Novari Health provides much-needed support to reduce surgery wait times

Novari Health, a Kingston entity since 2003, started out as a project inside Kingston General Hospital (KGH) aimed at creating an organizational system to support their list of patients waiting for surgery and provide eBooking for procedures.

The surgical waitlist software was originally designed as a colour-coded list that shows each patient, what they’re waiting for, and how long they’ve been waiting in order to reduce wait times and allow office managers to see “at a glance” who could, and should, be scheduled next.

Kingston Health Sciences Centre has been using the software since its inception, and Novari Health has expanded into five other provinces, as well as internationally to Australia and New Zealand.

“KGH realized that software for one hospital is good, but it doesn’t really solve a big problem across the province or across the country, so they commercialized [the software],” shared John Sinclair, President of Novari Health. “That actually morphed into what is now known as Novari Health, still based in Kingston, and it’s grown from literally three or four people up to about 80 people right now.”

The majority of Novari’s employees are located here in Kingston, and they are mainly software engineers and software architects, along with project managers. “We’ve grown into one of the fastest growing, if not the fastest growing, digital health companies. We make software that improves access to care,” Sinclair expressed.

The health care system still relies heavily on paper, and most requisitions from physicians’ offices to other clinic or care settings are sent and received over fax, Sinclair explained. This requires a lot of time and organization to keep the system moving and, unfortunately, has room for errors. By moving the entire process into a software system, his hope is that patients will not fall through the cracks, and more connection will be available to place patients with offices and settings that have availability which general physicans offices may not be aware of.

“All that is generically referred to as access to care,” Sinclair said of his explanation. “What’s interesting is that Canada is actually second last amongst industrialized countries of the world when it comes to access to care.”

“As Canadians, we’re all very proud of our healthcare system, as we should be. The quality of care you get when you get into the system is really good in Canada. It’s getting into the system that’s the problem,” he continued.

Sinclair went on to say that the COVID-19 pandemic has exacerbated the limits of our current healthcare system. “The backlog is measured likely in hundreds of 1000s of patients in Ontario, waiting for surgeries,” he said. “There are also patients that didn’t go see a surgeon during COVID. It was hard to get into your GP and then it was hard to get a referral and it was hard to get a consult time. So there are patients out there that would normally already be on a waitlist, but they have yet to appear in the system so no one really knows the magnitude of the problem.”

The Ontario government is investing big money in reducing the surgical wait times across the province. $18 million will be invested in “centralized surgical waitlist management to increase use of electronic referrals and support work to enable efficient tracking of surgical information, making better use of specialist and hospital resources and reducing patient wait times,” according to a release from the province, dated Wednesday, Jul. 28, 2021 — and essentially exactly what Novari Health already has available to provincial and regional healthcare providers.

The Novari Health software system has expanded from surgical wait list management, which Novari aptly calls their Access to Care system, into other list management options, and is extremely customizable. Hospital and clinic systems are different at each location, so the software offers approximately 1000 settings and can be individually configured to fit as needed.

In April 2020, Novari Health was selected to create virtual waiting room and virtual clinic software in a collaborative initiative of the Ontario Medical Association, OntarioMD, Ontario Ministry of Health and Ontario Health. Funding for the project was provided by Canada Health Infoway, an independent, federally funded, not-for-profit organization. Read Kingstonists coverage of this initiative here.

In late June 2021, a healthcare agreement to adopt a shared health information system in southeastern Ontario was announced. Novari will expand the current use of the Novari Access to Care platform, and have their software integrated with the Cerner Millennium system to support a paperless process.

“The Ontario Ministry of Health, Ontario Health and hospitals across the province have been working to mitigate the impact of the COVID-19 pandemic on patients,” the company said in a press release discussing this partnership. “Having a modern referral management, wait list management and electronic workflow system complements these efforts for all patients including those waiting for surgical & medical consults, surgery and other procedures.”

A newer development in the Novari Health system is a central intake and referral management solution, what they call eRequest. Sinclair described it as “a multiple triage system,” and said a central intake system could spread the health care requests across a broader geographic location, for those willing to travel for procedures and appointments, and in doing, lessen the wait times across the province.

“A General Practitioner would send an electronic referral for whatever you need to central intake. Central intake would review it, and will use the system to make a routing decision as to where they’re going to send you, again using wait times and proximity. So, you’re guaranteed to get in as quick as you can and as close to home as you can,” Sinclair explained.

These two pieces of software work together like two pieces of a puzzle. Once central intake locates an appropriate location for the appointment or procedure, the Access to Care system tracks the patient through initial consult, wait list, and procedure scheduling.

When asked if they have seen results of their software implementation, Sinclair told Kingstonist, “We do have data which indicates that providing wait list management systems to those responsible for scheduling patients drives down wait times. And what they also see is patients not calling the surgeon’s office every week saying ‘when’s my surgery, when’s my surgery’. It’s now structured.”

“In addition,” he continued, “the academic literature and real world experience shows that referrals managed through a central intake process are more efficient, more equitable, and help ensure that the right patients get treated at the right time and by the right physician or clinic.”

“We didn’t know we were building software to help Canada respond to the pandemic until the pandemic happened,” Sinclair concluded, noting that access to care has been a chronic problem for the Canadian healthcare system. “It’s an area of weakness for Canada and impacts so many people.”

Learn more about Novari Health and their software systems on their website.