eHealth Strategy

1
eHealth Strategy

• A Healthier Tomorrow

2
The South West LHIN Webcast Series
The South West LHIN would like to thank you for
your participation in our A Healthier Tomorrow
webcast series. Please stay tuned for future
webcasts!
A Healthier Tomorrow
3
Objectives for South West LHIN Webcast Series

• Inform partners of LHINs vision, mission,
  values, and health system improvement goals.
• Inform partners of how the Priority Action Teams
  future directions align with the LHIN goals and
  how recently funded projects move us closer to
  the desired state identified by the Priority
  Action Teams.
• Acknowledge contributions of volunteers and
  partners who were actively involved in defining
  the development of the LHINs work.

A Healthier Tomorrow
4
Purpose of this Presentation

• Provide an overview of the provincial eHealth
  Strategy
• Provide examples of Provincial eHealth
  initiatives
• Provide an introduction to the future South West
  LHIN eHealth Strategy
• Provide examples of how the South West LHIN
  eHealth activities are enabling Priority Action
  Team recommendations
• Describe the mechanism to guide, lead and provide
  oversight for the projects and initiatives
  currently underway
• Provide examples of South West LHIN eHealth
  initiatives

A Healthier Tomorrow
5
eHealth Ontario

• In August 2008 Cabinet approved the creation of
  eHealth Ontario to play a lead role in
  coordinating the execution of the eHealth
  strategy
• eHealth Ontario is the single point of
  accountability for eHealth initiatives in the
  province
• Smart Systems for Health (SSHA) and the eHealth
  Program of the Ministry of Health are now eHealth
  Ontario

A Healthier Tomorrow
6
(No Transcript)
7
eHealth Ontario Guiding Principles

• eHealth Ontario will focus on enabling clinical
  outcomes (value) for better patient care, not
  technology for its own sake
• Early clinical benefits are the key to building
  and sustaining support for the eHealth strategy
• The eHealth Strategy will be transparent
• Advice from experts with a track record of
  success will be sought
• Performance metrics and success indicators will
  be measured and reported publicly

A Healthier Tomorrow
8
eHealth Ontario Guiding Principles contd.

• Partnerships will be established to deliver
  eHealth solutions
• Deployment models will vary by product
• Wherever possible, legacy systems will be
  leveraged to achieve provincial goals
• Clinical content of solutions must be relevant
  and complete
• Clinicians will be engaged early and often to
  ensure project success

A Healthier Tomorrow
9
Ontarios eHealth Strategy 2009-2012www.ehealthon
tario.on.ca

• 3 Clinical Priorities
• Diabetes Management To control and manage
  diabetes more effectively in order to reduce
  associated complications and costs
• Medication Management To implement on-line
  management of prescription medications in order
  to minimize preventable adverse drug events
• Wait Times To reduce waits in Ontario emergency
  departments and the incidence of inpatients in
  acute care settings waiting for alternate levels
  of care

A Healthier Tomorrow
10
Clinical Priority Diabetes Management

• 900,000 Ontarians have Diabetes, and each year
• 350 people will go blind
• 2,300 people will have a heart attack
• 1,100 will have a limb amputated
• 3,200 people will die
• 23,000 people will discover they have this
  disease
• 165,000 people will visit an emergency department

A Healthier Tomorrow
11
Clinical Priority Diabetes Management contd.

• Baseline Dataset Initiative
• Diabetes Registry
• EMR interoperability with the Diabetes Registry
• OLIS interoperability with the Diabetes Registry

A Healthier Tomorrow
12
Clinical Priority Medication Management
There will be 394,000 preventable adverse drug
events in Ontario this year, resulting in

• 240,000 physician office visits
• 36,000 hospitalizations
• 4,000 deaths

A Healthier Tomorrow
13
Clinical Priority Medication Management contd.

