ce ehealth update - central east lhincentraleastlhin.on.ca/.../ehealth_-_board_presentation_.pdf ·...

CE eHealth Update A Primer and Overview

Presented To:Central East LHIN Board of Directors

October, 2010

AgendaAgenda

1. eHealth Ontario Update

2. Who is eHealth in the CE LHIN?1) Team; Committees; Collaboration2) Funding Sources3) What we do; Strategy, Projects, Support, Communication

3. Key projectsDeep Dive

4. Future Directions

For Information other projects at end of presentation

NOTE: Definition of acronyms attached to presentation.

3

• Baseline Dataset• Diabetes Registry

• EMR interoperability with Diabetes Registry

• OLIS interoperability with Diabetes Registry

Diabetes Management• ePrescribing Demonstration Project

• Drug Information System (DIS)• Drug Profile Viewer (DPV)

• Systemic Treatment Computerized Physician Order Entry (CPOE)

Medication Management• eReferral and Resource Matching

• Emergency Department Reporting System (EDRS)

• Wait Time Information System (WTIS)

Wait Times

CLINICAL PRIORITIES

FOUNDATIONAL PRIORITIES

Cornerstone Information Systems• Client, Provider, User, Consent Registries

• Portal• Health Information Access Layer (HIAL)

• Physician eHealth• Ontario Lab Information System (OLIS)

• Telemedicine• Consumer eHealth

Clinical Activity Information Systems• Diagnostic Imaging/PACS

• Chronic Disease Prevention and Management/Colon Cancer Check

• Hospital Information Systems• Electronic Child Health Network (eCHN)

• Performance Management Systems(Critical Care Information System,

CCIS; Surgical Efficiency Target Program, SETP; Community Care Information Management, CCIM)

• Community CareAccess Centres Systems

Ongoing Development to Support Future Clinical Priorities Beyond 2012 toward an EHR in 2015

Technology Services• Data Centre

• Network• Email

• User Support•

Authentication/Registration• Application Maintenance

Enabling Practices And Talent Management • Procurement and

Contract Management• Program Management Office

• Architecture and Standards Development and Maintenance

• Privacy• Metrics and Benefits Measurement Program

• Data Quality Improvement Program

• eHealth Human Resources Expansion Program

eHealth Ontario Strategy

eHealth EnablesCE eHealth Vision: Better eHealth = Better Health

1. Bring Providers Together:Lead Collaboration and Integration of Health Technology

2. Lead and Support Projects to drive Strategies (eHealth Ontario (EHO), LHIN, Central East Executive Council(CEEC):

1. Support of LHIN / CEEC Initiatives2. Project Management (CE LHIN and external partners)

3. Support and Develop eHealth Best Practice/ Standards including:1. Project Management 2. Clinical Documentation 3. Technology Delivery 4. Technology Integration

4. Communicate and Educate the system Providers and Community on eHealth

April 2007 April 2008 April 2009 April 2010 April 2012

Central East LHIN/ e-Health Implementation Road Map

Consumer Portal #1

Clinical Viewer #4

Patient Scheduling #1

Scanning #1

SharePoint #5

e-Library #5

Staff Portal #5

e-Referral #1 ALC Resource Matching and Referral

Telemedicine #1

Decision Support #4e-MAR #4

Infection Control #4

Positive Patient ID #4

Pharmacy #4

Data Centre #1

Dictation/Trans. #2

Quality / Risk #4

Data Warehouse #4

Order Entry #4

Patient Registration #2

Case Mgmt. #1

Office Systems #2

VOIP #2

HOBIC Clinical Documentation #4

Emerg Dept IS #1

Staff Scheduling #5

Human Resources #2

Financials #2

Kiosks #1

Dialysis #1

Case Costing #2

Work Order #2

Payroll #2

Materials Mgmt #2

CPOE #4

Telecomm #2

Coding #2

Drug Profile Viewer #4

Radiology #1

PACS #1

Year 1 Year 2 Year 3 Years 4 & 5

OLIS #1

EMPI #3

Wait Times IS #3

Operating Room #1Resource Database #3

Meditech #1

Shared Project Management

Network uplift project

6

Diabetes Pilot

TDIS Project

CGTA

Credentialing

Community ehealth

Arrows mark projects by Key Sponsor CEEC, Ehealth, LHIN, Partnership

1) Team, Committees, Collaboration

Carolyn Kanhai, EA to L. HooperMarlene Ross, Sr. Project MgrKarol Eskedjian, Sr. Planning Mgr

