless experience for patients.
➌ Physician Subject Matter Experts (Physician SMEs)
They will be responsible for working with the Clinical Informatics Specialists and Oracle Health team
members to design and build the system and adjust workflows as needed for physicians. They will be
responsible for working with the Clinical Informatics Specialists and Oracle Health team members to design
and build the system while also adjusting workflows as needed for physicians.
➍ Subject Matter Experts (SMEs)
They are department/program experts who support solution team members with specific solution and
process knowledge for a specific functional area. The SMEs will play a key role in support, adoption,
change management, design decisions as well as engaging with the clinical teams, physician SMEs and
operational leadership to ensure all requirements are understood and built into the system.
16 PROJECT REACH

02 Background
➎ Physician Super Users
They will be experts in the workflows and software. They will provide ongoing support to their peers during
the go-live phase.
➏ Clinical Informatics Specialists
Associated to each Oracle module (i.e. power plans, research, ED), the Clinical Informatics Specialists are
Sunnybrook resources dedicated to data collection and system design, design decision making, build and
other activities. They will also be responsible for the ongoing maintenance of the solution.
➐ REACH Champions
Part of the Interprofessional teams’ Best Practice Champion initiative, REACH Champions are clinicians
helping to raise informatics awareness among peers. They also support local engagement, deliver microlearning,
foster clinical informatics best practices, as well as gather data to support the HIS transition and
research.
PROJECT REACH 17

03
Education &
Resources
This section is divided into three key areas. Below is a brief explanation of
what you can expect from each of these areas.
INFORMATICS
FOUNDATIONS
→
So what is clinical informatics?
We’ll break down common
informatics terminology, best
practices, and Infrastructure.
CHANGE
PRINCIPLES
→
There are a number of ways to
manage change. Here we go
over some common theories
and frameworks.
COLLABORATION
This section gives an overview
→ of collaboration approaches,
some of which we will employ
for the project.
18 PROJECT REACH

03
Education &
Resources
INFORMATICS FOUNDATIONS
What is Clinical Informatics?
Clinical Informatics is an interprofessional and integrative field that applies the
principles of computer science and information science to healthcare (health
sciences research, health professional education, public health and patient care).
COMPUTER
SCIENCE
CLINICAL
INFORMATICS
HEALTHCARE
INFORMATION
SCIENCE
This field describes the use and application of technology to assist in the gathering, storage, processing
and interpretation of health information. As such, technology is viewed as a tool which health providers can
use to improve health care services. In using the principles of computer and information science, the field
of health informatics focuses on understanding a number of key areas:
• How health information can be used in care delivery
• How health information can be used to improve patient care
• How health information technologies (HITs) can further be leveraged
to improve health care and outcomes.
PROJECT REACH 19

03
Education &
Resources
INFORMATICS FOUNDATIONS
What are some common
terminologies?
As you begin this journey, you will come across a number of terms that you
may not be familiar with. We’ve put together a list of common informatics
terminology to help get you started.
• Alert Fatigue: Improper configuration of systems can trigger false or overwhelming volumes of
warnings, leading to users overlooking or ignoring alerts.
• Decision Support Tools: Automation or alerts used for enhancing health-related decisions and actions
with pertinent, organized clinical knowledge and patient information to improve health and healthcare
delivery.
• eHealth: A term used broadly to describe the utilization of information and communications
technologies across the care continuum to support a variety of functions that range from administration
to health services delivery.
• Electronic Health Record (EHR): An electronic health record (EHR) system is an electronic record
of health-related information on an individual that conforms to nationally recognized interoperability
standards and that can be created, managed, and consulted by authorized clinicians and staff across
more than one health care organization.
• Health Information Exchange (HIE): The infrastructure to support easy of securely sharing health
information electronically to improve care efficiency, quality and safety.
• Health Information Systems (HIS): A combination of vital and health statistical data from multiple
sources, used to derive information and make decisions about the health needs, health resources,
costs, use, and outcome of health care.
• Information and Communication Technologies (ICT): Encompasses all those digital and analogue
technologies that facilitate the capturing, processing, storage, and exchange of information via
electronic communication.
• Interface Engine: A specialized server and software solution used to format, translate, and
communicate healthcare related data between systems using various protocols.
• Interoperability: The ability of computer systems or software to exchange and make use of
information. (Oxford Dictionary).
20 PROJECT REACH

