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eHealth Strategy


Physician EMRs. CCAC Systems. DI/PACS. HIAL. WTIS. EDRS. Telemedicine. eCHN ... Family Health Teams to integration patient results from Meditech to office EMR's ... – PowerPoint PPT presentation

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Title: eHealth Strategy

eHealth Strategy
  • A Healthier Tomorrow

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
A Healthier Tomorrow
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
Purpose of this Presentation
  • Provide an overview of the provincial eHealth
  • Provide examples of Provincial eHealth
  • 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

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

A Healthier Tomorrow
(No Transcript)
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
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
Ontarios eHealth Strategy 2009-2012www.ehealthon
  • 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
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
  • 165,000 people will visit an emergency department

A Healthier Tomorrow
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
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
Clinical Priority Medication Management contd.
  • ePrescribing Demonstration Project
  • Drug Information System (DIR)
  • Drug Profile Viewer (DPV)
  • Systemic Treatment Computer Physician Order Entry

A Healthier Tomorrow
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
  • 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
Clinical Priority Wait Times (ER/ALC) contd
  • eReferral
  • Emergency Department Reporting System (EDRS)
  • Wait Times Information System (WTIS)

A Healthier Tomorrow
Ontario eHealth Strategy
Medication Management
Wait Times
Diabetes Management
Cornerstone Information Systems
Clinical Activity Information Systems
Technology Services
Enabling Practices and Talent Management
Each solution group will be delivered using most
appropriate delivery model
A Healthier Tomorrow
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
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
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
  • 65 Community Support Services
  • 28 Community Mental Health Agencies
  • 14 Addictions Agencies

A Healthier Tomorrow
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
  • 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
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
Diabetes Registry
North South Cerner Project
eHealth Project Management Office
LHIN-Project Management Office Coordination/Tracki
A Healthier Tomorrow
1) eHealth Initiatives Provincial
eHealth Adoption Steering Committee Mandate
2) eHealth Initiatives South West LHIN
A Healthier Tomorrow
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

A Healthier Tomorrow
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

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

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

A Healthier Tomorrow
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
eHealth Initiatives Provincial
  • Emergency Neurosurgery Image Transfer System
  • 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
Expert Consult Workflow

A Healthier Tomorrow
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
  • 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
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
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
  • 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 or call
    1-866-454-OTN1 (6861)

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
  • 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
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
1) eHealth Initiatives Provincial
eHealth Adoption Steering Committee Mandate
2) eHealth Initiatives South West LHIN
A Healthier Tomorrow
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
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
eHealth Initiatives South West LHIN
  • Common Order Sets
  • Develop multi-disciplinary orders sets for the
    right medical intervention for the right patient
  • 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
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
Connecting Thames Valley and GBHS
eHealth Initiatives South West LHIN
  • 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
  • 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 Service Information Location
Electronic Health Record (EHR)

A Healthier Tomorrow
Electronic Health Record
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
  • 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
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
  • Network Single Sign-on with Proximity card
  • Electronic interface from Patient Monitors to
  • 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
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
  • 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
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.
  • Client Management TRAVEL AGENT
    CM at Clients home.
  • Standardize Workflows Frameworks Shutting
    down old Intranets.
  • WOHKN Network Training Management.

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
  • 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
Priority Action Teams Recommendations
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
  • Focus must be on the person and their information
    and integration of patient care

A Healthier Tomorrow
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
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
Thank you for joining us!
A Healthier Tomorrow
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