• ePrescribing Demonstration Project
• Drug Information System (DIR)
• Drug Profile Viewer (DPV)
• Systemic Treatment Computer Physician Order Entry
  (CPOE)

A Healthier Tomorrow
14
Clinical Priority Wait Times (ER/ALC)

• Emergency room wait times are at an all time high
  in Ontario
• Nearly 50 of emergency room (ER) visits are made
  by patients with non-urgent or less urgent care
  needs
• 90 of ER patients are treated within 9.4 hours
  from triage/registration to the time they leave
  the ER
• ER wait times are five times longer for ER
  patients admitted to hospital (35 hours)
• 75 of their total ER time is spent waiting for
  an inpatient bed
• A major factor causing long ER wait times is the
  high number of alternative level of care (ALC)
  patients occupying acute care hospital beds

A Healthier Tomorrow
15
Clinical Priority Wait Times (ER/ALC) contd

• eReferral
• Emergency Department Reporting System (EDRS)
• Wait Times Information System (WTIS)

A Healthier Tomorrow
16
Ontario eHealth Strategy
Medication Management
Wait Times
Diabetes Management
Cornerstone Information Systems
Clinical Activity Information Systems
Technology Services
Enabling Practices and Talent Management
17
Each solution group will be delivered using most
appropriate delivery model
A Healthier Tomorrow
18
SW LHIN eHealth Vision Statement

• Better Information gt Better Care gt Better Health
• To enable measurably better information, better
  care, better health and less travel for all.

A Healthier Tomorrow
19
LHIN role in Health IT Infrastructure

• Will not develop its own IT Department or
  Services organization or significant IT staffing
• Will act as the Governance body (Standards /
  Project approval-funding / Governance etc.)
• Has a large vested interest in promoting the
  adoption/use of standard IT infrastructure and
  enabling innovations
• Wont directly support the implementation and
  technical support needs of primary care physicians

A Healthier Tomorrow
19
20
LHIN role in IT Infrastructure contd

• The Challenge
• Provide a more reliable IT environment for
  smaller institutions
• Drive economies of scale
• Across the SW LHIN
• 74 Long-Term Care Homes
• 2 Community Health Centres (plus 3 under
  development)
• 65 Community Support Services
• 28 Community Mental Health Agencies
• 14 Addictions Agencies

A Healthier Tomorrow
20
21
eHealth Adoption Steering Committee

• Members are selected from across the continuum of
  care and geography of the South West LHIN.
• Members are systems thinkers, influencers, and
  leaders.
• Comprised of senior representatives from the
  various sectors in the health care system, based
  on skill set, experiences, geography and include
  a mix of individuals from LHIN Funded Sectors,
  Partner Sectors and Community Partners.
• Although a formal communication plan will be
  developed and implemented, all members will be
  expected to seek input from, and relay
  information to, their respective sectors and
  local/regional partners.
• Additional representatives will be invited to
  join the Steering Committee or attend specific
  meetings as an expert resource, as required. The
  Steering Committee may establish other sub-groups
  as necessary.

A Healthier Tomorrow
22
South West LHIN Implementation Model (draft)

• System Level Goals
• Healthier Community
• Equitable Access
• Quality
• Sustainability
• Integration

South West LHIN Board
Health Professionals Advisory Committee
South West LHIN CEO and Staff
CDPM Steering Committee
Best Level of Care Quality Steering Committee
Health System Design Steering Committee
eHealth Adoption Steering Committee
OneMail
Diabetes Registry
PAT RECOMMENDAT I ONS
North South Cerner Project
eHealth Project Management Office
LHIN-Project Management Office Coordination/Tracki
ng/Reporting
COMMUNICATION
A Healthier Tomorrow
23
1) eHealth Initiatives Provincial
eHealth Adoption Steering Committee Mandate
2) eHealth Initiatives South West LHIN
A Healthier Tomorrow
24
eHealth Initiatives Provincial Early Adopter

• Diabetes Registry (SW LHIN Early Adopter)
• An initial deliverable of the eHealth Strategy
  is a Diabetes Registry in support of the
  governments Diabetes Strategy and commitment to
  Chronic Disease Prevention and Management. The
  Registry will serve as a tool to help people with
  diabetes and their care givers manage the disease
  better.

A Healthier Tomorrow
25
Diabetes Registry contd.

