Technology, in the form of online connectivity, is advancing pandemic preparedness and making it easier for doctors to manage their rotating shifts and overlapping schedules.

Traditionally, on-call shifts from multiple locations revolve around paper-based trails that are often confusing –even conflicting. Juggling these rosters resembles the stress loads borne by air-traffic controllers.

Obstetrician Guy-Paul Gagné, M.D., knows firsthand the challenges facing shift schedulers at Montreal’s LaSalle General Hospital. Responsible for the rotating shifts of nine doctors in three hospitals, Gagné explains that it is virtually impossible to create schedules without knowing the interrelated schedules of everyone involved. “My secretary spends half a day locating a doctor,” he said. “That time lost has a huge cost component, not to mention inconvenience to the patient.”

Coordinating schedules and ensuring coverage at every clinic, hospital, nursing home, and prison causes constant confusion. Trading on-call shifts is a nightmare for shift managers. Uncertainty rules when penciled-in changes to schedules are posted in numerous places: Which roster is current?

“I’ve never seen a doctor scheduling system that wasn’t paper based,” reported Steven Rector, M.D., an emergency physician from Atlanta, Ga. “Our schedule is distributed on paper. We make schedule requests on paper and pencil in changes on the master copy in the emergency department.”

A unique solution to this chaos comes in the form of online, real-time software called CHYMA (pronounced “k-eye-ma”). CHYMA was developed by general practitioner Dennis Reich, M.D., from Sudbury, Ontario, who was confronted with creating shift schedules for several clinics. Reich’s software solution enables managers to post shifts live online where they can be accessed and traded anywhere at any time. (See software screenshot for shift schedule trading.)

Pandemic Preparedness

Two key questions confront all pandemic planners: How do we find out where our resources are, and how do we connect with them quickly and easily?

A recent 10-point plan to alleviate pressure on America’s emergency departments in the event of a disaster was proposed by the American College of Emergency Physicians to Congress. ACEP warned that agencies on the federal, state, and local levels could not control medical disaster response and recovery without fully connected and coordinated health resources.

In summary, collection and dissemination of data is vital. ACEP’s proposal (February 2006) emphasized the need for connectivity to “implement protocols to collect and monitor real-time data for syndromic surveillance, hospital inpatient and emergency department capacities, and ambulance diversion status”.

Access to current information and mobilizing key personnel in an outbreak or pandemic emergency requires a shared communications strategy in real time. The U.S. draft proposal of its pandemic flu plan envisions major disruptions in society from an outbreak with about 40 percent of the workforce falling ill, requiring government to work with health officials and the military while they contain the pandemic and maintain order. Coordinating volunteers will play a major role as manpower and movement will be restricted, says the 228-page report.

“Mobilizing ER physicians, front-line healthcare workers, public health units and government agencies, including the police, fire departments, or military, would be crucial for an effective and immediate response,” said Reich. “When key players in healthcare and emergency preparedness want to coordinate cross-institutional communications, CHYMA can help.”

Quarantine Protocols

A central recommendation in reports following Toronto’s Severe Acute Respiratory Syndrome (SARS) crisis emphasized the need for fast, effective, real-time communications with physicians and healthcare workers. During the SARS outbreak, emergency physicians at Scarborough General Hospital were catapulted into an abrupt realization: They urgently needed a better tool to coordinate scheduling and communications while dealing with highly contagious disease and its many isolation-related problems. In CHYMA they found a solution. Doctors can now relay constantly changing isolation protocols among quarantine-exposed physicians as well as trade shifts online in real time, without breaking quarantine barriers.

In Sault Ste. Marie, Ontario, the group health center, 10 regional health facilities, clinics, hospitals, the coroner’s office, and police department are using CHYMA in a citywide strategy. Across Canada, approximately 5,000 physicians are using the software for a variety of applications from shift creation and trading to document sharing, messaging, and providing an audit trail of shifts worked for physician billing purposes. CHYMA also provides online links to medical journals and procedures.

“Now that shift changes are in real time, we have a current up-to-date schedule,” said Mark Fletcher, M.D., director of the Family Focus Medical Clinics’ 65 doctors, in Halifax, Nova Scotia. “This software has solved a lot of problems that can occur when physicians start trading shifts.”

