New EHR Governance Underway
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- Steven Bell
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1 N E W S & E V E N TS September 2010 IN THIS ISSUE: NEW EHR GOVERNANCE UNDERWAY NEW MEDICATION PROFILE VS PIN APPLICATION THE ALBERTA NETCARE EHR ROADSHOW PORTAL ACCESS THROUGH SUNRISE CLINICAL MANAGER EMR SOLUTIONS IMPLEMENTED ACROSS THE PROVINCE THE PEOPLE BEHIND ALBERTA NETCARE PORTAL 2004 MIGRATION LEARNING CORNER DATA AVAILABILITY UPDATE Alberta Netcare EHR Newsletter Vol. 6 No. 1 Sept New EHR Governance Underway The new Integrated Clinical Working Group (ICWG), met for the first time in Red Deer, on May 8, Fifty-two health care professionals participated in the full day event. The inaugural meeting of the ICWG was a successful day, engaging a broad range of experienced clinicians. said Dr. John Coppola, Co-Chair of the ICWG. Dr. Coppola believes that a coordinated effort, based on effective clinical advice, will ensure that the EHR continues to evolve and meet the needs of the health community. The current subgroups include: Personal Health Portal (PHP) Shared Health Record (SHR) Alberta Netcare Portal Drug (PIN) former PIN Safety & Usability Panel (SUP) EHR Business Operations EMR Evolution and Integration - Release Planning Some of the subgroups have already started their monthly meetings, the remaining groups are scheduled to start meeting in the fall. Emphasis will be on issues of usability, safety, and clinical workflow, as each subgroup provides specialized input into these key areas of interest. The work of the ICWG will result in products and services that are better positioned to meet the needs of the user community. The ICWG is comprised Dr. John Coppola, Co-Chair of the ICWG of clinical representatives from across the province, both rural and urban centers, involving many facets of the health system. Some of the participating health professions include: physicians (both community and specialists), pharmacists, nurses, laboratory technicians, clinic managers, as well as representatives from: acute care centers, primary care networks, and Alberta Health Services. Donna Pipa, pharmacist and member of the ICWG Drug subgroup, explains that the ICWG plays a critical role in ensuring that authorized providers are able to get access to Alberta Netcare that access is granted to those that need it to provide patient care. The group s extensive clinical expertise will be directed toward providing advice and feedback into the development of the EHR and related initiatives. Specialized subgroups have been formed to address the key EHR domains. Each subgroup will examine issues relating to the designated domain and provide recommendations to the greater ICWG. Additional subgroups will be established as the need arises. Inaugural meeting of the ICWG, Red Deer, Alberta
2 NEW MEDICATION PROFILE VS PIN APPLICATION The September 16, 2010, Alberta Netcare Portal release features a new Medication Profile that provides a simple view of patient allergies, intolerances and medication history, as well as an easy-to-read summary of a patient s key medication drug information. The Medication Profile was created in response to a request by the Integrated Clinical Working Group to provide a summary of a patient s medication profile. This functionality is currently available in the Pharmaceutical Information Network (PIN) as the Print Profile with History, but is now accessible directly below the Dynamic Patient Summary link in the CDV tree. The Medication Profile will function as a quick alternative to functionality available through PIN. The new Medication Profile allows health care professionals to view a patient s drug summary, or a detailed listing of medications for a specified number of months, that includes: a list of prescription, dispenses and other medications; and a list of known allergies and intolerances Clinicians will still need to access PIN in order to: create prescriptions; review any prescription managements that may have been entered by a prescriber (including any drug-to-drug interactions that have been managed); review prescription notes that may have been entered; update a prescription status (hold, release or discontinue); create a new allergy or intolerance entry, or update an existing entry; and review any historical information related to an allergy or intolerance. Below: Screenshot, Medication Profile COMING SOON: The Alberta Netcare EHR Roadshow Alberta Netcare is planning a Roadshow in southern Alberta, to provide an opportunity for health care professionals to learn more about the Electronic Health Record, and the benefits to clinical workflow and patient care. Stay tuned for dates, locations and other details.
