Canada Health Infoway and the pan-Canadian EHR

1
Canada Health Infoway and the pan-Canadian EHR
Shelagh Maloney Executive Director, External
Liaison, Canada Health Infoway Evolution of
Health Care Federal Healthcare Partnership March
18, 2008
2
Outline

• Canadians expectations and the electronic health
  record (EHR)
• The benefits of the EHR
• Canada Health Infoways role and strategies
• Alignment with FHP initiatives
• Progress and Future direction

3
What Canadians expect

• Accurate information that moves with them
• Communication between their various health care
  providers
• Protection of their privacy
• Input into decisions
• Elimination of undue risk
• Timely access/results

4
Need to manage health information will intensify
10
Resource pressures are intensifying

• Health care costs and personnel shortages are
  increasing
• Improved performance management, remote access,
  and productivity gains will be needed

Care settings are shifting
Consumerism is growing

• Care is shifting from GPs and acute care to home
  care and other alternatives in the community
• Integration among these increasing points of care
  will be necessary as patients will pass through
  several care settings during treatment

• Canadians are demanding a more transparent and
  timely health care system
• Improved performance management, alternative
  access channels, and self care must be developed

Population is aging

• The burden of chronic diseases and cancer is
  increasing as the baby boomers age
• Lifestyle choices are also increasing the
  incidence (e.g., diabetes, cardiovascular)
• More proactive medicine (e.g., screening,
  guideline compliance) will be needed to provide
  high-quality, cost-effective treatment over
  longer care cycles

Sources CIHI Sanofi-Aventis Statistics
Canada OECD WHO Centre for Chronic Disease
Prevention
5
Interoperability challenges
Homecare
Emergency Services
Clinic
Community Care Centre
Pharmacy

• 700
• 40,000
• 315,000
• 29,000
• 26,000
• 1,600

• hospitals
• general practitioners
• nurses
• specialists
• pharmacists
• long-term care facilities

Specialist Clinic
Laboratory
Diagnostic
Hospital Emergency
6
Canada Health Infoway

• Created in 2001
• 1.6 billion in federal funding to date
• Independent, not-for-profit corporation
• Equally accountable to 14 federal/provincial/terri
  torial governments
• Matching P/T contributions account for 25 of
  eligible project costs

Mission To foster and accelerate the development
and adoption of electronic health information
systems with compatible standards and
communications technologies on a pan-Canadian
basis with tangible benefits to Canadians.

• Goal
• By 2010, every province and territory and the
  populations they serve will benefit from new
  health information systems that will help
  modernize their healthcare system. Further, 50
  per cent of Canadians will have their electronic
  health record readily available to their
  authorized professionals who provide their
  healthcare services.

7
Access to detailed data
Patient information
Results and images
Medical alerts
Medication history
Interactions
Immunization
Problem list
7
8
EHR Overall benefits and value

• Reduced wait-times for diagnostic imaging
  services
• Improved availability of community based health
  services
• Reduced patient travel time and cost to access
  services
• Increased patient participation in home care

ACCESS

• Improved interpretation of diagnostic and
  laboratory results
• Decreased adverse drug events
• Decreased prescription errors
• Increased speed and accuracy in detecting
  infectious disease outbreaks

QUALITY

• Increased access to integrated patient
  information
• Reduced duplicate tests and prescriptions
• Reduced physician prescription call-backs
• Reduced patient and provider travel costs

PRODUCTIVITY
9
Infoways investment programs
Total of 1.6 billion in federal funding
10
Longitudinal Record Services
Common Services
The EHR architecture
Communication Bus
JURISDICTIONAL INFOSTRUCTURE
Ancillary Data Services
Registries Data Services
EHR Data Services
DataWarehouse
ImmunizationManagement
PHSReporting
SharedHealth Record
DrugInformation
DiagnosticImaging
Laboratory
HealthInformation
ClientRegistry
ProviderRegistry
BusinessRules
EHRIndex
MessageStructures
NormalizationRules
TerminologyRepository
LocationRegistry
Security MgmtData
Privacy Data
Configuration
HIAL
Hospital, LTC,CCC, EPR
PhysicianOffice EMR
EHR Viewer
Lab System(LIS)
RadiologyCenterPACS/RIS
PharmacySystem
Public HealthServices
Physician/Provider
Physician/Provider
Physician/Provider
Lab Clinician
Radiologist
Pharmacist
Public Health Provider
POINT OF SERVICE
10
11
Linked jurisdiction networks
Distributed, message-based, peer-to-peer network
of e-health systems
EHRS
EHRS
EHRS
EHRS
EHRS
EHRS
EHRS
EHRS
EHRS
EHRS
11
12
Alignment with FHP Initiatives

• Infoway has reviewed and endorsed the proposed
  FHP Enterprise Architecture Plan (EAP)
• the EAP demonstrates a very solid understanding
  of the EHRS Blueprint and necessary standards and
  that, in addition to meeting your FHP member
  organizations operational needs, it also
  provides a workable framework to leverage and
  expand upon the various jurisdictional ERH
  implementations across the country
• The FHP strategy effectively leverages the
  current jurisdictional investment commitments
  made by Infoway with an incremental federal
  investment that is significantly less than would
  be required if developing a pan-Canadian solution
  in isolation of the other infostructures
• The potential development of common and/or shred
  trust, security models and mechanisms to be sued
  between interconnected FHP partners will
  facilitate interoperability and ensure an
  appropriate level of privacy and security.

13
Summary of project activity
245 active and completed projects with an
estimated value of 1.332 billion as at Dec.31,
2007
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?

• ?Registries ?Diagnostic Imaging ?Drug
  Info Systems ?Lab Info Systems
  ?Telehealth
• ?Interoperable EHR ?Public Health
  Surveillance ?Innovation Adoption ?
  Number of Projects

14
The way forward
Finish what has been started in electronic health
records and public health surveillance
1
Foundational Elements
Implement electronic medical records in physician
offices and physician order entry systems in
hospitals
2
Enable public visibility for wait times and access
3
Trial and perfect more advanced functionality in
wait times and chronic disease management
4
Additional Elements
Facilitate patient self-care and empowerment
5
15
Making a difference
16
Thank you