• Manage the disease by monitoring whether patients
  receive evidence based interventions
• Electronically monitor adherence to best
  practices for patients with diabetes and provide
  alerts to physicians when best practices are not
  being followed
• Measure baseline level of care and report on care
  gaps

A Healthier Tomorrow
26
Diabetes Registry Preliminary Timelines

• Request for Proposal (RFP) released (Q2 2009/10)
• Limited release working prototype in use (Q4
  2009/10)
• Begin Diabetes Registry deployment to 14 LHINs
  (Q4 2010/11)

A Healthier Tomorrow
27
The Ontario Diabetes Strategy is enabled by the
Diabetes Registry
Diabetes Registry
eHealth Strategy
Diabetes Strategy
Provides comprehensive tools for effective,
best-practice diabetes care
Ensures IT enables improved patient access and
care for more effective use of healthcare
resources
Improves health outcomes for Ontarians living
with diabetes and reduced health care costs
through health promotion and disease prevention
programs, self-care management and access to
specialized resources and health care
professionals
A Healthier Tomorrow
28
eHealth Initiatives Provincial Early Adopter

• The Provider View (SW LHIN Early Adopter)
• The Diabetes implementation is part of the early
  stage that will bring together an individuals
  health information from various clinical systems
  and provide a secure single access point for
  up-to-date information such as lab test results,
  drug history and diagnostic imaging reports.

A Healthier Tomorrow
29
eHealth Initiatives Provincial

• LHIN 1-2 Diagnostic Image Repository (SWO DI-r)
  and the LHIN 3-4 Diagnostic Image Repository
  (DI-r)
• Provides access to images from any hospital in
  South West Ontario (LHIN 1, 2, 3 4) allowing for
  region-wide consultation.

A Healthier Tomorrow
30
Diagnostic Imaging Repository (DI-r)
Grey Bruce
SWO Regional MAP (LHIN 3/4 not shown)
Kodak Carestream PACS Cerner HIS/RIS
South Bruce Grey
Listowel Wingham Philips I-Site
PACS Medisolutions HIS/RIS
Bluewater/Sarnia Agfa PACS Meditech HIS/RIS
Regional Repository
Chatham Kent GE Centricity McKesson HIS/RIS
TVHPP/Huron Perth Region GE Centricity Cerner
Meditech HIS/RIS
Windsor Region McKesson PACS Quadris McKesson
HIS/RIS
31
eHealth Initiatives Provincial

• Emergency Neurosurgery Image Transfer System
  (ENITS)
• On June 2, 2008, the Neuro Action Team, on behalf
  of the Neurosurgery Expert Panel, approved using
  the electronic solution (ENITS) for transferring,
  storing, and accessing neuro images which will be
  sent to a separate shared PACS at LHSC from CTs
  across the province
• The ENITS Shared PACS (ESP) project will provide
  an interim solution to improve patient access to
  care in the case of urgent head trauma. This is
  meant to be a short to mid term solution until
  full access to Provincial DIr is available (i.e.
  SWO DIr)

A Healthier Tomorrow
32
Tele
-
Neurosurgery
Expert Consult Workflow




















A Healthier Tomorrow
33
eHealth Initiatives Provincial

• Ontario Lab Information System (OLIS)
• Is a single provincial system that allows all
  laboratory information within Ontario to be
  exchanged electronically between health care
  providers (practitioners, hospitals, community
  laboratories)
• OLIS is an early step in moving the health system
  away from paper-based to electronic records.
• Grey Bruce Health Services was one of the
  Foundation Adaptors for OLIS and has been sending
  results into the OLIS database since 2007.

A Healthier Tomorrow
34
eHealth Initiatives Provincial

• ONE Mail and ONE Network
• ONEMail E-mail that allows health care
  professionals to send patient information
  quickly, confidently and securely between
  registered users.
• ONENetwork ONE Network Access allows health
  care providers to confidently and securely share
  information over a high-speed network built for
  health care.