03
Education &
Resources
INFORMATICS FOUNDATIONS
Understanding the Electronic
Medical Record Adoption Model
(EMRAM)
The Electronic Medical Record Adoption Model (EMRAM) is an eight-stage (0-7) model that measures
clinical outcomes, patient engagement and clinician use of EMR technology for acute care hospitals and their
affiliated ambulatory care settings. Its aim is to strengthen organizational performance and health outcomes
across patient populations. EMRAM is the industry standard for digital transformations and has been for
decades. It is supported by the Healthcare Information and Management Systems Society (HIMSS). As
Sunnybrook embarks on Project REACH, our goal is to go-live with stage 6 functionality.
Stage
⓿
➊
➋
➌
➍
➎
➏
➐
Name
Department systems not installed
Ancillary systems installed
Clinical data repositories
Electronic documentation and
enhanced security
Governance and electronic orders
Data integration
Advanced data exchange
Dynamic health record
For more information about the EMRAM stages, you can visit
the HIMSS website (himss.org/maturity-models/emram).
PROJECT REACH 21

03
Education &
Resources
CHANGE PRINCIPLES
A breakdown of change
theories and frameworks
There are many ways to manage change and we have a number of options available to us.
In this section we’ll give you an overview of a number of change management frameworks.
Clinical Informatics Change Management Framework
A commonly used model in clinical informatics breaks down change into six key elements.
Identify and address
needs, perceptions and
expectations
To guide and maintain the
direction of project
Stakeholder
Engagement
Governance and
Leadership
Monitoring and
Evaluation
Understanding current
process and improvement
opportunities
Workflow
Analysis and
Integration
To determine project
effectiveness, gaps,
risks and success
Communication
Consistent, repeated
and targeted for
stakeholder groups
Training and
Education
Providing knowledge and specific
skills, should be ongoing
Source: Diagram adapted from Canada Health Infoway
22 PROJECT REACH

03
Education &
Resources
CHANGE PRINCIPLES
System Deployment Life Cycle
There are eight EHR implementation phases: Planning, Acquisition, Configuration, Testing, Education,
Deployment, Evaluation, Maintenance & Personalization. To be successful, it is crucial to have end-users
engaged early on and throughout these phases. Since the lifecycle is continuous, for the Sunnybrook
implementation we may simultaneously be at different points with different products.
Ongoing up keep of the
system including integration
of changes/updates
8
Maintenance &
Personalization
1
Planning
Identifying needs
and stakeholders
User adoption, benefits data
collection and analysis
Launch of the
system with support
staff assistance
7
Evaluation
6
Deployment
5
Education
System
Deployment
Life Cycle
4
Testing
2
Acquisition
3
Configuration
RFP process to
select vendors
Defining use and
updates required for
available function
Communicating workflow, policy
and practice changes. Providing
user systems education
Systems staff test
functionality and user
acceptance testing
Source: Diagram adapted from The Information System Consultant’s Handbook (1999)
PROJECT REACH 23

03
Education &
Resources
COLLABORATION
How do we approach
collaboration?
Interprofessional Collaboration Core Competencies at Sunnybrook
In Clinical Informatics as in the clinical environment it is critical that we work collaboratively in a
competent manner. There are six core competencies to support the success of interprofessional teams
- shared decision making; values and ethics; communication; conflict resolution; reflection; and role
clarification. The competencies cover a number of domains:
• Practice and care
• Education
• Research
and quality
improvement
• Leadership
Role Clarifiication
Shared Decision Making
Interprofessional
Improvement
Education
Interprofessional
Research & Quality
Interprofessional Values
& Ethics
Interprofessional
Leadership
Interprofessional
Collaboration
Interprofessional
Practice & Care
Communication
Refllection
Interprofessional Confllict
Resolution
Source: Adapted from Sunnybrook paper published in Healthcare Management Forum (2022)
24 PROJECT REACH

