Canada Health Infoway Update

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1 Canada Health Infoway Update Presentation to North East LHIN ehealth Advisory Committee May 9, 2013 Terry Moore, Executive Regional Director, Canada Health Infoway

2 Canada Health Infoway Created in 2001 as an independent, not-for-profit corporation Accountable to 14 federal, provincial and territorial governments $2.1 billion in federal funding to date Matching jurisdiction contributions account for 25 per cent of eligible projects costs, plus on-going operations and maintenance Leadership National leadership, expertise and services to support the jurisdictions in their e-health implementations EHR Architectural Blueprint pan-canadian standards Strategic Investor Co-invest with jurisdiction and private sector partners Involved in project planning, risk management, deliverable quality and benefits realization Gated funding approach 3

3 Where are we today? 9

4 Program activity summary (December 31, 2012) Legend Registries Diagnostic Imaging Drug Info Systems Lab Info Systems Telehealth Interoperable EHR Health Surveillance Innovation & Adoption Patient Access to Quality Care Electronic Medical Record and Integration Consumer Health Solutions 386 active and completed projects with an estimated value of $2.10 billion as at December 31, 2012

5 Benefits evaluation 4 significant benefits evaluation studies have been completed by Infoway to date: Diagnostic imagining 25-35% productivity increase for radiologists up to $1 billion in annual savings when fully implemented Drug information systems savings valued at $436 million as of 2010 up to $2.3 billion in annual savings when fully implemented Telehealth 260,000 events in 2010 $70 million annual travel savings Available at 13

6 Benefits evaluation EMRs improving Community-based care Primary care EMR adoption more than doubled from 2006 to 2012 (23% to 56%) Benefits related to practice workflow valued at $800 million ( ) Health system benefits from reduced adverse drug events and duplicate tests valued at $584 million ( ) Advanced use of EMRs can improve preventive care and CDM, but use varies across Canada 6

7 $500 million provided in March

8 Infoway s business direction Working with the jurisdictions, Infoway will: Advance availability, adoption and use of electronic health information systems Increase deployment and use of EMRs in physician offices Support clinicians in adoption and use of new technologies Invest in consumer health solutions 15

9 Goals of the EMR and Integration Program 1. Significantly increase the number of EMR systems in community and ambulatory clinic settings in use by primary care and specialist clinicians 2. Achieve increased clinical value from the EMR systems 3. Upgrade and connect EMR systems to the available electronic health record infrastructure 16

10 EMR Program May 2013 EMR Program Start-up EMR Program Ambulatory EMR / HIS Connect EMR Upgrade 10

11 EMR deploy To accelerate the implementation and use of EMRs for physicians and nurse practitioners in physician offices and other care settings Community EMRs Cumulative enrolment of approximately 11,000; 5800 Ontario $99 million invested to date; $50 million Ontario Reimbursement and adoption linked to achievement of clinician enrolment clinical value (CV) 1 criteria use by clinicians upgraded functionality clinical value (CV) 2 e-prescribing 22

12 Primary care use of EMRs Sources: Commonwealth Fund (2006, 2009 & 2012) and National Physician Survey (2004, 2007 & 2010)

13 Ambulatory EMR and HIS Connect Invests in projects that deploy EMR capability in the ambulatory setting in a manner that enhances patient care by capturing clinical notes from specialists, and sharing information to and from other care settings via the EHR. Extends the value of the EHR to authorized users by integrating with systems at the point of care (HIS). Ideally this is accomplished in a manner that also supports users of the ambulatory EMR. Currently 20 (11 Ontario) approved projects across the country with 11,879 seats; 5,000 Ontario Over 1700 implemented $100 million invested to date; $41 million Ontario Projects in BC, AB, SK, MB, NL, NU, QC, ON 23

14 Ambulatory EMR/HIS Connect projects Approved as of May 2012 BC = 1 provincial project AB = 1 project at Edmonton Clinic SK = 3 projects MB = 1 provincial project ON = 11 projects QC = 1 provincial project NL = 1 provincial project NU = 1 provincial project 24

15 Ambulatory EMR / HIS Connect Ontario projects approved as of May 2012 Approximately 5,000 ambulatory EMR seats Projects: Group Health Centre The Ottawa Hospital Women s College Hospital Toronto Hospital for Sick Children York Central and Southlake Grey-Bruce, North York & Toronto East General HNHB LHIN Regional Oncology 4 centres Sunnybrook Odette Cancer Centre North East LHIN 19 hospitals North West Regional Oncology 15 hospitals Children s Hospital of Eastern Ontario 25