The software’s unique, scalable solution is Web-based and integrates smoothly into existing operations: One clinic manager said the system was up and running in no time because it uses the common intuitive browser functions with which we are all familiar. For shift schedulers, dialing for doctors is now a headache of the past.

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For Immediate Release

MONTREAL, QUEBEC, June 2, 2008…The Scarborough Hospital (TSH), Canada’s largest urban community hospital, has selected Chyma to help improve on-call scheduling and communications between physicians. The implementation of Chyma for their team of more than 700 physicians has begun with the busy ER departments at the two hospital campuses and will soon be expanding to the department of general medicine.

“Chyma reflects the commitment of the Scarborough Hospital (TSH) to excellent patient care, and leadership among Canadian hospitals through the adoption of innovative healthcare information technology,” said Jeanie Joaquin, Vice President of Patient Services at the TSH. “Equally important, Chyma supports our medical team in a meaningful way by giving them a tool to save valuable time in the on-call scheduling process. As an added benefit, we believe that Chyma better positions TSH to attract doctors and locums in our community while enabling our physicians to better manage their schedules and balance their lives.”

“Now with a few mouse clicks, doctors and administrators using Chyma at the TSH will know in ‘real time’ which physician is on where and when,” said Mark Gregory, Vice President of Marketing and Communications for Chyma. “The technology is a visionary tool for planning for healthcare emergencies, healthcare resource allocation, and informatics.”

Chyma (pronounced K-eye-ma) is a Web-based tool that enables physicians and healthcare administrators to manage on-call schedules. Designed by a doctor, Chyma has the features and functionality healthcare professionals want including:

• Rapid generation of schedules
• Schedule grouping for multi-departments and multi-communities
• Vacation approval
• Conflict catcher
• Intuitive Vista and Mac look
• OnNow! full screen (airport style) display
• File and ‘contact’ sharing, and secure email across communities
• Fast, reliable Net 2.0 Architecture with Ajax components.

Chyma (www.chyma.net) is currently in use in leading hospitals in Canada including St. Michaels in Toronto, St. Joseph’s and McMaster University in Hamilton, the North Bay General Hospital and the Children’s Hospital and St. Justine’s in Montreal as well as primary care networks (PCNs) in Alberta such as Calgary Foothills, Calgary Rural and Highlands.

Chyma is owned by IsaiX Technologies (www.isaix.com), a leading Montreal-based technology company with a focus on the life sciences and financial sectors.

MONTREAL, QUEBEC (November 5, 2007) – Chyma Systems just released it latest version of the scheduling software for scheduling physician shifts. This robust application increases versatility and now synchronizes with Outlook. Additional advanced features save doctors even more time.

“Chyma has gained widespread recognition among physicians for playing a leading role in developing an easy, on-line application for coordinating on-call shift schedules,” said Dr. Dennis Reich, Chyma Systems, Director of Medical Information. “We are very excited by the new features in the ‘rules-based scheduler’.

Dr Saleem Razack, Pediatric Residency Program Director at McGill University, uses the latest version of Chyma to manage schedules for approximately 70 residents per month in the pediatrics program at the Montreal Children’s Hospital (MCH)/McGill University. Previously he found the process of generating on-call schedules by hand to require approximately 60-80 manpower hours/month by their chief residents.

“We investigated several on-line solutions over the years, but always found the “rules-based scheduling” to be the lacking point,” says Dr Razack. “There are so many guidelines and parameters to take into account for each person and responsibility, with time off to rest, etc., and thus rules-based scheduling for us was a must.”

Dr Razack explained the diverse parameters he had to consider when scheduling: Some residents may be at the MCH for 4 weeks, some for 4 years, and coordinating different skill levels, shift work in the Emergency Department and overnight on-call shifts, was a challenge. He also had to meet the requirements of the provincial collective agreement between medical residents and the Ministry of Health. Finally, he has residents from many programs in addition to pediatrics and must meet each program’s specific requirements for resident scheduling to accommodate teaching sessions, etc.

