central lhin 2016-2017 ehealth strategic plan

Central LHIN

2016-2017

eHealth Strategic Plan

Presentation to Central LHIN Board of Directors

June 2016

Contents

1. eHealth 2.0 – update on the Ministry’s Vision

2. Central LHIN’s eHealth Plan – Alignment with eHealth 2.0• Hospital Report Manager & ED Notification

• Telemedicine & Telehomecare deployment

• Coordinated Care Tool

• eConsult

3. International Context – The Commonwealth Fund’s Findings &

Alignment of Central LHIN’s eHealth Plan

4. Next Steps & Next Year

5. Appendix – Central LHIN’s full 2016/17 eHealth Plan

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eHealth 2.0 –

Update on the Ministry’s Vision

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Ministry Vision - eHealth Strategy 2.0 in a

nutshell

The goal of this strategy is to make technology an integral and

routine part of Ontarians’ healthcare experiences.

We will build capacity in the system for planning and funding digital

health technology as a commodity like any other. The intention is to

make this Ontario’s last “ehealth” strategy in that from now on we will

weave technology into the core fabric of future health system

strategies.

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eHealth 2.0 Ministry Vision - Investments and

Challenges

Ministry Priorities

1. Hospital Information System (HIS)

2. Hospital Report Manager (HRM) & eNotification

3. Telemedicine and Telehomecare deployment

4. Care Coordination Tool (CCT)

5. eConsult

6. Regional Integration (Connecting Ontario)

7. Ontario Laboratories Information System (OLIS)

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The Ministry’s funding of LHIN eHealth activities is intended to ensure that provincial eHealth

priorities are successfully delivered in partnership with provincial eHealth delivery organizations

including eHealth Ontario, OTN and OntarioMD. The following outlines the 7 provincial ehealth

priorities for 2016-17:

What can eHealth 2.0 do for patients?

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Central LHIN’s eHealth Plan –

Alignment with eHealth 2.0

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Description:Hospital Report Manager (HRM) enables physicians using Electronic Medical Records

(EMRs) to securely receive electronic hospital reports into their patient’s medical record

within 30 minutes of transcription.

eNotification will notify the CCAC and Primary Care (through HRM) when patients: present

to the hospital Emergency Department (ED), are discharged from the ED, are admitted to a

hospital inpatient unit, and are discharged from the hospital inpatient unit.

Deliverables:• CLHIN to work with OntarioMD and Primary Care Providers to increase adoption of HRM through

engagement and conferences.

• CLHIN to work with OntarioMD and the OACCAC to accelerate hospital adoption of eNotification

• Implement eNotification at Markham Stouffville Hospital, Central LHIN’s pilot site, by Q2

• Investigate expansion to other hospitals

Increase adoption by 120 Clinicians (baseline 861, target 981 Clinicians) resulting in

approx. 58% of CLHIN primary care practitioners receiving reports through HRM.

Implement eNotification at 2 Central LHIN public hospitals (baseline 0, target 2 Hospitals)

eHealth Strategic Initiatives – ProvincialHospital Report Manager (HRM) Adoption & eNotification

Central LHIN Lead: Daniel Mainville

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Description:

THC allows clients, via electronic telemetry monitoring, to input and transmit their vital health

information from their home to a remote monitoring care team. THC provides opportunities

for proactive client coaching and education as well as rapid response from the care team to

an emerging health crisis.

Deliverables:

• Central LHIN will continue to monitor adoption of the existing THC Program and expand

use in more (3-5) congregate settings.

• Central LHIN will investigate and potentially pilot the use of remote monitoring in priority

areas such as: Palliative Care, Post-Acute and Chronic Disease Management (Diabetes)

• Central LHIN will participate in OTN sponsored quantitative and qualitative evaluation

being done by THETA. Quantitative evaluation will assess impact on utilization of health

services pre and post THC enrollment.

Achieve 100% of THC enrollment targets (920 patient enrollments across the LHIN)

eHealth Strategic Initiatives – ProvincialTelehomecare (THC)

Central LHIN Lead: Karen Blackley

* (UofT – Toronto Health Economics and Technology Assessment collaborative).

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Description:Telemedicine equipment is used by health service providers to deliver care to patients via two-way

videoconferencing (virtual assessments) and store forward technology. Our goal is to imbed telemedicine into

models of care, where appropriate, to improve the patient experience and enhance health system capacity.

