hcdc innovation presentation-june 10, 2015 ehealth innovations in the haliburton highlands
TRANSCRIPT
eHealth Innovations in the Haliburton Highlands
June 10, 2015
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Agenda
• Strategic Context• Organizational Strategy• IT Strategy• Remote Patient Monitoring Projects
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Strategic Context
MoHLTC & Provincial eHealth Objectives
HHHS Vision, Mission,
Strategic Plan
Community Partners & CE
LHIN
EHR & Industry Trends, Standards
Infra
stru
ctur
eFo
unda
tionIM/IT Strategic & Tactical Plan
Patient Transfers 2013/14
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Historic Future
Individual care providers Collaborative teams of providers
Treating individuals when sick Keeping populations healthyFocus on volumes Focus on volumes and outcomes
Maximize resources & assets Appropriate levels of care at the right placeCare at centralized facilities Patient-convenient care sites / centres of excellence
Treating patients all the same Customize care for each patient & family (based on standards)Challenges with chronic patients Create venues for special Chronic Care services
Responsive to those seeking service Responsive to the needs of the communityBest Efforts Highly reliable organization
Reactive to Financial / Business indicators Case based clinically integrated costs
Treatment in a Health Facility Treatment through an integrated partnership
Health provider silos throughout the community Integrated Health HubProvider centric (little information transfer) Patient and Family Centric, sharing, and transparentUninformed Patients Informed and Highly Engaged Patients (when capable)Do it for me & treat my disease / condition Do it with me (and my coach) – holistic needs
Strategic Context - Key Trend Changes in Healthcare
Adapted from: http://practicalanalytics.wordpress.com/2013/07/15/informatics-or-analytics-understanding-healthcare-provider-use-cases/
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thca
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rend
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Strategic ContextAvailability of EMRsPatient CentricInnovationAccelerated Elec Recs
RM&R, cGTA, OLISHRMChronic DiseasePanoramaCCO
Improved Access to CareAccess & Wait TimesFunding ReformSystem Design & IntegrationTransitions, Quality & Safety
MobilityeHealth ConsumersIntegrated D.SInformation Sharing
IntegrationCommunity EngagementEffective People & TeamsQuality & ExcellenceSustainability
Secure Access to InformationInteroperabilityEfficient & EffectivePredictive & AdaptableCollaborative
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Strategic Plan 2014-2017
Compassion • Accountability • Integrity • Respect
Health SystemIntegration
Leaders in Innovative
Rural Health Care
CommunityEngagement
Sustainability
EffectivePeople and
Teams
Quality and Service
Excellence
Minden Hospital / Hyland Crest Long-Term Care Home
Haliburton Hospital / Highland Wood Long-Term Care Home
Community Support Services
SupportiveHousing Offices:
Haliburton, Minden, Wilberforce
Rural Health Hub Structure
Mental Health Services
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IT STRATEGY & INNOVATIVE PROJECTS Haliburton Highlands Health Services
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IT Strategic Plan
15/16 16/17 17/18 18/19 19/20
FHT
Financial System
CCAC CSS - Devices
Support EMSCIS
Plan / Pilot Big Pilot Deploy
Personal Technology – Hand or Home Health (& Monitoring)
Support CCP testing Support CCP Provincially
Planned Discharge Notification to CCAC
CCD to Practice Solutions
Lab / DI Info to Practice Solutions
CCD: Continuity of Care DocumentsCCP: Coordinated Care PlanCIS: Clinical Information SystemCSS: Community Support Services
CIS PreparationOrder Sets
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IT BenefitsPatient Story•One Chart•Big Picture / My Picture•Trending and Intelligence
•Team Communication
Process Improvement•Clear Plan of Care•Time to Care•Safe•Less Waste
Performance Intelligence•Standardized Care•Patient Goals Tracking•Follow-up / Follow-thru•Teamwork
Patient Self-Management•Education•Navigation•Direct My Care•Contribute to My Care
Learn and Improve•Identify Issues•Tools to Improve•Enable Education•Enable Research
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Remote Patient MonitoringUniversity Health Network (UHN) eHealth Global Innovation Group• UHN project 1:
– Jointly submitted for the SPOR project, not disease specific. • UHN project 2 option a:
– Home Remote Monitoring: Diabetes or heart– Need a dedicated % staff. Lifestyle management.– Health Coach – focus on preventing adverse events
• UHN project 2 option b:– Self – Management. Phones and peripherals in less high risk, for 3-6 months.
Need teachable moments with Physician• https://dl.dropboxusercontent.com/u/30476893/mHealth%2BRemote%2
BPatient%2BMonitoring%2BImproves%2BHeart%2BFailure%2BManagement-SD%20copy.mp4
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Remote Patient MonitoringOntario Telemedicine Network (OTN) Telehomecare Model• Supports patients living in their own homes through health coaching and
monitoring
• Delivered by clinicians with training in self-management support and health coaching
• Complements the care provided by the primary care provider
• Time limited secondary-prevention intervention for patients with COPD or CHF
• Derived from evidence based guidelines, and approved by a provincial clinical expert committee
• https://www.youtube.com/watch?v=zXtF47XC0Hg
OTN Telehomecare Model
Clinician Health Coaching: Teaching the Patient how to self-manage
& meet their goals
Patient Empowerment:At home; Sets Personal Goals; Submits
vitals/ health responses
Simple Technology in Home:Tablet, BP Cuff, Scale & Pulse oximeter
Efficient MRP Engagement: Clinician provides regular updates, consults
as required
Remote Patient Monitoring: Weekday feeds & Alerts
TC -reduced ED Visits by 48% and Hospital Admissions by 44%.
CW - reduced ED Visits by 56% and Hospital Admissions by 58%.
Central - reduced ED Visits by 48% and Hospital Admissions by 57%.
OTN Telehomecare ModelConsistent results across LHINs
– 48-56% reduction in ED visits– 44-57% reduction in Hospital Admissions
Sustained Results, 6 months postSustained reduction in ER & inpatient admissions 6 months
post THC discharge
ED Visits 56% - 71% reduction
Inpatient Admissions 56 % - 76% reduction
OTN Telehomecare Model
Telehomecare Patient FeedbackPatient Experience (Toronto Central Results)
– 87% of the patients would definitely recommend the program to others– 98% agreed that the THC nurses understood what was important to
them– Managing medications properly was the most important patient
learning“I can’t see why anyone wouldn’t want to try Telehomecare. It was so simple, so enjoyable to learn. I’d rather do this than leave it to chance. It’s my life I’m dealing with…I’m looking for just a little longevity. It’s a no brainer.”
- Ian, Telehomecare Patient
OTN Telehomecare Model
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HHHS Benefits and Challenges
Benefits / Strengths• Focused on patient safety and
experience• Focused on community engagement• Looking for information mobility in the
community• Deep desire for sustainability and
predictability• Committed IS/IT partners• Desire to link and leverage• Desire improved integration• Keeps the personhood of the patient
in mind
Challenges• Small hospital with aging patient
population• Highly dependent on IS/IT partners• Younger staff recruited expect
electronic systems• Physicians are looking for a clear,
integrated, and fairly rapid pathway to electronic records
• Resources• Need better communication efficiency• Desired pace of change may exceed
capacity to deliver without strong partnerships
Leaders in Innovative Rural Health Care
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QUESTIONS?