“We greatly appreciated the willingness of Chyma’s IT team to work closely with us to tailor the scheduling algorithm to our needs,” says Dr Razack. “A schedule such as ours is almost like a living organism — constant care and adjustments were required in the beginning to de-bug problems as the program was piloted. We applaud the company’s willingness to look at our needs and refine the program in an efficient and timely manner. We are beginning to see manpower savings, benefits such as easier post-schedule changes, and the creation of on-line practice communities (which we did not anticipate), that show us that this tool has the potential to enhance residency education significantly.”

Chyma has a broad communications and scheduling capacity, and that’s why entire communities like Sault Ste. Marie’s emergency responders and all its health regions use Chyma,” said Dr. Reich. “We are rapidly becoming the tool of choice for large groups of doctors, such as the Ontario Medical Association’s section on General Family Practice and their 8,000 members, and PEDS Ontario, and Primary Care Networks in Calgary, just to name a few.”

Chyma Systems is owned by IsaiX Technologies (www.isaix.com), a leading Montreal-based technology company with a focus on communications, training and marketing in the life sciences and financial sectors. Chyma offers numerous tools with its shift trader, including a contact manager, scheduler, knowledge bank, CHE and CME, and medical references.

Overview of new features added to Version 3.06

For greater expediency, users can now create templates by department or by communities. They can also create a template based on another schedule or another template in the same department.

A new interface in the automated rules-based scheduler now provides complete information about each shift transacted, including user name, date and time, duration, status, forward and backward cool down periods around shifts, and conflicts if any.

There is also a new function that previews the month’s schedule and allows it to be saved as an excel file. Administrators also have greater access and control to schedules by accepting or declining events created by other users. Or administrators can utilize an Auto-approve feature.

When an event that requires approval is added to a schedule, emails are sent to the administrator notifying that an event needs approval. Another email is sent to the user when the event is confirmed or declined.

Shift trades are now possible between departments or buildings making administration of a larger facility more efficient.

The “On Now” section conveniently shows 48-hour shifts for improved management of schedules.

Users can add personal events to their calendar for easily coordinating or modifying schedules. A new link allows users to “view personal calendar”. When this calendar is shown, all available shifts are displayed in the personal calendar. Users can look at their personal events and decide if they want to accept or decline an available shift.

Other new features include:

• Schedule grouping in one interface for multi-departments and multi-communities
• Rules-based scheduling to handle complex schedules including medical residents, shift preferences and protocols, and much more
• Vacation approval
• Faster performance with Microsoft®.Net 2.0 architecture
• Improved conflict catcher
• Easy to navigate Vista® and Mac® interface
• Who is on? an airport-style rotating “OnNow!” full screen schedule showing physicians on duty. Ideal for display in key hospital and clinic care areas

Physician scheduling just got faster and more effective. Chyma Systems has announced the launch of a Chyma Rules feature that automates the building of fair and conflict-free schedules. This intelligent rules software is based upon multiple department, facility and individual instructions or “rules”, and users’ time-off requests. All Chyma clients will get the new Chyma Rules tool by March 2007.

Chyma (pronounced “ki-ma”) is a simple-to-use, but robust Web-based tool that enables physicians and healthcare administrators to manage physician, employee, and on-call schedules. Designed by a doctor, Chyma has the features and functionality healthcare professionals want including:

• Shift-trade tools that enables posting/proposing trades and reviewing, accepting or rejecting shifts from other doctors or administrators
• Accessibility from any computer with web access, 24/7
• Integration of many department or facility calendars into one personal calendar
• A conflict checker to avoid physician schedule overlaps
• Automated “rules-based” schedule generation
• Secure communications channels to support better information-sharing
• Staff workload and billing reports.

Approximately 13,000 Canadian physicians are using Chyma. After the SARS outbreak in Canada, the Scarborough General Hospital realized it needed a better tool to coordinate emergency physician scheduling and communications. They chose Chyma. They joined a rapidly growing number of leading hospitals and clinics across the country now using the tool including St. Michaels, Toronto, Sault Ste. Marie Hospital, St Joseph’s Hospital, Hamilton, Family Focus Medical Clinics in Halifax, and the Vancouver General Hospital.

Physicians and hospitals use Chyma to automate complex tasks and create more transparent, accessible and better work schedules which improves efficiency and cuts administrative costs.

For more information contact Chyma: