Health System Transformation through Information Management. March 2015

Transcription

1 Health System Transformation through Information Management March 2015

2 2 Session Agenda Background: Please see HIMSS-COACH ehealth Update 2014 AOHC presentation! CHC Information Management Strategy (IMS) Current State IMS Benefit Evaluation IMS v2.0 Next Steps Q & A 2

3 A 3 Unified Network Working Together AOHC membership is unified and organized to serve as transformation enablers. 75 or 100% of Community Health Centres (CHCs) 10 or 100% of Aboriginal Health Access Centres (AHACs) 15 Community Family Health Teams (CFHTs) 8 Nurse Practitioner-Led Clinics (NPLCs) We work together for better outcomes 3

4 4 AOHC Mission (under revision) Transformative change; Improve health and wellbeing; With People/Community-centred; For those facing barriers to health. Strategic Directions 2020 (under revision): 1. Champion Health Equity and Population Needs-Based Planning; 2. Advance Primary Health Care as the health system foundation; 3. Increase access to Appropriate services for people facing barriers; 4. Demonstrate value, effectiveness and improved health outcomes through the experience of people and communities 4

5 5 Model of Health & Wellbeing 5

6 Information Management Strategy 6 Overarching Principles: Information Management Owners acting as a unified sector 6

7 7 Information Management Strategy The Information Management Strategy is designed to support optimal client service and care provided by AOHC member organizations through the strategic management of information and information systems. Strategic Objectives Improving client health through high-quality care Improving the health of communities Alignment to the broader provincial healthcare sector Accountability and sustainability Effective and efficient information management tools and processes 1. Get Electronic 2. Share your Data 3. Promote Collaboration 4. Improve Health Work Streams ehealth Alignment (Electronic Medical Record System, Drug Profile Viewer, HRM, cgta, IDS, etc) Non-Operational Reporting and Analytics Community Initiatives Online Resource Ontario Healthcare Reporting Standards/Management Information System Legacy Systems Management 7

8 IM Strategy Portfolio: Mar/15 ehealth Alignment Electronic Medical Record Project (84/90 complete) Drug Profile Viewer Project (completed May 2012) Non-Operational Reporting & Analytics: Business Intelligence & Reporting Tool Community Initiatives On-Line Resource v.2 (completed July 2014) MIS & OHRS Project- Project (completed Mar/13) Legacy Systems Management (on-going) 8

9 9 EMR Project Scope Current release Nightingale on Demand 9.2.4: Hospital Report Manager/SPIRE/POI/TDIS integration; OLIS (Lab) integration; Personal Development Groups; ENCODE-FM classification system; OCAN/RAI-CHA & Integrated Assessment Record capabilities* Next release: Nightingale v.10 due in Summer/15: Bilingual ASP EMR in Ontario; Complimentary Practices EMR * Awaiting ministry approval Traditional Healing Working Group 9

10 10 EMR Implementation Plan As of March 1/15 10

11 11 EMR Project: Apr/15 Nightingale on Demand : 84 Centres Implemented - Over 93% Completed 62 CHCs, 10 AHACs, 10 NPLCs, 2 FHTs 4,100 NOD users 1,271,042 Clients have been migrated 61,823,212 Client Records have been migrated Hospital Report Manager/SPIRE/POI/TDIS integration (~37 centres) OLIS (Laboratory) integration Provider Query Personal Development Groups custom coding ENCODE-FM classification system embedded in NOD Appointment Reminder system integration Nightingale v10 - Summer/15: Only OntarioMD bilingual ASP EMR in Ontario OCAN/RAI-CHA capabilities* Traditional Healing Working Group incorporate Traditional Healing minimum dataset * Seeking approval & funding 11