16 Clinical Innovation & Adoption program Strategically invest in, and showcase, selected initiatives with tangible value for clinicians and Canadians and that also include: Benefits that can be easily communicated to the public and our broader stakeholder community Can be rapidly deployed Can be rapidly adopted by consumers and/or providers Currently 18 (7 Ontario, 5 multi-jurisdiction projects that include Ontario) approved projects across the country $18 million invested to date; $6.6 million Ontario $3.5 multi-jurisdictional Projects in BC, AB, SK, MB, ON, QC, PEI 26

17 Demonstration project focus areas Clinical Innovation E-referral CPOE (hospital and community) Synoptic reporting Decision support/ workflow Secure clinical messaging Consumer Health E-scheduling (book appointments) Prescription renewal Patient access to health information Secure e-consultations 27

18 Clinical Innovation & Adoption Ontario projects approved as of May 2012 Projects: The Ottawa Hospital Clinical Mobility App North York CPOE Toolkit Develop & Order Set Expansion Trillium Long Term Care CPOE Mobile Order Set Develop London Health Sciences CPOE Replication HHSC Multi-Device Mobile Access to Clinical Connect TC LHIN Resource Matching and Referral (RM&R) UHN Evidence-Based Infection Control 28

19 Clinical Innovation & Adoption Multi-jurisdiction projects approved as of May 2012 Five multi-jurisdictional projects that include Ontario Projects: Synoptic Reporting #1: Expanding Engagement and Adoption (Expansion): a Pan-Canadian Partnership in Cancer Surgical Structured Synoptic Reporting Synoptic Reporting #2: Expanding Engagement and Adoption (Adoption): a Pan-Canadian Partnership in Cancer Surgical Structured Synoptic Reporting Canadian Health Outcomes for Better Information and Care (C-HOBIC) Phase 2 Pan-Canadian Canadian Dental Association CDA UHN Synoptic Reporting CPAC Expansion CPAC Adoption C-HOBIC Colonoscopy & Colposcopy Synoptic Reporting 29

20 Consumer Health Solutions program The Consumer Health Solutions investment program was established to educate and empower Canadians by providing electronic access to their health information and health care services. Part of the dollars available to invest in consumer health projects will be allocated to demonstration projects: Demonstration projects will focus on specific areas that Canadians have identified as priority information needs or services. Projects will enable the testing and demonstration of how consumer health solutions can be deployed and the value associated with their use. Currently 7 (4 Ontario) approved projects across the country $7.5 million invested to date; $5 million Ontario Projects in AB, ON, QC, NS 30

21 Consumer Health Solutions Projects approved as of May demonstration projects 31

22 Consumer Health Solutions (CHS) Ontario projects approved as of May 2012 Projects: Sick Kids - Family Health Engagement in Pediatrics Lawson/LHSC - Mental Health Engagement Network CCO - Diagnostic Assessment Program Electronic Pathway Solution (DAP-EPS) UHN - Consumer Access to Personal Health Information for Asthma Self-Management 32

23 E-health Future Directions Canada s Priorities

24 Purpose Canada has been on its national e-health journey for 10 years and is now 6 years into Vision The Infoway board felt it was an opportune time to reflect on the progress made, determine where the current direction would take the country and whether a course adjustment is required prior to any consideration for new funding. 24

25 Over 500 Stakeholders Were Consulted Stakeholders representing consumers (37%), clinicians (25%), government & administrators (30%), vendors (3%) and others (5%) from across Canada were consulted between October 2011 and February Interviews Focus Groups Stakeholder Forums 14 one-on-one/small group meetings with jurisdiction Deputy Ministers of Health and key representatives. 39 stakeholder focus groups with individual Canadians and clinician groups 10 regional stakeholder forums were held in Vancouver, Edmonton, Winnipeg, Toronto, Montreal and Halifax, including sessions with the Federal Government, National Associations, the Privacy Forum and 25

26 Stakeholder Priorities & Key Enablers Governance & Leadership Policy & Legislation Resource Capacity, Capability & Culture Practice & Process Change Healthy Living Continuity of Care Access to Services Quality Improvement Person Centred Care Efficiency Improvement Privacy & Security Interoperable ehealth Solutions Business Case & Benefits Realization 26

27 Opportunities for Action Bring Care Closer to Home Patient Monitoring Personal Health Record Provide Easier Access e-rxrenewal e-visits e-scheduling e-navigation Support New Models of Care Ambulatory EMR Community-based EMR Electronic Health Record Discharge Summaries Referral Management Chronic Disease Management Improve Patient Safety Hospital Medication Management Medication Reconciliation e-prescribing Enable a High-Performing Health System Clinical Analytics Health System Analytics Public Health Surveillance LEAN Foundational Clinical Systems Hospital Information System Home Care / Long Term Care Systems 27

28 Terry Moore Thank You

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