GTA West DIr

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GTA West DI-r

• Regional Diagnostic Imaging Repository

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Presentation Overview

• Concept of the DI-r
• GTA West Project History
• GTA West Project Description
• GTA West Project Procurement Strategy
• Current Status of the GTA West
• Next steps
• Questions and Open Discussion

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Concept of the DI-r Visual Representation

• Reference eHealth MOH 2006

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Concept of the DI-r - Challenges

• Funding for Modalities, PACS, Archives and
  Infrastructure
• Hospitals and IHFs have different models (both
  need access to images at point of care)
• Unique Patient Identification - EMPI
• High capacity, high availability networks not
  sufficient across the province
• Many existing film-less sites lack sufficient
  resources for full redundancy to provide seamless
  business continuity
• Strong provincial leadership needed, clinical
  quality guidelines and standards, local and
  regional governance, collaboration and sharing
  required, balanced with independence
• Reference eHealth MOH 2006

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Concept of the DI-r - Challenges

• Interoperability of various RIS/PACS solutions
• Organizations at different stages of film-less
  maturity, aggravating persistence of
  Transportable Media (Films, CDs)
• PACS investments often perceived as departmental
  instead of enterprise
• Balancing economies of scale with DI solution
  performance needs (response)

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Concept of the DI-r - Rationale

• Supports biggest considerations Clinical needs,
  Funding, Governance, Flexibility and Performance
• Supports patient referral, provider service
  patterns, existing and new collaboration
• Sharing and Clustering where viable, respects
  hospital and IHF differences
• Incorporates existing PACS/RIS investments,
  solutions and initiatives underway

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Concept of the DI-r - Rationale

• Uses existing data centers
• Accommodates geography and network variances
• Provide options in the future for consolidating
  functions

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Concept of the DI-r - Rationale

• Supports patient referral and provider service
  patterns
• Limits local infrastructure burdens, optimizes
  resources

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Concept of the DI-r - Rationale

• Levers Extensive investments which have been made
  in departmental and enterprise RIS/PACS no tear
  downs
• Supports established and new collaborative
  frameworks (e.g. In Urban/Suburban/Rural and
  North geo clinical profiles, where resource
  shortage is acute, region/group collaboration and
  sharing is extensive)

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GTA West Project History

• The GTA West Diagnostic Imaging (DI) Repository
  Project is a joint initiative commissioned by a
  voluntary consortium of 22 hospital corporations
  that span the central and southern regions of
  Ontario. The project launched in mid 2007 to
  undertake a Phase 0/1 Planning Project sponsored
  by Canada Health Infoway (Infoway).
• GTA West represents the last DI-r in Ontario
  (second last in Canada) and is being sponsored by
  the Ministry of Health, Canada Health Infoway and
  the participating Local health Integration
  Networks.

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GTA West Project History

• GTA West started off with a group of hospitals
  that are located in the western side of Greater
  Toronto Area (population 2.5 Million)
• The group expanded beyond the GTA borders to
  include hospitals and regions that had not yet
  joined a DI-r

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GTA West Project Description - Region

• LHIN 5
• Headwaters Health Care Centre
• William Osler Health Centre
• LHIN 6
• The Credit Valley Hospital
• Halton Healthcare Services
• Trillium Health Centre
• LHIN 7
• Baycrest
• Bridgepoint Health
• Centre for Addiction and Mental Health
• The Hospital for Sick Children
• Mount Sinai Hospital
• The Salvation Army Toronto Grace Health Centre
  

3 Million DI exams
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GTA West Project Description

• UHN is acting on behalf of the participating
  hospitals as their representative with respect to
  the execution and administration of the
  agreements with Canada Health Infoway and the
  eHealth office of the Ontario Ministry of Health
  and Long term Care
• Canada Health Infoway will fund 75 of the
  eligible costs
• The Ministry of Health has agreed to fund the
  remainder of the costs
• There are no operational costs to hospitals for
  the first 2 yearsMOH funded.

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GTA West Project Description Project Team
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GTA West Project Description - Committees

• Clinical Oversight Committee
• The GTA West Clinical Oversight Committee will be
  responsible for providing clinical oversight for
  the planning, development, implementation and
  operation of a shared digital diagnostic imaging
  repository (DI-r).
• Review, approve and deliver the clinical
  components of the Current State and Future State
  Architecture and Clinical Requirements documents
• Review project deliverables as may be requested
  by the PMO resources from time to time
• Technical Advisory Committee
• Provides technical oversight for the planning,
  development, implementation and operation of a
  shared digital diagnostic imaging repository
  (DI-r).
• Review and recommend the Future State Technical
  Architecture and Technical Requirements documents
• Provide advice to the PMO resources as to the
  content of the above documents
• Review project deliverables as may be requested
  by the PMO resources from time to time

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GTA West Project Description - Deliverables
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GTA West Project Description End Goals

• To deliver a DI-r capable of accepting PACS data
  as well as RIS data in native format from
  multiple institutions and present it through a
  3rd party viewer and within the GTA West partners
  RIS or PACS
• To deliver a DI-r that will facilitate the
  integration of the other DI-r systems in Ontario

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GTA West Project Procurement Strategy
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GTA West Project Procurement Strategy

• Decided to procure a service and not a solution
  to ensure that an existing public entity would be
  able to govern the system with minimal to
  moderate effort
• Built a comprehensive RFP administered by a RFP
  administrator and controlled by fairness
  consultants

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GTA West Project Procurement Strategy

• Sections of RFP
• Clinical Use cases
• Technical
• Governance
• Privacy and Security
• Total Cost
• Company profile

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Current Status of the GTA West

• 95 Completed Phase 0/1
• Site surveys
• RFP architecture
• RFP evaluation
• Selection of vendor
• Governance group
• Contract signing

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Next Steps

• Complete Phase 2 funding exercise for CHI and
  eHealth Agency
• Redo business case
• Sign on partners
• Build Project team
• Initiate project in Sept 2009
• First go-live site late 2010

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Questions?