2) Funding/ Budget

ePMO –manages

and oversees projects

DCC• Funded by

Hospitals, OntarioBuys, Ministry of Health

HITSS• Funded by

Hospitals

eReferral• Funded by

eHealth OntarioTDIS• Funded by

eHealth Ontario under cGTA initiative

etc

ePMO is funded by eHealth Ontario to build infrastructure (such as personnel, office rental all expenses associated with maintaining ePMO)

to support the implementation of Provincial eHealth strategies

What We DoeHO

Initiatives

CEEC

Multi-LHIN Projects

CE LHIN Initiatives

• HIS Consolidation• Joint Procurement• Eclipse• SharePoint Project Site• Hospital IT Shared Services

• Readiness Initiatives (Diabetes Strategy)

• eReferral – Primary Care• RM&R - ALC Referral• Provincial Specifications• TDIS (Phase I / II)

• DCC• Privacy / Security - OLPP• RM&R• LHIN Shared Services• eReferral – Primary Care• CGTA

• eHealth Steering Comtee • Hospital IT - Committees• PCWG – Regular updates• Coalition Committees• Community Consultation• Symposium • Surveys / Validation• Newsletter/ Website• Project Support

TDISThese are a few Key Projects of CE eHealth team:

1. TDIS2. DCC3. eReferral: Primary Care4. Community Services eHealth5. Hospital IT Shared Services

What is TDIS?

Project Goals and Objectives:

To ensure family doctors and other community physicians received information concerning a patient’s hospital stay within 72 hours of discharge from the hospital

TDISEnhancing the Continuity of Care

Facility Vendor Practice Name # PhysiciansPeterborough PSS Peterborough Family Health Team 16

Community & Lakefield 23JONOKE Medical Centre on Charlotte 18Nightingale Greater Peterborough Family

Health Team25

TSH Health Screen

Dr. Rana, Dr. Chris Jyu

Others to be identified by the Vendor.

64

LHC PSS Bowmanville Clinic 30Oshawa Clinic 55

JONOKE Glazier Clinic 27Medical Associates Port Perry 30Brooklin Medical Centre 9

Rouge Valley PSS West Durham Family Health Team 7

Pickering Village Family Health Team

1

Nightingale Drs. Mohan and Nazareno 2Dr. Asano 1

Total 292

Phase I (Pilot) Phase II (Expansion)

Extend the system to additional Facilities:3 Hospitals:

•Ross Memorial, •Ontario Shores, •Haliburton

1 CCAC,2 CHCs, and additional primary care physicians (approximately 200)

Yellow: Live

Others: Go Live by End of November


When Complete:•All CE LHIN Hospitals will be transmitting discharge summaries electronically to participating community physicians office either through Fax, or directly into the CMS

TDIS - Proposed Migration Strategy into the cGTA solution


Data Centre ConsolidationThese are a few Key Projects of CE eHealth team:


Short Term To establish “Gold Standard” to enable HIS application integration To provide safe, secure and redundant (Tier 3] Data Centre for our Hospitals To create a governance model to execute the Data Center Consolidation project and

create the organization to manage the ongoing services To explore available Funding from eHealth and Ontario Buys

Medium Term HIS application consolidation planning and implementation

Long Term Further consolidations of commodity based IT applications and services

Data Centre Consolidation

DCC Strategic Imperatives

16

Data Centre Consolidation Collaboration18 Hospitals, 4 LHINs (CE, C, SE, WW)

Potential Early Adopter

LHIN Hospital

CE Campbellford Memorial HospitalCE Haliburton Highlands Health ServicesCE Lakeridge Health CorporationCE Ontario Shores Centre for Mental Health SciencesCE Peterborough Regional Health CentreCE Ross Memorial HospitalCE Rouge Valley Health SystemCE The Scarborough Hospital