3 THE PEOPLE BEHIND ALBERTA NETCARE THE ALBERTA NETCARE PORTAL TEAM The Alberta Netcare Electronic Health Record (EHR) is a provincial record of Albertans key health information. As a communication tool, it plays a critical role in enhancing patient care health professionals are not only able to draw from their own patient interactions and records, but can access data from facilities across the province. Having more complete information available at the point of care enables clinicians to make better treatment decisions. Most authorized health care providers access the EHR through the Alberta Netcare Portal, a secure online viewer. As a web-based interface, the Alberta Netcare Portal allows users to access data in real time, no matter where they are in the province. As of July 31, 2010, the total number of unique users who have accessed Alberta Netcare Portal (ANP) over the past six months was approximately 27,000. This includes a variety of health service providers, including: physicians, pharmacists, nurses, and allied health professionals. The Alberta Netcare Portal (ANP) makes data available from over Back row: Second row: Front row: Missing: 152 provincial data sources, including laboratory, diagnostic imaging, ADT and transcription systems, the Pharmaceutical Information Network, and a variety of other clinical sources. New sources are continually added as part of a quarterly release schedule. For a detailed summary of information sources, Portal users can download the current Data Availability Table from the ANP Login page. As with many complex initiatives, the Alberta Netcare Portal is made possible through the ongoing efforts of a group of key people, who build, maintain and update the Portal application technology. The Alberta Netcare Portal Support team is made up of sub-teams to accomplish different aspects of ANP operations. The Support Team is comprised of: the New Development team, which manages product upgrades and builds new functionality and enhancements for the portal; the Operational Support teams, which are responsible for ongoing application maintenance, maintaining the databases, servers, storage and networks required to operate the Portal, help desk user support, user registration, product testing, and implementing ANP releases; the Data Integration team, which is responsible for working with new data sources and helping them connect their systems through the provincial Health Information Exchange (phie) system to the repositories moving health information securely, quickly and accurately from the data sources to the Alberta Netcare repositories; and the Repository Support team, which is responsible for maintaining and upgrading the Netcare repositories housed in Edmonton and Calgary including maintenance of the EHR Index which provides the summary of results available for a patient. The Support Team sets the release schedule based on the advice and priorities set by the provincial Integrated Clinical Working Group (ICWG), according to the provincial Information Management Strategy. The Portal team also works with the ICWG to gather design recommendations, so that the resulting functionality effectively supports clinical workflow. Bryan Wicentowich, Rosa Nash, Rob Kotyshyn, Nathan Geisbrecht, Mazen Kasim, Roy Uchman, Matt Wearmouth, Cameron Bain, Tim Kubasek, Harvey Plain, Bonnie Caithness, Derek Balay John Lee, Tom Lee, Sheri Dwyer, Brenda Buhr, Sylvia Toews, Michael Szeto, Heming Yang, Michael Chong, Rita Marrazzo, Jadie Tang, Angela Russo Dan Rouault, Doug Hunt, Dan Poirier, Caryn Harris, Martin Tailleur, Brent Swekla, Thanh Truong, Gary Picard, David Shaw Susan Watson, Corinne Blair, Keith Mah, Karen Bulmer, Leah Prins, Mark Scheffer (Calgary team): Russell Padgham, Dimitri Bezglashi, Trevor Sandor, Rob Tremblay
4 ON THE CALGARY HORIZON Alberta Netcare Portal Access through Sunrise Clinical Manager Patient data is created and stored in many different systems across Alberta. This creates a challenge for clinicians who need timely access to patient data from various locations. The Parameter Launched Browser (PLB) in Sunrise Clinical Manager (SCM) allows access to patient information such as provincial lab, community lab, diagnostic imaging reports and drug information not currently available in SCM. This information is available without having to re-enter patient identifiers and searching in another system. The goal is to reduce the amount of time it takes for Calgary clinicians to access critical information by providing access to key patient data from facilities across the province. Patient safety, system performance and benefit to workflow were the key considerations in the development of the PLB. In addition to ongoing design consultation, clinical users participated in detailed testing and analysis of the PLB. As a result, significant progress has been made toward the seamless transfer from one system view to another. SCM users in Calgary emergency departments and urgent care centres can now view patient information in the provincial electronic health record simply by launching the Alberta Netcare Portal tab in SCM, and entering their Alberta Netcare user ID and password. The patient highlighted in SCM will