College of Paramedics of Nova Scotia: a flexible registrant management database

Ursula Cullen (host, FlowForma)00:00

Today's webinar is hosted by FlowForma Process Automation. I'm Ursula Cullen, the events manager at FlowForma, and I'll be your host. Our panel will discuss digitalization and how the College of Paramedics of Nova Scotia created a flexible registrant management database.

Karl Kowalczyk00:45

I'm Karl Kowalczyk, Executive Director and Registrar with the College of Paramedics of Nova Scotia. I'm a paramedic by profession, I used to be an army reservist, and I've managed an educational institution.

Nicole Webb01:16

I'm Nicole Webb, the administrative coordinator at the college. I'm not a paramedic, I just greatly appreciate them, but I have a background in research and statistics.

Rick Dowell01:43

I'm Rick Dowell, co-founder and co-CEO of Pontem Innovations. We help organizations use their data more effectively through data analytics and process automation, we're a FlowForma partner, and we've worked with CPNS for over two years.

Lana Vandrasco02:13

I'm Lana Vandrasco, a business solutions manager at Pontem Innovations. My background is in project management and continuous improvement, and I've worked closely with Karl and Nicole to implement and evolve their registrant management database.

Rick Dowell02:51

We often think of a database simply: we input data, it's stored, and we pull it out as needed. In practice, the interaction between a registrant and a regulatory college is much more complex and fluid. The workflow changes depending on the registrant's situation, and the college needs internal processes to make sure every box is ticked, efficiently.

Rick Dowell04:50

The pain points we hear from regulatory colleges: databases can be rigid, while stakeholders such as the board or the government keep asking for different information. That rigidity brings high IT and database costs, static reporting that can't answer the follow-on question, slow responses from providers, and a lack of clarity over who owns the data. In this system the data is owned by the College of Paramedics of Nova Scotia, with no gray area. And without nuanced workflow, processes take a very long time, sometimes still on paper.

Karl Kowalczyk07:07

We're a statutory body that regulates the practice of paramedicine in Nova Scotia. We came into existence on April 1, 2017, and assumed responsibility for all registration, licensing and professional conduct decisions from Emergency Health Services Nova Scotia, inheriting a system from a database service provider along with it.

Karl Kowalczyk07:52

Our database now has about 1,900 registrants, up from about 1,200 who transitioned. Each year roughly 1,260 renew their licenses and about 100 new registrants join. That's a large registrant population for two and a half staff. We only recently hired a deputy registrar, so for years Nicole and I managed the processes.

Nicole Webb09:07

We inherited a lot of information with all those registrants, and what we do with it is really important: how we access it, retrieve it and retain it.

Karl Kowalczyk10:00

We looked for almost two years. Through the Nova Scotia Regulated Health Professions Network, 22 other healthcare regulators in the province, and counterparts across the country, I heard about their systems and a lot of database service providers. Our key driver was flow. We could capture and report the data government needed, but there was no natural process to send an application back to the applicant to fix and resubmit.

Karl Kowalczyk11:34

The other big piece was security. I always asked database providers how I'd know my data was secure, and they wouldn't really tell me or allow third-party testing of their system.

Karl Kowalczyk12:35

Then there was data quality. Registrants would type lowercase names or postal codes, and when we pulled data out for letters it looked sloppy and unprofessional. Nicole spent a significant amount of time cleaning that up, so having data come in clean from the applicant was a key requirement.

Karl Kowalczyk13:58

And when I talked to a database provider, I was talking to someone who knows data, not someone who knows flow. When we met Rick and Cam, their question was: Karl, what's your flow? They listened and put it in place the way we needed. With the previous provider it was like pulling teeth.

Rick Dowell16:08

To summarize: customizable workflow, created the way you want and adjustable in future, because it's never set and forget. Flexible reporting, so clean, structured data lets you automate letters and pull reports at your fingertips instead of spending six hours in Excel. And registrants entering and revising their own information, so a small team isn't stuck doing manual work.

Lana Vandrasco18:35

This is the registrant portal, a secure portal where registrants see their basic license information and the key forms they need to submit. Karl and Nicole control which registrants have access.

Lana Vandrasco19:12

One form is the verification of registration. When a registrant opens it, it prefills all their personal details from the system, so they only complete the questions specific to the request: recipient details, special instructions, acknowledgement, signature and payment method. The invoice amount is filled in too. Submitting it starts the workflow.

Lana Vandrasco20:29

This is the CPNS admin center. Every day Nicole can open her verification of registration forms and see the summary: 175 completed, two waiting for review, including the one we just submitted. She opens it, checks the submission and records the payment.

Nicole Webb21:37

Every organization has forms, and people are sick of paper. This form used to come to me as JPEGs, pieces of paper, forms with coffee stains, and I had to reformat it before I could send it to another regulator. Now I fill in my part in about five clicks and download a PDF with both pages, complete and in the right format. This was a game changer for us, and we'll never go back to paper.