12 Operational Systems Information Holdings Analytics Information Consumers 12 NORA Strategy & BIRT Project Who Why MOHLTC CHCs / AOHC LHINs Partners Consumers Performance Management Planning Knowledge Transfer Funding & Accountability Standards Security & Privacy Analyzing Score carding Data Mining Forecasting Data Sharing Agreements Sector Specific Holdings CHC Provincial data store Local data store Data Mart Health Data Branch Health System Holdings CIHI LHINs Business Processes CMS Current Other ASP Accounting TBD Local HR Local TBD CI Current Web Inventory Other 12

13 Number of CHCs Evidence-Based Data Quality Pre/Post Data Quality Improvement Data Remediation - Client Service Event and Average MSAA Variance to LMIS and NOD to BIRT Load Errors NOD 3% ECR Service Events ECR MSAA NOD Service Events Industry DQ Norm: ± 5% BIRT DQ Standard: ± 3% 0 0.0% 5.0% 10.0% 15.0% 20.0% 25.0% 30.0% 35.0% 40.0% 45.0% 50.0% Percent of Errors vs total records submitted 13

14 BIRT: From Vision to Reality 14

15 BIRT: From Vision to Reality (cont d.) LHIN OHRS Dashboard Mock-up

16 16 Community Initiatives On-Line Resource A web-based system documents the effectiveness of CIs in improving health within communities that are engaged in community development work Inventory: shares knowledge of community initiatives by capturing CI objectives, planned activities and health conditions addressed Evaluation: Assess community initiatives in terms of community response, enablers/barriers to success, lessons learned Alignment: Incorporating Canadian Index of Wellbeing indicators for external benchmarking and Quality Improvement 16

17 Governance Structure 17

18 18 IMS Mid-Point Benefit Assessment Funded by AOHC members Sponsored by the Information Management Committee The IMS Benefit Assessment will align with Canada Health Infoway s Benefits Evaluation Framework A Project Advisory Group will include representation from CHC IMS Committee, LHINs, ehealth Ontario, Canada Health Infoway and AOHC Glenn Alexander, Champlain LHIN CIO, N&EO LHINs Cluster CIO Tamara Shewciw, NE LHIN CIO, IMC Liaison Member Brian Ktytor, NW LHIN Sr. Dir/eHealth Lead Mel Casalino, Sr. Director, Physician ehealth Program, ehealth Ontario Dr. Wei Qiu, Chief Medical Informatics Officer, ehealth Ontario Simon Hagens, Director, Benefits Realization The evaluation was undertaken by Deloitte, an independent firm Completion: February/15 18

19 Infoway s Benefit Evaluation Framework Infoway's Benefits Evaluation Framework focuses on the causal relationship between the implementation of an effective solution, the adoption of that solution and the resulting impacts: an effective, manageable approach for understanding progress towards objectives, identifying barriers, and communicating successes. The framework will be adapted, with indicators defined that are most relevant to the sector. 19

20 Major Activities from IM Strategy v1.0 as of March 2015 ehealth Alignment Activities Update Status Planned Nightingale NOD deployment 84 sites live 93% In Progress Hospital Report Manager equivalents with EMR Over 9 sites implemented In Progress Hospital Report Manager within Nightingale 13 sites live, 12 in-progress 36% In Progress Drug Profile Viewer 20 sites implemented Completed NightingaleRemind 5 sites implemented Completed OLIS Patient Query Standard NOD implementation Completed Unplanned Nightingale on Demand Product Improvement Resolved client safety, privacy issues, and functional issues In Progress Read Only Environment For sector-wide outages Completed Governance Structures New: Operations Committee, RUGs and Privacy Working Group In Progress Traditional Healing New fields for NOD/N10 and ENCODE-FM In Progress Connecting GTA cgta to integrate with NOD In Progress Nightingale v10 Development of Nightingale v10 70% In Progress 20

21 Major Activities from IM Strategy v1.0 as of March 2015 Non-Operational Reporting and Analytics Activities Update Status Planned BIRT 1.0 Developed the platform Completed BIRT 2.0 Initial reporting capabilities Completed BIRT 3.0 Advanced reporting capabilities 95% In Progress BIRT 4.0 OHRS statistical data in BIRT 25% In Progress Unplanned Enterprise licensing June 2014 Completed AHAC and NPLCs Awaiting MOHLTC approval In Progress Enterprise Cognos Training March / April 2013 & January 2015 Completed 21

