Canada Health Infoway

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• Canada Health Infoway

ACHIEVING RESULTS
ACHIEVING RESULTS
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Todays Meeting

• Our core business is investing with partners to
  develop, replicate and deploy, reusable,
  interoperable EHR solutions faster, better and
  more cost-effectively than any of our partners
  can do alone.
• Provide an overview of Infoways 2003/04
  Business Plan
• Highlight progress to date
• Discuss industry opportunities

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Infoways Past Year Performance
In less than one year, Infoway has committed over
20 of the 1.1B M in project investments
Canada-wide.
218Mcommitted
Major Projects
Sponsor

• NL Centre for Health Information
• AB Capital Health Authority
• BC Ministry of Health Services
• SK Health Information Network
• Infoway
• Infoway
• CIHI

• Client Registry Provincial Client Registry
• Client Registry - Regional EMPI
• Provider Registry Systems Product Delivery
• Provider Registry Systems System Integration
• Architecture EHR Solution Blueprint
• Architecture Data Definition and Standards
• National Electronic Claims Standard

Round 1
110M contracted
Diagnostic Imaging Systems (4 projects) DI
Shared Services Drug Information Systems (5
projects) PIN Project Solution
Portability Drug Messaging Standards
Thames Valley HospitalsOnt. Fraser Health
AuthorityBC Alberta Health Saskatchewan
Health Infoway
Round 2
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Infoways Role
Infoways role as an investor focuses on initial
investment in a solution its deployment. Our
unique role is in providing strategic leadership.
Intervener
Developer
Strategic Investor
Funder

• Set standards and requirements for robust,
  interoperable products and outcomes
• Provide leadership in researching and setting
  strategic direction for EHR and development to
  speed implementation
• Establish success criteria
• Flow or withhold funds based on status and
  quality of products

This is Infoway role. We will act outside
this role only by exception.
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Recognizing and Responding to Change
These factors have led to changes in our
direction and influenced the strategic approach
that underlies the 2003/04 Business Plan
Strategic Factors

• New money
• Compressed implementation timeframes
• Need for better alignment with Members
  priorities
• Immature market for solutions and skills
• New economic reality for IT and investment
  industries
• New Telehealth mandate

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Infoways Revised Strategy
Mandate Develop the key elements of
interoperable EHR solutions six year timeframe

• The Strategy
• Focus on six investment programs
• Leverage investments reuse, replicate, align,
  deploy
• Collaborative planning with health ministries and
  other partners
• Form strategic alliances with private sector
• Focus on end-users to gain acceptance
• Public sector sponsors with investment in
  projects

• Infoways Investing Philosophy
• Accelerate the development of EHRS involves
  breaking new ground
• Reduce costs and overall risk accelerate
  implementation
• Adjust strategy to reflect learning and experience

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Investment Portfolio
The areas of investment have remained remarkably
constant the only addition is that of
Telehealth

• Investment Programs EHR Building Blocks
• Telehealth
• Laboratory Information Systems
• Diagnostic Imaging Systems
• Drug Information Systems
• Registries
• Infostructure

• All program areas include Change Management and
  Knowledge Management and Benefits Evaluation

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Investment EstimatesInfoway Target Commitment
Over Six Years
The estimates include solution development,
change management, knowledge management, benefit
evaluation and transition planning in each
jurisdiction.

• Additional
• jurisdictional costs
• One-time and ongoing operating costs
• Networking infrastructure
• Clinical data capture/acquisition
• Ongoing operations, maintenance
• Enhancement of hardware/software systems and
  servers, etc.

Jurisdictions and initial investment 600 - 800 M
Infoway 1.0 - 1.2 B

• Telehealth
• Laboratory Information Systems
• Diagnostic Imaging Systems
• Drug Information Systems
• Registries
• Infostructure

100 - 150 M 150 - 200 M 220 - 280 M 185
- 240 M 80 - 110 M 190 - 260 M
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Investment Formulas
New Allocation Principles

• Predictability
• Facilitate compressed negotiations
• Higher investment for new solution development
  less for mature solutions or existing
  technologies

• Favour shared services approach
• Acknowledge added costs of early adopters
• Defined by program
• determined by capital, technology and
  implementation risks

Formulas by Program of Infoway investment
To be developed in Investment Program Strategies
Estimated commitments may be revised and
subject to information emerging from transition
plans
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Investment Estimates Infoway Target Commitments
by Year
Target commitments in all six Investment Programs
starting in 03/04
Infoway Program Investment

• 60 of Infoways and 40 sponsors commitment
  estimated in the first three years
• The rate of Infoways investment depends on
• Jurisdictions readiness to implement
• Jurisdictions ability to provide matching
  investments

