Welcome and Introductions
Murray Glendining Co-Chair, cSWO Steering Committee
President and CEO, London Health Sciences Centre
eHealth Ontario Remarks
Alice Keung Chief Operating Officer
Co-Chair, cSWO Steering Committee David Rounthwaite Chief Executive Officer Designate
• Healthcare …silos of providers and organizations …minimal integration of information or services
• unacceptable wait times
• sub-optimal outcomes
• patient safety concerns
• system inefficiencies
• spiraling costs
• Healthcare must become more individual-centered and consumer-driven:
…accessible …integrated …community-based …multi-disciplinary …promote wellness and …self-managed care
…Enabled by eHealth services which provide enhanced
…sharing of information …communications …coordination …between providers and with individuals
Connecting South West Ontario
• eHealth Ontario’s regional eHealth program for South West Ontario
Connecting South West Ontario
• eHealth Ontario’s regional eHealth program for South West Ontario
….created in partnership with the four Local Health Integration Networks and health service providers of South West Ontario ….through an extensive planning exercise involving all stakeholders
Connecting South West Ontario
• eHealth Ontario’s regional eHealth program for South West Ontario
The Program’s immediate priority is the deployment of
eHealth Services which …make an individual’s electronic health care information …from across the continuum of care …accessible in a timely and secure fashion …at any point of care in South West Ontario
Connecting South West Ontario
• eHealth Ontario’s regional eHealth program for South West Ontario
• Services will be used by more than 46,000 health care professionals at approximately 3,500 organizations in South West Ontario
• 3.6 million residents in South West Ontario will have an integrated electronic health record (~100% of local population)
• This is approximately 30% of Ontario’s population.
SWO Health Care Organizations Utilizing cSWO Program
• 68 hospitals (100%)
• 4 CCACs(100%)
• 18 PHUs(100%)
• 2,900 primary care providers
(Physician Offices,
Community Health Centres, Family Health Teams)
• 530 community health
providers (CMHA,LTC,CSS)
Connecting South West Ontario
• eHealth Ontario’s regional eHealth program for South West Ontario
• Alignment is key to success
…with clinical and system priorities of Local Health Integration Networks and health service providers
…With architectures and standards of Ontario’s eHealth Blueprint
Connecting South West Ontario By enabling enhanced models of care, the cSWO Program will Result in Significant and Pervasive Benefits:
Better Care
Improved Safety
Improved Access
Improved Value
Deployment & Program
User Experience
Quality
Timeliness/Value
Strategic/System
Other
1
2
3
4
5
6
Connecting South West Ontario By enabling enhanced models of care, the cSWO Program will Result in Significant and Pervasive Benefits:
Better Care
Improved Safety
Improved Access
Improved Value
Deployment & Program
User Experience
Quality
Timeliness/Value
Strategic/System
Other
1
2
3
4
5
6
IMPROVED VALUE:
Improved patient and user experience
Reduced duplication of laboratory & diagnostic tests
Reduced costs of managing paper records and efficient transfer of accurate information
Improved productivity with cost re-allocation/shifting, possible cost savings
IMPROVED ACCESS:
Improve the breadth and depth of information available for patients across the continuum of care
Better access to services through enabling improved navigation across the healthcare system
Improved provider communications & care transitions across the continuum
IMPROVED SAFETY:
Improved access to important infection control information to protect clinicians and patients
Fewer medical errors
Reduced exposure to inappropriate and duplicate procedures/tests, medication errors, etc.
