DEMYSTIFYING ELECTRONIC HEALTH Presented to Central East LHIN Board of Directors. January 22, 2014

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1 DEMYSTIFYING ELECTRONIC HEALTH Presented to Central East LHIN Board of Directors January 22, 2014

2 What is ehealth? What is an Electronic Health System? EHR, EMR and PHR / CIS/HIS Where does the electronic information come from? What role does the data contributor play in the electronic health record? EHR: Consumers, Care Providers, and LHINs Population Health Management Central East LHIN Drivers 13/15 What initiatives will have the most impact the Central East LHIN in the next 1-2 years Group Discussion 2

3 What is ehealth? 3-3 -

4 ehealth is an overarching term used today to describe the application of information and communications technologies in the health sector. It encompasses a whole range of purposes from purely administrative through to health care delivery. 4

5 For example: Within the hospital care setting, ehealth refers to electronic patient administration systems; laboratory and radiology information systems; electronic messaging systems; and, telemedicine -- teleconsults, to name a few. Within the home care setting, examples include teleconsults and remote vital signs monitoring systems used for diabetes medicine, asthma monitoring and home dialysis systems Within the primary care setting, ehealth can refer to the use of computer systems by general practitioners and pharmacists for patient management, medical records and electronic prescribing. 5

6 A fundamental building block for all of these applications is the Electronic Health Record (EHR), which allows the sharing of necessary information between care providers across medical disciplines and institutions. Other important uses of ehealth are found in the areas of continuous medical education and public health awareness and education. 6

7 What is an Electronic Health System? 7-7 -

8 The interoperability, how everything connects to and works within all of the information management systems that contribute to and ultimately inform and shape the Electronic Health Record. 8

9 EHR, EMR, EPR, CIS, HIS & PHR? 9-9 -

10 Electronic Health Record (EHR) a systematic collection of electronic/digital health information about individual patients or populations. designed to contain and share information from all providers involved in a patient s care may include demographics, medical history, medication and allergies, immunization status, laboratory test results, radiology images, vital signs, personal statistics like age, weight and broader social determinants of health. 10

11 Electronic Medical Record (EMR) a digital version of a paper chart that contains a patient s medical history from one practice/organization. used by healthcare practitioners to document, monitor, and manage health care delivery within a care delivery organization. Electronic Health Records (EHRs) are reliant on Electronic Medical Records (EMRs) being in place, and EMRs will never reach their full potential without interoperable EHRs in place. Do not confuse EMR with a CIS - Clinical Information System 11

12 Electronic Patient Record (EPR) A hospital or clinical organizations record of a patient. May be both paper and electronic used by healthcare practitioners to document, monitor, and manage health care delivery within a care delivery organization for a period of time. There may be multiple versions varying from organization to organization Not a complete record. 12

13 Personal Health Record (PHR) a health record where health data and information related to the care of a patient is maintained by the patient. intention of a PHR is to provide a complete and accurate summary of an individual's medical history which is accessible online. a PHR could include allergies and adverse drug reactions, chronic diseases, family history, illnesses and hospitalizations, imaging reports, lab test results, medications and dosing, prescription record, surgeries and other procedures, vaccinations and, observations of daily living. 13

14 Clinical or Hospital Info System (CIS/HIS) Clinical information system is a technology based system applied at the point of care and designed to support the acquisition and process of information as well as providing storage and processing capabilities. It includes a collection of various information technology applications that provide a central repository of information related to patient care across distributed locations A Hospital information system is a comprehensive, integrated information system designed to manage all the aspects of a hospital operation, such as medical, administrative, financial, legal and the corresponding service processing. Traditional approaches encompass paper-based information processing as well as resident work position and mobile data acquisition and presentation. CIS / HIS includes the patient information as well as the connectivity to other systems related to the delivery of care (incoming and outgoing) 14

15 Where does the electronic information come from?

16 Data Contributors: Community Care Access Centres (CCACs) Community Support Providers Clinicians Hospitals Clinics Patients Public Labs Long Term Care Homes Pharmacies Tele Care Electronic Health Record 16

17 What role does the data contributor play in the electronic health record?

18 Patient Electronic Health Record Identity Management Integration Layer Care Provider/Organization LHIN(s) Health Information Custodians (HICs) from various sectors capture and hold the health information Hospital Clinicians Clinics Patients Public lab CCAC Pharmacy Housing Public Health Tele Care Community Support Providers Ministry of Children and Youth, Justice and Employment Pharmacy Long Term Care Other Sectors Health Information Custodians (HICs) 18