automatically display in the Alberta Netcare Portal window. Clinicians can highlight all, or select patients within their SCM patient list, then scroll through their highlighted patient list in the Alberta Netcare Portal view. Only one sign-in is required per session, allowing clinicians to view multiple patients without re-entering user information. SCM users who already access Alberta Netcare Portal will no longer need to open a desktop browser and search for their patient. The initial pilot included select super users of the Alberta Netcare Portal and SCM applications. AHS staff requiring Alberta Netcare Portal access should contact the Alberta Netcare Deployment team: Phone: (toll free) [email protected] EMR SOLUTIONS IMPLEMENTED ACROSS THE PROVINCE Change Management Services and Data Management Assistance Available to POSP-Enrolled Physicians Alberta Health and Wellness, Alberta Health Services and the Alberta Medical Association are pleased to announce that the new Physician Office System Program (POSP) Electronic Medical Record (EMR) solutions are successfully being deployed across the province. The new EMR solutions are turnkey including software, hardware, networking, system interoperability and 24/7 support within the cost of the solution. These solutions build on the basic capabilities of an EMR, such as electronic charting, billing and scheduling and include better tools for chronic disease management, population health, referral management, as well as access to diagnostic imaging reports and lab results. Physicians can also expand their systems beyond the POSP-funded offering to include additional custom features geared to their own workflow practises. The three qualified service providers are Med Access, Practice Solutions and Wolf Medical Systems. POSP has divided the path to automation in four key phases: Choose, Prepare, Implement and Use. Physicians and clinic staff are invited to review the process by using the POSP Interactive Transition Guide, a web-based tool designed to assist physicians and clinic resources in understanding the steps and processes involved in implementing an EMR. To make an informed choice on EMR solutions, eligible physicians should take advantage of the many change management services that POSP provides: a business requirement study to help determine where the clinic is and where it would like to go; assistance with a data management strategy including guidance through data extraction, migration and retention options available; vendor demonstrations and in-clinic EMR solution demonstrations by peers already using the new solutions; help with privacy impact assessments and online privacy training for you and your clinic staff; and valuable resources such as educational podcasts, fact sheets and forums. If your clinic or Primary Care Network is interested in learning more about the new complete EMR solutions, contact your POSP change management advisor through the POSP website:
5 Learning Corner New Learning Materials now available! The Alberta Netcare Portal Learning Centre has developed a variety of new learning materials for users of the provincial EHR. The What s New page will provide users with an instant update of all of the recently added resources. The Learning Centre s primary learning areas include: Alberta Netcare Portal Getting Started in Portal Delivery Site Registry (DSR) Person Directory (PD) Pharmaceutical Information Network (PIN) Privacy, Security & Confidentiality Frequently Asked Questions (FAQs) Quick Reference Cards (QRCs) e-demos Links Reading Rooms EHR Releases e-demos E-Demos have been developed (with voice-overs) to introduce users on how to use PD. An e-demo is also available to demonstrate how PIN integrates with the health system. Privacy, Security & Confidentiality These are some of the most important (and often misunderstood) requirements of the EHR. The Health Information Act (HIA) establishes the rules for the collection, use and disclosure of health information with the Alberta health system. Every Alberta Netcare Portal user, whether clinical, pharmacy, or administrative, is responsible for ensuring that he or she is accessing the system appropriately following the rules set out by the HIA. It is important for everyone who may come in contact with health information to follow the HIA and be aware of their responsibilities. The Learning Centre has added a new section dealing strictly with Privacy, Security and Confidentiality. The information is written in plain language to make it easier for users to understand their roles and responsibilities as a custodian or affiliate. This information will be particularly valuable for new staff members. The Test Your Knowledge quiz includes 10 questions and real-life scenarios related to Privacy, Security and Confidentiality in the Alberta Netcare EHR workplace. If you have a question or concerns relating to Privacy, Security or Confidentiality, please contact the experts at the HIA HelpDesk: Phone: (toll free ) [email protected] Questions about any other topics or resources available on the learning centre can be directed to: [email protected]. Reading Rooms Reading Rooms have been created to host supplementary materials for each