LHIN Hospital

SE Brockville General Hospital

SE Lennox and Addington County General Hospital

SE Quinte Health Care

LHIN Hospital

C Southlake Regional Health CentreC Stevenson Memorial HospitalC York Central Hospital

LHIN Hospital

WW Cambridge Memorial

WW Grand River Hospital

WW Guelph General Hospital

WW St. Mary's General Hospital

Server Consolidation

Storage Consolidation

Network Consolidation

Data Centre Consolidation Application Consolidation Shared business process

Email, Directories, etc

Interoperable & Scalable

Integrated EHR:• Enable new

services• Facilitate flow

of patients

Health Systems Technology Consolidation

Technology Consolidation Business Case

Work Flow Alignment

Standard Processes &

Best Practices

• Shared Services• Improved health

data & quality indicators

• Reduced Risk & Medical Error

• Automated Processes

Benefits

Time / Disruption

Integrated delivery of careApplication Consolidation HIS and Commodity products

Val

ue a

nd C

ost

Savi

ngs

eReferral – Primary Care to SpecialtyThese are a few Key Projects of CE eHealth team:


eReferral - Primary Care

Primary Care

Purpose / Objectives: Support Physician adoption of eHealth Facilitate electronic referral from primary care to specialists

Streamline and expedite process Improve Data Quality and eliminate error and rework Develop Physician Two Way Communication Decision Support for Primary Care (who is being seen by whom and when)

Stakeholders: Primary Care / Family Physicians Specialists / Specialty Service providers Central East LHIN / South East LHIN eHealth Ontario

Expected Outcomes: Automated referral system for two pilot pathways

(SE – Total Joint Replacement, CE – Mental Health Tertiary Services, Generic path) Decision Support tools for Primary Care for each pathway (checklist / assessments) Catalogue of physicians, their services, and approx. wait times Tools to further develop pathways within the LHINS

eReferral - Primary CareStatus as of October 2010:

Vendor Selection completed – Navantis Inc. Data Gathering process (Definition Stage) for design specs Integration discussion (for EMRs and HIS systems) EOI for Primary Care participation by CE LHIN

Approval of Project

(02/10)

RFS Info

Gather(03/10)

Vendor selection

(6/10)

CE LHINPath

Decision(7/10)

Project Start (8/10)

Project Design ( 11/10)

Project Build

(02/11)

Testing / Eval.

(03/11)

Close out

(April 2011)

Project Schedule

Primary Care

Community eHealth SupportThese are a few Key Projects of CE eHealth team:


Community eHealth SupportPurpose / Objectives: Recognized Community Sector(s) not sufficiently represented in eHealth Strategic Plan Community Consultation process by eHealth Team (begun 2009) Ask the CE community Sectors

• “How can eHealth Help you improve the delivery of care? What needs to be incorporated into the updated Strategic Plan?

Phase I: Engage stakeholders Phase II: (through Task Group) recommendations of initiatives; initiative detail

and priorities / ranking according to sector(s)Stakeholders: Long Term Care CCAC CHCs Community Care In-Home Services Initially Physicians and Pharmacy – Not able to attend

Expected Outcomes: Better understanding of community Sector(s) eHealth needs and how to support; Initiatives and that would support (detail on what / how) and priority/ rankings Methodology to engage community and develop “readiness” of community sector(s) Information on how to incorporate Community Sector(s) providers into Strategic Plan

Community eHealth SupportTASK GROUP RESULTS

1. 34 Recommendations / Initiatives 2. 5 Proposed Strategies to support Sector(s)3. Identified Issues and Barriers for Sector(s)

Incorporate into eHealth Strategy & Implementation

Proposal Review; Funding & Approval

• No Cost• Quick Time Frame• Minimum Resource“ Low Hanging Fruit”

• Limited Cost• Into Current Projects• Part of Initiatives“Integrated Results”

• Need to Source Funds• Develop from ‘0’ • Highest Resource

“New Initiatives”