19 Identity Management In the banking system you are not continually asked to login and verify who you are; you can access your information and work with the bank on-line (i.e. Credit application;) Health care access and use of data is not there yet. Integration Layer Chequing Savings TFSA Visa MasterCard Amex Home Ins Life Ins RRSP RESP Stocks Reuters Tax Advise Investment Tools Education Tool Kits General Information Example Banking Industry 19

20 Ontario has a target to deliver all components of the ehealth Blueprint by DRAFT CONFIDENTIAL - Not for distribution

21 End User components establish point of service applications to provide access to key data and functions requiring focus on increasing adoption over time End User Access Integration Layer EHR Data 21 DRAFT CONFIDENTIAL - Not for distribution

22 Ontario ehealth Blueprint - sectioned END USER ACCESS Portals (i.e. cgta, Clinical Connect), Consumer Health Portals (Health Care Connect, Health Options Kiosk) Multiple access points (hospitals, MOH, Laboratory, Telemedicine, Mobile, Home, Community Services Includes: access applications and tools (forms), points of care and service INTEGRATION LAYER Registry Services, Wait List (CCO), Provincial and Regional Hubs Includes Identity Mgmt., Authentication, Auditing, Info Security DATA LAYER (SHARED RESOURCES) Standards ehealth network and infrastructure Reference Libraries Registries (EMPI- Patient Index, Provider Doctors) Regional Data Systems (OLIS, PACs, Immunization, Hospital Report, Population Health 22 DRAFT CONFIDENTIAL - Not for distribution

23 EHR: Why is it important to Patients

24 Electronic Health Record Patient Example Physician EMR 24

25 EHR: Why is it important to Care Providers

26 Electronic Health Record Care Provider/Organization EHRs allow providers: Access to patient history and visit information from multiple sources Aggregate data for trends (i.e. infection control) Alert provided to anomalies - receive notification or alerts if patients are out of norm (i.e. Vitals) Example - EHR 26

27 EHR: Why is it important to LHINs

28 Electronic Health Record LHIN(s) 28

29 29

30 In the next 24 months, what are the initiatives that will have a significant impact on Central East LHIN? 30

31 1. Coordinated Care Tool (CCT): In conjunction with Health Links, the CCT will be an electronic method of viewing and updating the care plan that will be fed from other health systems to populate the data. 2. CIS / HIS Refresh: Hospitals will go through a process to procure and implement and transition to a new system which will provide enhanced function including physician documentation. 3. CONNECTING GTA: Connecting GTA provides a central repository for the Central Ontario cluster of patient reports from Hospitals, CCACs, Long Term Care Homes, Family Health Teams, and provincial repositories including OLIS with viewer access to a patient s collective information. 4. HRM / TDIS: Hospital Report manager will provide hospital and cgta data input directly into the physician EMR 31

32 What else will be in the pipeline in the next 24 months? 32

33 Central East LHIN Strategic Aims Reduction of demand for Long Term Care so seniors spend 320,000 more days at home in their communities by 2016 Continued improvement of patient Vascular Health so they spend 25,000 more days at home in their communities by 2016 Strengthen the system of supports for people with Mental Health & Addiction issues so they spend 15,000 more days at home in their communities by 2016 Increase the number of palliative patients who die at home by choice and spend 12,000 more days in their communities by To support these drivers, IM/IT opportunities have been developed to support the following IM/IT strategic directions: Ensure infrastructure and enablers are in place to achieve LHIN strategic initiatives Improve information sharing across the continuum of care Improve access to information required to manage the health system Improve the efficiency and effectiveness of health system resources 33

34 Central East LHIN / CLUSTER DELIVERY List of Projects (from Deloitte work 2012) Based on the Deloitte ehealth Services Strategy (2012) the initiatives listed to the left are in various stages of involvement for Central East LHIN. It is based on the development planning for the Central Ontario Cluster (6 LHINs). The level of involvement is identified for the Central East LHIN from full delivery in the LHIN to awareness of other LHINS implementation. In 2014, funding changes will allow the cluster to undertake a three year planning cycle and allow for longer project cycles and improved planning of activities. 34

35 Questions? 35

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