A Healthier Tomorrow
35
The Ontario Telemedicine NetworkAvailable
Virtually Everywhere

• What is OTN?
• Independent not-for-profit organization, funded
  by the Province of Ontario
• Direct Transfer Payment Agent of the Ministry of
  Health
• Programs and services are delivered by over 2000
  HCP in over 640 sites across the province via
  1230 videoconferencing systems
• What is Telemedicine?
• Delivery of clinical care by HCPs to patients via
  videoconferencing systems
• Delivery of education/best practices to HCP and
  students via video and the web
• For more information go to www.otn.ca or call
  1-866-454-OTN1 (6861)

36
SW LHIN Telemedicine Growth YTD

• Telemedicine Examples in the SW
• LHIN
• Rehab Intake Assessments and
• Discharge Planning (Huron/Perth)
• Mental Health ACT Team Support Specialty
  Psychiatry Clinics Tele Crisis (Form 1
  Avoidance)
• Acquired Brain Injury Survivor and Family
  Education Series
• Telehome Care Chronic Disease Management (COPD
  and CHF)
• Dementia Care Network
• New employee Orientation Sessions
• Mental Health Lunch and Learns,
• Grand Rounds

17, 346
10, 637
37
eHealth Initiatives Provincial

• The Physician IT Program is managed by OntarioMD
  and includes
• A selection of approved Clinical Management
  Systems (CMS)
• A Transition Support Program designed to help
  physicians acquire and use information technology
• A Primary Care IT Funding Plan

A Healthier Tomorrow
38
1) eHealth Initiatives Provincial
eHealth Adoption Steering Committee Mandate
2) eHealth Initiatives South West LHIN
A Healthier Tomorrow
39
eHealth Initiatives South West LHIN

• Results from Electronic Patient Record (EPR) to
  Physician Electronic Medical Records (EMR)

• Grey Bruce Health Services is sending electronic
  results from their Cerner HIS to 89 physician
  practice EMRs
• The Thames Valley Hospital Planning Partnership
  is now starting a project to leverage the success
  in Grey Bruce
• Huron Perth Healthcare Alliance is planning
  integration pilots with Family Health Teams

A Healthier Tomorrow
40
eHealth Initiatives South West LHIN

• Common Desktop Infrastructure (CDI)
• As eHealth initiatives are identified and
  implemented it will be critical for health
  service providers to have adequate and compatible
  computer hardware and software. This will help
  expedite the implementation process.
• CDI will help identify the needs across the LHIN
  and create strategies to better position health
  service providers.
• A current state hardware software inventory of
  all Health Service Providers within the SW LHIN
  is currently underway

A Healthier Tomorrow
41
eHealth Initiatives South West LHIN

• Common Order Sets
• Develop multi-disciplinary orders sets for the
  right medical intervention for the right patient
  context
• Reduces errors, reduces costs, best practice
  evidence based
• Grey Bruce Health Services has been working with
  Open Source Order Sets (OSOS)
• In the south a project team has been reviewing
  OSOS and Zynx to leverage the evidence based
  research library to facilitate clinician use of
  current literature to support their order set
  development and maintenance
• Huron Perth region also received LHIN funding and
  are planning their approach to move forward.

A Healthier Tomorrow
42
eHealth Initiatives South West LHIN

• North South Connectivity Project
• The North South Connectivity Project is the
  first phase of a larger implementation that will
  eventually create a platform for the development
  of the electronic health care record
  incorporating community and primary health care
  services. The 1st phase will connect the
  hospitals in the North (GBHS) and South (Thames
  Valley, Exeter,Wingham/Listowel) to provide
  access to patient clinical data.

A Healthier Tomorrow
43
Connecting Thames Valley and GBHS
44
eHealth Initiatives South West LHIN
thehealthline.ca

• A web portal that provides access to health
  services information and much more
• Began as innovative partnership between CCAC,
  health unit, hospitals grew to cover the South
  West
• Developed eight years ago, now attracts more than
  1.5 million visits per year
• Accurate, up to date, credible
• Trusted source of truth

A Healthier Tomorrow
45
thehealthline.ca Service Information Location
Maps
46
Electronic Health Record (EHR)

A Healthier Tomorrow
47
Electronic Health Record
48
Grey Bruce Information Network

• Provincial
• Wait Time Information System (WTIS)- expansion to
  include all surgeries
• Diagnostic Imaging Repository (DI-r) currently
  sending all new images to the London archive and
  beginning the migration of previous images
• Electronic Child Health Network (eCHN) working
  on migration of results
• Critical Care Information System (CCIS) - live at
  all the rural hospitals
• Ontario Laboratory Information System (OLIS) -
  GBHS is live. All mapping for SBGHC and Hanover
  Hospital is competed. Currently working on the
  CR120 privacy trigger.
• Local
• Pediatric Wait List - built and awaiting go live
  date next month
• CCAC Integration - work continuing to move
  forward
• Nursing Documentation - all hospitals will be
  live except for Owen Sound by June 2009
• Open Source Order Sets (OSOS)- continues to be
  built into Cerner