22 Major Activities from IM Strategy v1.0 as of March 2015 Community Initiatives Online Resource Activities Update Status Planned CI Tool 1.0 Initial platform Completed Unplanned CI On Line Resource 2.0 Second generation application and new platform Completed Alignment with Canadian Index of Wellbeing domains and indicators Sense of Community Belonging, Physical Activity and Poverty Index 66% In Progress 22

23 Major Activities from IM Strategy v1.0 as of March 2015 Ontario Healthcare Reporting Standards (OHRS) / Management Information System (MIS) Activities Update Status Planned 49 Centres using MS Dynamics GP n/a Completed Unplanned Advocating for remaining Centres and for HRIS Meeting with ADM in Jan/15 In Progress 23

24 Major Activities from IM Strategy v1.0 as of March 2015 Legacy Systems Management / Contract Management Activities Update Status Planned Not part of original IMS plan n/a Unplanned Enterprise read-only licences Managing five legacy systems contracts Completed Enterprise Up-To-Date licences Contract completed with premium service at25% cost reduction and enterprise licensing Completed Development of applicationindependent solution Proof of Concept completed for 3/5 legacy EMRs 55% In progress 24

25 25 Summary CHC sector s IM Strategy is directly aligned with Ministry and LHIN priorities CHC IM Strategy is a cost-effective approach to ehealth Largest and most complex EMR deployment in Canada CHCs are the only sector able to report MSAA s through a single Business Intelligence Solution Frozen budgets, and downloading of IT/IM costs put significant financial burden on member organizations. Aligning to the Canadian Index of Wellbeing The IM Strategy enables a person/community-centric approach that will empower and help improve health 25

26 IM Strategy v2.0 26

27 27

28 Influencers CHC, NPLC, AHAC & CFHT Sectors SWOT/SOAR analysis Sector meetings IMS Benefits Evaluation Health Quality Ontario HQO will develop a publicly available catalogue of health system indicators used for their performance monitoring and reporting. Ministry Priorities A focus on upstream interventions Emphasis on community wellness Enhanced services for mental health and addictions issues A system that really is a system Guaranteed access to primary care Focus on measurement and evaluation to drive quality improvement 28

29 Influencers Local Health Integration Networks New MSAAs Ministry of Health and Long Term Care Minister s Action Plan 2.0 Health Links - coordination of care for high needs clients ehealth Initiatives ehealth Ontario provincial solutions (e.g. HRM/cGTA) Canada Health Infoway (e.g. ebooking) Aboriginal Communities Traditional Healing programs 29

30 Please refer to Appendix 1 (attached)

31 Next Steps Confirm Priorities Work through the committee structure Prioritize/approve list of projects Develop Budgets & Business Cases Determine project timelines Validate staffing model Create and approve budgets Document and Share IMS v2.0 31

32 Next Steps Finalize IMS v2.0 Complete EMR implementation Funding: 1-time and Operating Governance Performance Management & Quality Improvement focus 32

33 33 IM Strategy Lessons Learned Voluntary collaboration Underestimate complexity Privacy Power of leadership & vision Communicate, communicate, communicate Stakeholders expect more than they pay for Keep your eye on the goal Time is your arch-nemesis Communicate - some more This has been continues to be a blast! 33

34 The journey continues Thank you / Merci / Miigwetch! 34

35 Appendix 35

36 Information Management Strategy v2.0 Concepts EMR: NOD: Nightingale on Demand is an ASP-based electronic health record solution for healthcare professionals. N10: Nightingale version 10 (aka Nightingale v10) is the new platform of Nightingale Informatix Corporation s (NIC) electronic health record solution. Enabling Systems: OHRS/MIS: Ontario Health Reporting Standards/Management Information System involves the development of reporting standards by Community Health Centres (CHCs) throughout Ontario to ensure consistent and accurate financial and statistical reporting to the province. The first phase of the project revolved around the development of standards. HRIS: Healthcare Incident Reporting Services offers institutions in the healthcare industry with an accurate and efficient incident reporting and tracking system. Risk Management (Comply Track): Risk Management software available through the AOHC. 36