Clinical and System Priorities
• These defined cSWO Program implementation priorities and requirements
• These will drive adoption and realization of clinical and system benefits
• Significant focus on community sectors
1
Transitions and
pathways
from acute care
to community care
2
Integrated,
community-based,
patient-centered
care networks
cSWO Program Plan and Strategy
• Theme 1 – Rapid delivery of value by addressing clinical and system priorities through leverage and integration of existing assets
• Theme 2 – Establish capacity for sustained delivery, expansion and innovation
cSWO Program Governance and Delivery Model
Information Contribution
cSWO Program Management London Health Sciences Centre
cSWO Solution
Delivery Partners
cSWO Change Management & Adoption
Delivery Partners
eHealth Ontario
LHINs
Service/ Information Utilization
Working Groups
Funding, Governance & Management
Delivery
Participating HSPs
Steering Committee
Clinical Advisory Committee
Integrated EHR Services A rich, clinically-relevant set of patient information will be accessible through Regional Clinical Viewer (ClinicalConnect) (and a subset through HRM)
cSWO EHR - Information Available through ClinicalConnect
Data Source Patient
Demographics
Admissions / Visits /
Encounters Laboratory Radiology
Transcribed Reports
Medication Allergies /
Alerts Assessments Immunization
Medical History / Current
Conditions
Care Plans
Hospital Sector
Acute Care HIS HIS HIS, OLIS HIS, SWODIN,
DI/CS HIS HIS HIS
Cancer Care HIS HIS HIS, OLIS HIS, SWODIN,
DI/CS HIS HIS HIS
Complex Continuing Care HIS HIS HIS, OLIS HIS, SWODIN,
DI/CS HIS HIS HIS
Rehabilitation HIS HIS HIS, OLIS HIS, SWODIN,
DI/CS HIS HIS HIS
Community Sector
Community Care Access Centres CHRIS CHRIS CHRIS CHRIS
Community Mental Health and Addictions
IAR IAR IAR
Long Term Care IAR IAR IAR
Community Support Services IAR IAR IAR
Primary Care
Family Health Teams EMR to CDR EMR to CDR OLIS SWODIN, DI/CS EMR to
CDR EMR to
CDR EMR to CDR
EMR to CDR
EMR to CDR
Community Health Centres EMR to CDR EMR to CDR OLIS SWODIN, DI/CS EMR to
CDR EMR to
CDR EMR to CDR
EMR to CDR
EMR to CDR
Other Primary Care EMR to CDR EMR to CDR OLIS SWODIN, DI/CS EMR to
CDR EMR to
CDR EMR to CDR
EMR to CDR
EMR to CDR
Other
Public Health Laboratories OLIS
Community Laboratories OLIS OLIS
Community Radiology SWODIN,
DI/CS SWODIN, DI/CS
Electronic Medical Record Services • Regional Clinical Viewer (ClinicalConnect) Integration
• HNHB – All hospitals / HNHB Regional Cancer Program – 100% • WW – All hospitals – 100% • SW – Alexandra Marine and General Hospital, and Huron Perth
Healthcare Alliance complete, other SW hospitals underway • ESC – Bluewater Health complete, other ESC hospitals underway
• All four Community Care Access Centres – 100%
• Expanded data set
• Ontario Laboratory Information System (OLIS) connected
• Family Doctors Receiving Hospital Information • Electronic Medical Record Download/Hospital Report Manager
Readiness project live in the ESC
• Primary Care Data Repository Pilot planning underway
Change Management & Adoption Capacity
• The cSWO Program has built on the existing capabilities and relationships of a network of CM&A Delivery Partners for:
• Ongoing health service provider engagement and communications
• eHealth deployment and adoption planning
• Health service provider readiness assessment and gap remediation • Data sharing agreements • Privacy and security • Health Information Management/Data Quality
• Coordinating/supporting deployments
• Facilitating clinical and system change management
CM&A Delivery Partners • Erie St. Clair: TransForm
Shared Service Organization
• South West: South West Community Care Access Centre
• Waterloo Wellington: The Centre for Family Medicine Family Health Team
• Hamilton Niagara Haldimand Brant: Hamilton Health Sciences
Looking Ahead
• Continue with planned EHR integrations and implementation of eHealth Cornerstone Solutions
• Execute change management and adoption plans
• Initiate Benefits Measurement Program
• Implement ongoing planning/prioritization processes
• Transition to long-term sustainable Program Model
• Respond, Evolve, Innovate
Marzena Cran, RN Education & Development Clinician Hamilton Niagara Haldimand Brant Local Health Integration Network eHealth Office
TransForm Shared Service Organization
Paul Audet Chief Information Technology & Security Officer and eHealth Lead
South West Community Care Access Centre
Nancy Dool-Kontio
Senior Director, Strategic Planning and Integration
South West Successes To Date
• Leveraging existing strategic and operational partnerships in the health care system throughout the entire SW region: • 30 Hospitals • Primary Care • 73 Community Agencies • 36 Mental Health & Addiction Agencies • 78 Long Term Care Homes • 9 Public Health Units
South West Successes To Date
• Working collaboratively with other system-wide initiatives:
• Partnering for Quality
• Health Links
• Access to Care
• South West Self-Management
• SWO eHealth Coordinating Committee
South West Successes To Date
• Demonstrating established expertise in project management, change leadership and performance measurement
• Leveraging insights from Partnering for Quality EMR Needs Assessment to match identified gaps in information access/information management with suitable cSWO solutions
• Readiness Assessment pilot
Waterloo Wellington Successes To Date •The Centre for Family Medicine FHT has been