Preliminary Estimates Only.
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Investment Tracking Jurisdictional Priorities




West
ON
QC
East
Territories
BC
ON
QC
NB
NS
PE
NL
AB
SK
MB
YT
NT
NU
ofMembers Selecting Program
TBA
Collaborative Planning Sessions
P
P
P
P
P
P
P
P
P
P
P
P
31

Telehealth (TEL)
46
Laboratory Information (LAB)

39
Diagnostic Imaging (DI)

31
Drug Information (RX)

77
Registries (REG)

54
Infostructure (INFO)

• Collaborative planning1 completed deployment
  planning underway
• Registry applications and infostructure are high
  priorities for most jurisdictions because of near
  term benefit
• Jurisdictions priorities vary for telehealth,
  drug, diagnostic imaging and lab information
  systems, reflecting different EHR strategies

1 Quebec to be scheduled.
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Investment TrackingProject Activity Summary
Legend
SD Solution Development D Deployment

Active /or Complete Projects

• 22 projects underway or completed Canada-wide in
  12 months
• Majority of projects related to solution
  development, architecture and standards
• Over next 2Q, project activity expected to be
  underway in all jurisdictions

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Investment TrackingOverall Investment Portfolio
In less than one year, Infoway has committed over
20 of the 1.1B in project investments
Canada-wide.
03/04 Investment Commitments1
250
200
million
150
100
50
Total
INFO
TEL
LAB
REG
DI
RX
Investment Programs

• Exceeded FY03/04 committed investment target of
  127 million by 72.

1as of December 2003
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Investment Tracking Investment Summary FY 2003/04
Approval of project investments have been at a
faster rate than forecasted.
250
Since Inception
Projected to Year End
225
200
175
150
(000,000)
FY 2003/04 Committed Investment Target
125
100
75
50
25
Q3 2002/03
Q4 2002/03
Q1 2003/04
Q2 2003/04
Q3 2003/04
Q4 2003/04
Approved Investments

• 90 of FY 03/04 committed investment target has
  already been converted to contracted dollars in
  ongoing projects

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Investment Tracking Project Life Cycle Summary
Investments were made simultaneously across 4
investment programs to achieve near term business
value.

• Most projects in design/build/implementation
  phase
• Provider and client registries ready to deploy in
  2004
• Projects related to required enabling
  infostructure eg. Architecture-completed

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Investment Tracking Project Life Cycle
Deployment
Within the next 12 months, solutions will be
ready and deployment will start across Canada.
Deployment Readiness1
Solutions
REG-Client
REG-Provider
DI
RX
REG-Location
Q2 04
Q3 04
Q4 04
Q1 05

• Starter Toolkits are already available (e.g.,
  Client Registry)
• Registry applications will be ready for
  deployment in the first half of 2004
• DI and location registry application expected to
  be deployed late 2004/early 2005

1current forecast
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Investment Tracking Leveraged Value
Infoways leveraged investment approach is also
beginning to show promise in reducing time and
cost.
Compressed Time


Leveraged Investment
Client Registry - AB
( M)
Client Registry - NL
Investment Program
InfowayInvestment
Total Projects Value1
LeverageRatio
Provider Registry - WHIC
Provider Registry - SK
22.9
54.2
12.3
Diagnostic Imaging TVH, ON
Drug Info





20.4
44.5
12.2
Diagnostic Imaging FHA, BC

Registry
Total
43.3
97.4
12.2
Drug Information AB
Drug Information SK

• Significant cost reduction in solution
  development12 leverage
• Up to 24 month reduction in the time required
  from inception to signed contract

Sample Benchmark
0
36
6
12
24
30
18
Months
Sample Benchmark Estimate of the typical
timeline (inception to contract) for large-scale
projects within government and other industry
sectors.
1includes sponsors prior and current investment
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Gaining Momentum Infoway 3 Year Timeframe
Program
Canada-wide coverage
Ongoing

• Telehealth
• Infoway approach defined and investments made

• Registries
• Applications ready to deploy
• Installed provider and client registry
  applications

Up to 100
Prototyped Up to 25 Completed

• Drug Information Systems
• Interoperable systems ready to deploy
• Installed systems
• National messaging standard for dispensed drugs
  and claims

• Diagnostic Imaging Systems
• Shared operations of DI systems
• Replication of DI solutions

Prototyped Up to 30
Prototyped Up to 25

• Laboratory Information Systems
• Solution approval
• Investment commitment

• Infostructure
• Required components, services, toolkits

Up to 50
19

• Canada Health Infoway

ACHIEVING RESULTS
ACHIEVING RESULTS
www.infoway-inforoute.ca 1-888-733-6462