application, as well as materials specific to an AHS zone. Learning Centre Reading Room Alberta Netcare Portal Reading Room AHS-Calgary Reading Room AHS-Edmonton Reading Room DSR Reading Room PD Reading Room PIN Reading Room User Feedback User feedback is important to guide the continual improvement of the site and the information it contains. Please send feedback or suggestions for additional FAQs to the Learning Centre at: [email protected]. Learning (Training) Environment For users whose roles require them to Add a Person to PD or Add a Newborn to PD you may now practice Adding / Updating a Person or Adding / Updating a Newborn before you actually work in the live environment. PORTAL 2004 MIGRATION Alberta Netcare would like to thank all of the pharmacies and physician offices that recently participated in the migration from Portal 2004 to the current Portal viewer. By migrating to Alberta Netcare Portal, pharmacists and physicians will have access to a greater range of information and decision support tools including more complete and accurate: laboratory data (specific lab results, flow sheets and lab values charting); transcribed clinical reports; diagnostic imaging text reports and images; and patient hospital admission and discharge history logs. The Alberta Netcare Deployment team will continue to work with Portal 2004 users that have not yet completed the migration process. Please note that Portal 2004 access is no longer available (as of June 10, 2010). Questions can be directed to the Alberta Netcare Deployment team at: Phone: (toll free) [email protected] The Learning Centre is accessed through a secure link on the Alberta Netcare Portal Login page: and the Learning Environment Login page: Look for the following icon: If you re not an Alberta Netcare Portal user and would like to be, please contact the ANP enrollment line: toll free or (780) in Edmonton
6 DATA AVAILABILITY UPDATE The data available to health service providers through the Alberta Netcare Electronic Health Record is constantly expanding, enabling users to view a more complete picture of their patients health. This allows for better diagnosis and treatment and increases the safety and quality of patient care. By receiving quick access to patient information, users can spend less time searching for data and more time treating patients. The following is an updated summary of available data in the Alberta Netcare Portal: Patient Demographics: demographic data and ID numbers are available for anyone registered through Alberta Health with a Personal Health Number (PHN) or Unique Lifetime Identifier (ULI). Data is available as far back as Drug Information: 88 per cent of all prescription dispenses expected in an average month are being added to Alberta Netcare. Laboratory Data: general lab, microbiology, pathology and blood bank data is available for all of the former regions. Note that there are many regional variations of when specific categories of data became available. Diagnostic Imaging (DI) Text Reports: the Alberta Netcare Portal includes reports from the Cross Cancer Institute, Tom Baker Centre, and all of the former regions. Note that there are many regional variations of when specific categories of data became available. DI text reports from the X-Ray Clinic at 124th Street were added June Echocardiogram results from the University of Alberta Hospital/Stollery Children s Hospital/Mazankowski Heart Institute were added June DI Ultrasound text reports from Dr. J. P. Mayo in Edmonton were added September DI text reports from Radiology Associates (Lethbridge), Campbell Clinics (Lethbridge), Haig Clinic (Lethbridge), Bigelow Fowler Clinic (Lethbridge) and Associate Medical Centre (Taber) were added September Transcribed Reports: from the former Capital region, admission histories, consultations, discharge summaries, operative/procedure reports, emergency discharge summaries, ECGs, community care client profiles and letters are available as far back as July Reports from the Cross Cancer Institute and Tom Baker Centre, including physician progress notes, admission histories, discharge summaries and initial consultations, are available back to May Operative reports from Cancer Surgery Alberta are available for the entire province as of June Immunizations: the former Capital region records from public health sites are available back to January These records do not include emergency or private office immunizations. ECG: the former Capital region ECG results are available for: Sturgeon Misericordia, University of Alberta, Leduc and Grey Nuns Hospitals. ECG results from the Edmonton General Continuing Care Centre were added June Current Alberta Netcare Portal users can access full data availability information from the Alberta Netcare Portal Login page. This includes the specific dates that information became available in the system. For additional details about data from a specific category or region, please contact the Alberta Netcare Deployment Team at or [email protected]. Contact us To contact us for more information call , or visit the Alberta Netcare website at Better Patient Information. Better Care Decisions.
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