deploying ClinicalConnect to health service providers in the WWLHIN since April 2012 through a cSWO Foundation Project called Project Cultivating Adoption of Regional eHealth (CARE) • 34 Health Service Provider organizations signed up as ClinicalConnect Data
Sharing Agreement Partner • Over 3300 user accounts registered to use ClinicalConnect • The first Long Term Care Facility, Nurse Practitioner Led Clinic, and Midwifery
Practice using an EHR in Ontario • Focus on adoption and clinical change management • Research and focus on benefits evaluation and realization • Presented at national and international meetings including eHealth 2013 in
Ottawa, ITCH 2013 in Victoria, HIMSS13 in New Orleans
Waterloo Wellington Successes To Date
•The success of Project CARE is the foundation for Waterloo Wellington cSWO Phase 3 Planning
•Project CARE closed January 2014 and has been merged with the Waterloo Wellington cSWO Phase 3, Implementation – the work continues
• Since November 2013
• Follow up/refresher training and ongoing support for over 250 ClinicalConnect users
• Pharmacy data available in ClinicalConnect from Grand River and Guelph General Hospitals
• Pharmacy data tested for St Mary’s General and Cambridge Memorial Hospitals
• Since January 2014
• First Public Health Unit using ClinicalConnect
• 3 new organizations and 5 new hospital departments using ClinicalConnect
• 5 new organizations introduced to ClinicalConnect
• 3 new organizations applied for partnership status – including the first sports medicine clinic and a multi-LHIN long-term care organization
• Hospital Report Manager integration with the hospitals understood and moving forward
• Hospital to Ontario Laboratory Integration System (OLIS) Integration – hospitals & OLIS team engaged and moving forward
• April 2014
• Over 60 solo practitioners contacted regarding ClinicalConnect access
• Go forward plan: Keep doing what we’re doing
Waterloo Wellington Successes To Date
• Recent Integrations • Private Lab Data from Provincial Lab Repository (OLIS) aggregated
with existing Hospital Labs
• Hospitals in Erie St. Clair and South West LHINs
• CCACs in Erie St. Clair and South West LHINs
• Additional Community Care Access Centre (CCAC) data from all four south west CCACs
• Patient header flag identifying Hamilton Niagara Haldimand Brant) Health Links patients
• Health Outcomes for Better Information and Care (HOBIC) Nursing Assessments
• Other Enhancements • Self-Service Password Manager for non-Hamilton Health Sciences users
• High Availability Infrastructure to support expansion
Other In-Progress Initiatives
• OLIS Data Collection project underway • Leveraging ClinicalConnect to feed HNHB hospital
labs to Provincial OLIS database vs. separate hospital integrations
• Integration between ClinicalConnect and South Western Ontario Diagnostic Imaging Network (SWODIN) • Pilot Go-Live for Joseph Brant Hospital and Norfolk
General Hospital images targeted for mid 2014
Meeting Business Service Requirements
• Expanded Training Services • Boot camps and support for Change Management & Adoption
Specialists
• Privacy Officers, Auditors, Local Registration Authorities
• Updated training materials
• Integrated training schedule
• Integrated Communications with Delivery Partners
• Implemented new communication process with Delivery Partners to share integration announcements
Meeting Business Service Requirements
• Additional resources in support of Service Delivery Planning, Project Delivery, Change Management, Privacy & Security, Electronic Health Record Support
• Affiliate Physician Process in place at Hamilton Health Sciences (HHS)
• Alternative for non-credentialed physicians in HNHB and WW to gain access to ClinicalConnect
• The Affiliated category is not intended to replace the current credentialing processes at HHS or other organizations in HNHB and WW LHINs, but rather offer an alternative method for physicians to obtain access to ClinicalConnect
• Process details have been shared and are available for other partners to leverage
• Currently several partners are adopting similar affiliate credentialing processes
HNHB Successes To Date
•Expanded Change Management team to roll out engagement strategy
• Onboarded additional health service providers since January • 6 Family Health Teams
• 2 Community Health Centres
• Developed confirmed list of Health Service Providers that meet criteria for deployment
• Successful in identifying 75% of primary care physicians
HNHB Successes To Date
Brant Six Nations Bridges Community Health Centre
St. Joseph’s Hospital Community Mental Health & Addiction
Halton Family Health Centre
Caroline Family Health Team Hamilton Family Health Team
Niagara Falls Community Health Centre
Canadian Mental Health Associations Hamilton Branch
West Niagara Mental Health Unit
• Stakeholder Engagement schedule developed and initiated
• Meetings with Primary Care and Community Sector providers, as well as Public Health Units, are underway
• 9 Kick Off Meetings in 2014
• Continued engagement with Solo Practitioners at local Academy Days
HNHB Successes To Date
•First group of readiness assessments completed for: • Primacare Family Health Team
• Caroline Family Health Team
• Grand River Community Health Centre
• Halton Family Health Centre
• Brant Community Healthcare System Mental Health & Addictions Services
• West Niagara
• 7 Solo Practitioners
• 157 Readiness Assessments in progress
HNHB Successes To Date
• Conducted Needs Assessment Survey and Workshop with participants from all LHINs in support of advancing Health Links initiatives
• Facilitating change opportunity by participating in HNHB Stop the Paper initiatives