Nicole Webb24:01

A key feature is passing an application back. Sometimes a registrant misreads the form or skims over it. I review what they gave me, and if something needs attention I select no, check off what needs fixing, and it goes back to them. If it looks good, it goes off to the other regulator. We've taken a process that relied on snail mail and multiple versions of a document to about three minutes.

Lana Vandrasco25:30

When Nicole saves her input, the system also generates a draft Word document, prefilled with everything from the registrant's step and hers: registration number, registration date and the rest.

Rick Dowell26:58

That's why structured data matters. Drop-down boxes and mandatory date fields mean these documents go out as is, without review or editing. And the forms can change over time, whether a new requirement arrives or the college simply wants to make a registrant's life easier.

Lana Vandrasco28:25

This is an initial registration application, now in the college staff review step. There are no more separate forms: applicants choose whether they're a new graduate, a graduate from another jurisdiction or an international applicant, and the form shows only the questions that apply. If something's incomplete, Nicole selects no to pass it back, picks the reasons, such as missing proof of identification or a criminal record check, and adds comments.

Nicole Webb30:50

The pass-back feature has let us eliminate email threads, paper mail and redundant work. Applications no longer disappear into a black hole. The reasons list is a copy of our checklist for an initial application, and the form has logic built in so it knows what to show. Applicants upload their own documents, so everything is in one spot. Applications used to take around two hours to review. Now I can review one in about five minutes and usually tell if something's missing in about 30 seconds.

Nicole Webb33:37

Pass-backs are communicated by email and timestamped, so we can show we're meeting our fair registration practices guidelines and processing things in a timely manner. We can also analyze what people commonly get wrong and make the form clearer.

Karl Kowalczyk34:48

This is where flow comes into play. When I asked for all these application forms, Cam's first question was why I needed so many. We walked through what we needed and what would make logical sense, and this is what was produced. Our previous provider couldn't even give us multiple applications.

Karl Kowalczyk36:05

During COVID we had to add a restricted temporary license for paramedic graduates, and within two weeks that application was up and running, because it flowed naturally from this one. For clarity, I have no relationship with Pontem. I'm saying this because I truly believe the system has improved our ability to operate.

Rick Dowell37:54

Something that interests me is the evolution. Where we started isn't where we ended up, because process and workflow are great candidates for continuous improvement. Nicole, do you have an example?

Nicole Webb39:01

The activity log. It was a dream of ours, and it was my birthday present. It's a living repository of everything we have on a registrant: inherited data, papers and PDFs, and every application that has come in through FlowForma. Rick told me early on that with this system the information would come to us, rather than us going looking for it, and the activity log is a platinum example of that.

Nicole Webb41:49

We can look at the individual or the group, over time or within groups. Each row could be a verification request, a staff note, a name change or a renewal. With one click I have someone's full application and documents if I need to audit something. It works for us; we're not working for it.

Rick Dowell43:51

Because data arrives through interactive forms and is stored in a structured way, the reporting is very flexible and can change with the college's strategy or the government's needs. When we started we had about ten dashboard pages; now there are over 50. That back-and-forth partnership is really important.

Rick Dowell46:14

Karl, the data also let you see the business in a new light, for example the true cost of processing applications.

Karl Kowalczyk46:54

With the previous database we could only accept one fee combining the application fee and the registration and licensing fee, which made refunds painful. Now applicants pay a $150 application fee, and once we accept the application they have 30 days to pay the licensing fee, so the two are distinct.

Karl Kowalczyk48:19

Application fees should cover our administrative costs. With a full year of data, I could see we bring in only about $20,000 in application fees, which doesn't come close to covering the cost of processing applications. Before, we couldn't even see whether it was an issue.

Rick Dowell50:41

How important is flexibility, given the evolving requirements for health regulatory colleges?

Karl Kowalczyk51:08

There's constant change. The Patient Access to Care Act, introduced in March, required healthcare regulators to stop charging application fees to labor mobility applicants. That took about half an hour of Pontem's time to put in place. The new Regulated Health Professions Act has also passed, and we're building out the regulations. I know the system can adapt to whatever that change is going to be.

Karl Kowalczyk53:02

And it's our data. When we moved from the old database, we had to pay a fee to get our own data out.

Nicole Webb54:12

It comes back to information being brought to us: accountability, timelines and security. We get sensitive information as a healthcare regulator, and everything is in a safe place when we need it. There's no tutorial for our system. We know how to use it because it's ours, and we built it together with Pontem using FlowForma's tools. It was a game changer for us.

Ursula Cullen (host, FlowForma)55:38

Thank you so much, that was inspiring, and it's great to see real dashboards and the process in action. FlowForma is a no-code process automation solution used by hundreds of thousands of people around the world, across construction, healthcare, education, financial services, manufacturing and more. You can request a free trial, Pontem's team will follow up, and the CPNS case study is in the resource panel.