03
Education &
Resources
COLLABORATION
Interprofessional
collaboration
What do each of these core competencies entail?
Below we break them down further.
Shared Decision Making
Teams come together to develop a shared plan, determine decision structures and assign accountability for
each task.
Values and Ethics
Teams create a climate of transparency, openness and willingness to collaborate, creating an inclusive and
psychologically safe environment.
Communication
Teams seek to achieve common understanding when communicating across roles and professions.
Conflict Resolution
Teams respond to anticipated or occurring conflict situations with appropriate and skilled interventions in a
timely manner by collaborating to create a range of solutions.
Role Clarification
Teams ensure that members understand each others’ roles, scopes and expertise. They also optimize
clinical workflows by identifying interdependencies and overlap thereby embracing full scope of practice.
Reflection
Teams learn from their experiences. Teams collaboratively identify strength and opportunities for
improvement.
PROJECT REACH 25

03
Education &
Resources
COLLABORATION
Understanding our environment
In healthcare, change is constant. It is crucial to understand the context to better anticipate the strategies
that are best suited to support any change. VUCA is a helpful acronym that you may have heard used
already in your time at Sunnybrook. It helps change leaders identify challenges as a result of four
compounding factors: Volatility, Uncertainty, Complexity, and Ambiguity. What do we mean by this?
Volatility
Characterized by instability or unpredictable situations, where something changes rapidly without warning
or is hard to forecast.
Uncertainty
Depicted by situations or events where we have insufficient information or where information is unclear
which can cause fear in the unknown.
Complexity
Described as a multi-faceted elaborate network of information or processes that can be understood or
explored from many perspectives.
Ambiguity
Represented by unclear reality with mixed meanings, where information is missing, inconsistent,
contradictory, or obscure leading to the multiple interpretations.
So, what is the best approach to deal with these factors?
26 PROJECT REACH

03
Education &
Resources
COLLABORATION
Managing external factors
Each environmental factor can be addressed with respective approaches and actions:
Volatility
→
Vision
Creating a clear, tangible, and strategic vision that aligns staff towards a common
goal or outcome can provide stability in a volatile environment.
Uncertainty
→
Understanding
Seeking to comprehend and listening attentively to staff and their concerns can help
to identify gaps and vulnerabilities, which can address and alleviate uncertainty.
Complexity
→
Clarity
Clarifying details, and focusing on simple solutions can enhance staff capacity,
flexibility and tolerance of complex situations.
Ambiguity
→
Agility
Responding to events and circumstances in a flexible and prompt manner and having
an eagerness to learn and adapt to evolving conditions can combat ambiguity.
PROJECT REACH 27

03
Education &
Resources
COLLABORATION
Project tools and resources
There are a number of tools and resources that you may come across as you
become more involved in Project REACH. One key tool is the RACI matrix.
This is a project management tool often used in informatics projects to identify key stakeholders and
to assign deliverables. It assigns roles across four main categories, that have been explained in more
detail below.
R
Responsible
Individual or team doing
the work.
A
Accountable
Individual or stakeholders
responsible for approval and
completion of the work.
C
Consulted
Individual or stakeholders who
review and provide input prior
to sign-off of work.
I
Informed
Individual or stakeholders who
require updates on progress or
decision but do not contribute to
the work.
PROJECT REACH 29

04
Our Engagement
Work
ENGAGING WITH STAKEHOLDERS
Working with Team Sunnybrook
towards a new HIS
We know that the participation of staff and clinicians with clinical, operational, organizational
and informatics expertise will be critical to the success of Project REACH.
From the RFP process to our work with the Arch Collaborative and more, our engagement work has helped
us understand what is important to each of you in the new HIS. In the following pages, we will go over
some of different ways Project REACH has relied on the expertise of all Sunnybrookers to date.
30 PROJECT REACH

04
Our Engagement
Work
ENGAGING WITH STAKEHOLDERS
Inventing the Future of Healthcare at Sunnybrook: The RFP Process and Vendor Selection
(2023-2024)
A key phase of the Project REACH journey, the RFP process and vendor selection allowed us to work
closely with Sunnybrookers to understand what mattered most to them. After a rigorous, multi-step
evaluation stage, that took place over 2023 and early 2024, Oracle Health was identified as the preferred
proponent for Project REACH. They received the highest scoring in the RFP evaluation, which included the
combined scores of over 400 staff and physicians. Oracle Health scored the highest in the non-financial
criteria, which included clinical requirements. This did not change once the financial evaluation was
included. You can read more about the RFP process in our FAQ section on Sunnynet.
By the Numbers
270
Physicians and staff participated in identifying
7150 core HIS functional requirements and
589 technical HIS requirements
65
Physicians and staff participated in patient
journey demonstrations with three vendors
433
Physicians and staff participated as evaluators
in stage 4 functional and technical
demonstrations with two vendors
PROJECT REACH 31