Deliverables:Central LHIN will develop a Telemedicine Strategy to build on recent implementations and successes. The

strategy will focus on:

• Monitoring and improving adoption with existing sites, particularly in Long-Term Care

• Expanding telemedicine use (PCVC and ‘Send Invite’) to support chronic disease management

• Supporting more health service providers to embed the use of telemedicine in the delivery of services

and clinical practice

• Using telemedicine for Central LHIN priority projects such as the delivery of better Palliative Care

• Expanding telemedicine use for underserved communities through available OTN programs – tele-

ophthalmology, tele-dermatology

Increase adoption by 15% from baseline (baseline: avg of 788 events/month as of Q4 15/16; target: avg of 906

events/month)

eHealth Strategic Initiatives – ProvincialTelemedicine

Central LHIN Lead: Karen Blackley

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Description:The Ministry and its partners are developing a Care Coordination Tool (CCT) that will make

the patient's coordinated care plan accessible by providers in the circle of care, and

facilitate secure messaging between providers. The CCT is currently in a proof-of-concept

and evaluation stage.

Deliverables:• Central LHIN will work with the Ministry and Central LHIN’s proof-of-concept

participating Health Link (HL), South Simcoe Northern York Region (SSNYR), to

support and guide their use of the CCT.

• Central LHIN will monitor the evaluation of the CCT and Ministry identified interim

solutions to inform the implementation of the selected solution in future years.

SSNYR HL to enroll 480 new HL patients and complete Coordinated Care Plans (CCPs) for them.

eHealth Strategic Initiatives – ProvincialCare Coordination Tool (CCT)


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eHealth Strategic Initiatives – ProvincialeConsult

Description:An eConsult is an electronic exchange of information between a primary care provider (PCP)

and a specialist which provides the patient with faster access to specialist advice and

potentially reduces travel and patient anxiety. An eConsult solution also: facilitates PCPs

locating the right specialist the first time, monitors the status of the PCP’s request, provides

an audit trail of the case interaction with the specialist, and has the potential to avoid

unnecessary referrals.

Deliverable:• Central LHIN to work with OntarioMD and OTN to begin adoption of the OTN eConsult

solution.

Increase early adopter adoption by 25 Primary Care Providers (baseline 38, target 63)

bringing our eConsult early adopters to 4% of CLHIN primary care providers. Note that

once solution is integrated with EMRs adoption targets will be much higher.


International Context

The Commonwealth Fund’s Findings &

Alignment of Central LHIN’s eHealth Plan

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The Commonwealth Fund – Performance of International

Health Systems

• Report ranks 11 countries on 5 dimensions of performance and concludes

that the adoption and effective use of modern health information

systems is a requirement of a high performing system

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Health Systems – Alignment with Central LHIN’s eHealth

Plan

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Coordinated

Care

Efficient

Care

Effective

Care

Patient Centred

Care

Equitable

Care

HRM & e-Notification √ √Telehomecare & Telemedicine √ √ √

Coordinated Care Tool √ √ √e-Consult √ √ √

Connecting GTA/Ontario √ √OLIS √ √ √

Integrated Assessment Record √ √EMR Adoption √ √

Resource Matching & Referral √ √ √

System Ranking Dimensions Used in Commonwealth Fund Report (not all inclusive)


Health Systems findings:

Health information technology was deemed as an enabler in

providing:

Coordinated Care – to ensure appropriate follow-up treatment, minimize risk of

error and prevent complications

Primary Care receives notifications that patient has been in hospital

Primary Care receives information needed to manage patient’s’ care post-hospital within 2 days of

discharge

Information and knowledge exchange occurs between Primary Care & Specialist and other care providers

Efficient Care – an efficient system seeks to maximize quality of care &

outcomes given resources committed, while ensuring that additional investments

yield net value over time

No duplicate tests/assessments

Medical history available at time of care/appointment

Patient does not return to ER after hospital discharge for complications

Provider can electronically exchange patient clinical information with other providers18



Health information technology was deemed as an enabler in providing:

Effective Care – patients receive services that are appropriate for

preventing or treating a given condition

Patients and providers receive computerized reminder notices for

preventative and follow-up care

Patient-Centred Care – care is delivered with the patient’s needs and

preferences in mind

Although a theme in eHealth 2.0 (patient portals, mobile apps for access on

smartphones)…we’re not there yet

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Health information technology was deemed as an enabler in providing:

Equitable Care - care does not vary in quality because of personal

characteristics such as ethnicity, geographic location and socioeconomic

status.

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Telehomecare

Telemedicine e.g. tele-ophthalmology

NEXT STEPS & NEXT YEAR…

• Continuing with no standalone IT projects!

• IT/IM as an enabler – see Appendix - full 2016/17

eHealth Plan & alignment with Annual Business Plan

• Quarterly Scorecard to measure results against

targets

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central lhin 2016-2017 ehealth strategic plan

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