A Healthier Tomorrow
49
Huron Perth Healthcare Alliance and Alexandra
Marine and General Hospital

• Provincial
• WTIS expansion
• OLIS Entering the project
• Local
• Physician Office integration working with Huron
  Perth Family Health Teams to integration patient
  results from Meditech to office EMRs
• Expansion of Electronic Health Record at all
  sites
• Network Single Sign-on with Proximity card
  technology
• Electronic interface from Patient Monitors to
  Meditech
• Emergency Department Tracker Board full
  featured tracking system for the ER. Untargeted
  into HIS going Live late 2009
• Wireless rollout for Nursing Point-of-Care
  Handhelds May 2009
• Voice-over-IP phone systems Live Oct 2008

A Healthier Tomorrow
50
Thames Valley Hospital Planning Partnership

• Provincial
• Wait Time Information System (WTIS)- expansion to
  include all surgeries
• WTIS ER/ALC Early Adoptor
• Diagnostic Imaging Repository (DI-r)
  interoperability of DI-repository with all LHIN
  1, 2. 3, 4 hospitals
• Emergency Neurosurgery Image Transfer System
  (ENITS)
• Electronic Child Health Network (eCHN)
• Critical Care Information System (CCIS)
• Ontario Laboratory Information System (OLIS)
• Local
• Order Sets/Western Ontario Health Knowledge
  Network (WOHKN)
• Cancer Care Ontario (CCO) Synoptic Reporting
• Electronic Patient Record (EPR) Platform
  Expansion Wingham/Listowel
• Shared Service established

A Healthier Tomorrow
51
South West CCAC

• GBHS eReferral Oncology, shared databases.
• Service Desk new features to allow for a more
  user friendly experience.
• Service Capacity Reporting System (SCRS) III
  adding a multi change feature.
• .ASP - .NET Conversion converting all old .asp
  pages to .net will help standardization
• Occurrence Reporting Tracking System (ORTS) III
  Integrated with Health Partner Gateway
• eCAFE- offline eReferral
• Intake Referral II - additional functionality
• Portals - Board, HAL.
• Survey - New question types, summary page,
  ability to complete at later date.
• Client Health Related Information System (CHRIS),
  Health Partner Gateway ONE MAIL Rolling out
  of CHRIS.
• theHEALTHLINE.ca Client Management TRAVEL AGENT
  CM at Clients home.
• Standardize Workflows Frameworks Shutting
  down old Intranets.
• WOHKN Network Training Management.

52
Priority Action Teams (PATs)

• The PATs worked on the Action Plans identified
  for each of the following Integration Priorities
• Strengthening and Improving Primary Health Care
  (PHC)
• Chronic Disease Prevention and Management (CDPM)
• Building Linkages Across the Continuum for all
  Seniors and Adults with Complex Needs
• Accessing the Right Services, in the Right Place,
  at the Right Time, by the Right Provider
• Utilization Access PAT to ensure an integrated
  approach to hip and knee total joint replacements
  across the LHIN
• Health Human Resources (HHR) Advisory Group

A Healthier Tomorrow
53
Priority Action Teams Recommendations
54
Key Messages

• eHealth is about enabling people to work together
• eHealth is about improving the flow of patient
  information, NOT about technology
• Provincial and regional (LHIN) eHealth strategies
  must support secure movement of patient/client
  information
• Focus must be on the person and their information
  and integration of patient care

A Healthier Tomorrow
55
Survey
Your feedback is valuable to us. Please take a
few moments to complete our short Online Survey
about this webcast. Just go to the South West
LHIN website homepage, and click on the link to
the survey
A Healthier Tomorrow
56
Questions
Dial 1-866-507-1212 and ask for South West
Local Health Integration Network Please note
If you have questions after the webcast, feel
free to email questions in to southwest_at_lhins.on.
ca. A full QA document will be posted on our
website at the end of the webcast series.
A Healthier Tomorrow
57
Thank you for joining us!
A Healthier Tomorrow