N.S. health authority CEO eyes technology changes to improve patient movement

Karen Oldfield might not know how long she'll be interim CEO of Nova Scotia Health, but she has a clear view of what she wants to achieve while in the job.

Oldfield was appointed to lead the provincial health authority by Premier Tim Houston five months ago. Since then, she's toured the province talking to health-care workers and meeting with as many people as she can to learn more about the system's inner workings and well-documented challenges.

"People have been very kind to share and teach and I just keep asking questions and it's really amazing what you unpeel and find when you keep asking the questions," she said in an interview Wednesday.

Following those conversations, Oldfield formed four key focus areas: work-life balance and human resources; improved technology; sustainable services in rural communities; and patient access and flow.

Some of these will take longer to tackle than others, particularly during a pandemic that's laid bare problems that have existed for years. Addressing staff shortages, for example, takes time because of the time needed to educate, train and recruit people.

In the short term, Oldfield has her sights set on improving patient flow and access in hospitals and using technology to do it.

Next month, the health authority will roll out a pilot program at Colchester-East Hants Health Centre in Truro that will allow people looking to attend the emergency department to triage online and be assigned an appointment.

Oldfield, who wants a similar pilot to happen at a Halifax-area hospital, is hoping the effort will ease pressure on overcrowded emergency departments. Officials won't take long to determine whether to expand the idea to other hospitals, she said.

"It could be 30 days, it could be 45 days, it could be 60 days — it's not going to be long," she said.

"If we see something there [that needs addressing], then we tweak. But if it's half-decent, it's going."

This outlook embodies the approach Oldfield, a lawyer by training who was originally tapped by Houston to be his deputy minister of priorities and planning, brings to the job. She wants to hear all ideas for improving the system and, if they're doable and make sense, she's willing to give it a try.

"You can't make decisions based on nothing. But if it's reasonable, then OK. It doesn't have to be perfect. Perfection stymies progress. And we need to get off the status quo."

This is the approach Oldfield is taking with respect to plans for a so-called command centre to monitor bed availability and patient discharges in real time. Often, patients are left waiting in emergency departments for hours until a bed becomes available. And because the discharge process is cumbersome and disjointed, that availability isn't always known about immediately.

The command centre is something that's been discussed in the past, but Oldfield said she wants it to happen this year. At a minimum, she wants an early version operating soon and the kinks can be worked out along the way.