37 Information Management Strategy v2.0 Concepts Decision Support: BIRT Development: Business Intelligence Reporting Tool is an open source technology platform used to create data visualizations and reports that can be embedded into rich client and web applications. AHAC (BIRT Phase I): Aboriginal Health Access Centre are Aboriginal community-led, primary health care organizations. They provide a combination of traditional healing, primary care, cultural programs, health promotion programs, community development initiatives, and social support services to First Nations, Métis and Inuit communities. There are currently ten AHACs in Ontario, providing services both on and off-reserve, in urban, rural and northern locations. NPLC (BIRT Phase I): Nurse Practitioner-led Clinic are primary health care models in which Nurse Practitioners work collaboratively with an inter-professional team, including a consulting physician, to provide comprehensive, accessible, and coordinated family health care services to people who formerly did not have access to a primary care provider (i.e. unattached patients). Patients register with the clinic to receive primary care on a long term basis, as in other primary care models. All of Ontario s 25 NPLCs are not-for-profit organizations. Some are led by a community board of directors and, of those community-governed NPLCs, 13 are members of AOHC. 37

38 Information Management Strategy v2.0 Concepts Community Development: CIOR: Community Initiatives On-Line Resource the replacement for the former CI Tool. Capturing evidence of impact on health status of communities. CIW: Canadian Index of Wellbeing is a composite index, composed of eight interconnected domains that measures stability and change in the wellbeing of Canadians over time. These domains include community vitality, democratic engagement, education, environment, healthy populations, leisure and culture, living standards, and time use. The CIW acts as a companion measure of societal progress to the Gross Domestic Product (GDP), which is based solely upon economic productivity. Consumer Health-e Strategy: Personal Health Record: a person can add their own health information and results and share their PHR with other providers as required. A PHR includes a subset of EMR data as well as data fro mother providers such as hospitals, longterm care homes, mental health and addictions, etc. Care Coordination: facilitating a person s journey through the health system. 38

39 Information Management Strategy v2.0 Concepts Integration: OCAN: The Ontario Common Assessment of Need - is a standardized, consumerled, decision-making tool that assists with mental health recovery. InterRAI-CHA: InterRAI Community Health Assessment System is an international collaborative to improve the quality of life of vulnerable persons through a seamless comprehensive assessment system. This is the standardized assessment tool used for Community Support Service programs. OLIS: Ontario Laboratories Information System. ehealth Ontario is leading the implementation of OLIS across the province as part of its provincial ehealth strategy. HRM: Hospital Report Manager is one of the value-added services for clinicians who have adopted an OntarioMD-certified EMR. HRM provides the functionality to receive hospital reports electronically from hospitals or Independent Health Facilities (IHFs) directly into the EMR. This will eventually replace regional solutions such as POI, TDIS and SPIRE. 39

40 Information Management Strategy v2.0 Concepts Integration (con t): IDS: Integrated Decision Support System Clinical Connect: A portal for providers that consolidates client health information across all providers including hospitals, CHCs, CCAC, Long-Term Care and other providers. Care Coordination Tool: Health Links enabling clinical data sharing solution from the Ministry cgta: Connecting Greater Toronto Area, is a regional ehealth solution that will evolve to become the provincial EHR infrastructure. cswo: Connecting South West Ontario, is a regional ehealth solution that will evolve to become the provincial EHR infrastructure. cneo: Connecting Northern and Eastern Ontario, is a regional ehealth solution that will evolve to become the provincial EHR infrastructure. 40

41 THANK YOU / MERCI / MIIGWETCH RODNEY BURNS, BSc (Hons Phys), MHA, CHE, CPHIMS-CA CHIEF INFORMATION OFFICER 41