04
Our Engagement
Work
ENGAGING WITH STAKEHOLDERS
Our Work with the Arch Collaborative (2024)
With the ultimate goal of establishing clinicians’ baseline experience with our systems in their current
state, in 2024 we partnered with independent research firm, KLAS Research. This endeavour is part of the
Arch Collaborative, a worldwide effort to improve Electronic Health Record (EHR) satisfaction for clinical
end users. KLAS Research facilitates the Arch Collaborative’s work by co-designing a confidential clinical
survey with hospitals, like Sunnybrook. Each individual’s responses to the survey regarding core factors
such as the EHR’s efficiency, functionality, impact on care, and so on were aggregated into an overall Net
EHR Experience Score which represents a snapshot of the clinician’s overall satisfaction with the EHR
environment at their organizations
The survey found that Sunnybrook clinicians are anxious for a single, centralized EHR to fix many of their
current workflow challenges. Our efforts to establish a baseline before the implementation of the system is
unique, and will ultimately allow Sunnybrook to set metrics for success that have been validated by data.
By the Numbers
680
Physicians and staff filled out the Sunnybrook
Arch survey that ran between May-July 2024
The largest professional areas covered were
nurses (38%), allied health professionals (31%)
and physicians (16%).
Based on the survey’s scoring system,
Sunnybrook clinicians’ satisfaction with the
current workflows is below average (6.9). When
benchmarking our score to other organizations,
we fall in the 23 rd percentile.
32 PROJECT REACH

04
Our Engagement
Work
ENGAGING WITH STAKEHOLDERS
Clinical Informatics Rounding Sessions (2024)
Between May-October, 2024, the Project REACH team ran monthly rounding sessions with point of care
clinicians and professional groups across the organization. It was an effort to better understand how
end users were feeling about the upcoming transition to a single health information system. Additionally,
the sessions were an opportunity for all participants to discuss current as well as future challenges and
opportunities related to the use and integration of technology into clinical workflows.
If you’re interested in learning more about these sessions and the main themes from them, you can read
more about it on the Project REACH section on Sunnynet (sunnynet.ca/REACH).
By the Numbers
211+
Sessions
conducted to date
Largest
professionals
group covered:
1500+
Participants from
across campuses
90%
Nurses
Frontline Staff
Health
Professions
6%
Support Staff
Learners
PROJECT REACH 33

Resource References
Canada Health Infoway. (2013). A Framework and Toolkit for Managing eHealth Change: People and Processes.
Retrieved from https://www.infoway- inforoute.ca/en/component/edocman/4037-a-framework-and-toolkit-formanaging-
ehealth-change/view-document?Itemid=103
Cernega A, Nicolescu DN, Meleșcanu Imre M, Ripszky Totan A, Arsene AL, Șerban RS, Perpelea A-C, Nedea
M-I, Pițuru S-M. Volatility, Uncertainty, Complexity, and Ambiguity (VUCA) in Healthcare.Healthcare. 2024;
12(7):773. https://doi.org/10.3390/healthcare12070773
Davis, W. S. (1999). The systems development life cycle. In The Information System Consultant’s Handbook (1st
ed., pp. 3–9). CRC Press. https://doi.org/10.1201/9781420049107-1.
McLaney E, Morassaei S, Hughes L, Davies R, Campbell M, Di Prospero L. A framework for interprofessional
team collaboration in a hospital setting: Advancing team competencies and behaviours. Healthc Manage Forum.
2022 Mar;35(2):112-117. doi: 10.1177/08404704211063584. Epub 2022 Jan 20. PMID: 35057649; PMCID:
PMC8873279.
Ontario Nursing Informatics Groups. (n.d.). Health Informatics. Retrieved from https://onig.on.ca/Nursing-Informatics
Registered Nurses Association of Ontario. (2017). Adopting eHealth Solutions: Implementation Strategies.
Retrieved from https://rnao.ca/sites/rnao- ca/files/bpg/Digital_Health_Guideline.pdf
34 PROJECT REACH

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