#1 – EASY #2 – INCORPORATE #3 – NEW

eHEALTH STEERING COMMITTEE The Task Group presented their results presented to the Steering Committee - May, 2010; Recommendations were ranked (Task Group) in order of priority/ importance to sector(s) Recommendations reviewed / evaluated by committee; and divided to 3 categories:

#1 being implemented, #2 being incorporated, #3 developing new project

Hospital IT Shares Services1. TDIS2. DCC3. eReferral: Primary Care / RM&R 4. eHealth Community Consultation5. Hospital IT Shared Services

Hospital IT Shares Services

• Hospital IT Shared Services• Purpose and Objectives: Develop a shared IT/IM function

between the Hospitals in the Central East LHIN, that will enhance the capacity of the organizations to implement and optimize eHealth initiatives

• Stakeholders: All public hospitals in the LHIN.• Expected Outcomes/Deliverables:

– MOU between participating Hospitals– Governance and management structure created– Implementation of shared IT/IM services– Enhanced capacity for IT/IM services in the CE LHIN– Adoption of best practices to improve quality of patient care

and safety.

Background• The Hospital CEO members of the CEEC

expressed an interest in the development of a

model for CE LHIN Hospital IT Shared Services

(HITSS). Seven of the nine hospital members

have signed a letter of intent, to develop a

business case and business/ enterprise model for

Shared IT services. Discussions with the remaining

two are underway.

27

Future DirectioneHealth Strategic Plan – Refresh

Retain Vision: BETTER E-HEALTH = BETTER HEALTH

Retain Plan Overall Strategies

Redesign Plan: less visionary and more action/ focused on needs

AUTOMATE, COLLABORATE, INTEGRATE AND COMMUNICATE Incorporate Change Since initial Strategic Plan:

Updated IHSP Shared Services model for Hospitals Include Community Services Primary Care – eHealth Adoption Changes to eHO Strategic Direction (Diabetes Registry)

Questions ?

Current CE eHealth Projects (as of October 2010)

1 ALC Tracking Tool (Support)A gap has been recognized in the understanding and gathering of ALC data from hospitals in a timely manner. Currently the data from CHI is 60 - 90 days later and the standards for reporting are inconsistent. Proposed project to automate nightly census data from all hospitals to a repository containing DE-IDENTIFIED data is supported by CE eHealth through planning work (i.e. Business case, project charter, evaluation of other current initiatives in the province.

2 CCAC -Product Support / Engagement (Support)Arising from recommendations of eHealth Community Consultation Task Group, CE eHealth is supporting CCAC initiatives (i.e. communication automation; vendor agreements for hardware and potential for hosting).

3 CCIM (Support)Support of CCIM's three Products: HIM, MIS, OCAN; projects to increase adoption of a standardized product for community based health care providers (non-physician). In order to increase the adoption rate in the CE LHIN, eHealth has agreed to support through communication and joint forums the project teams.

4 CHC Support IT (Lead)Review of methods to support CHCs in the automation and IT shared services models. This is in keeping with inclusion of other sectors in the eHealth Strategic Plan Refresh.

5 Clinical Doc Standards (Support)Support of the eCAG (Central East LHIN Electronic Clinical Advisory Group), the eHealth team organizes, supports, and participates in monthly meetings with a goal to improving and standardizing clinical documentation and moving toward electronic format of this documentation.

6 Connecting GTA (Oversight / Strategic Planning) (Support)Joint project of GTA LHINS (5) health service providers and clients to develop a HIAL (application connection), and common portal. The CE LHIN Regional CIO is currently the Chair of the Steering Committee; there are CE LHIN providers on the Technical and Business sub-committees; and the TDIS Phase II project is being funded through this project as a “clinical value project” in 2010 – 2011.

7 Continuity of Care Repository (Lead)Explore the potential of a single repository that would provide access to “continuity of care” documentation; standardized information that would move with the patient between providers and HSPs.

8 Data Centre Consolidation (DCC) (Lead)Project to consolidate eHealth Services across Central East LHIN. This includes a single data centre, a single hospital information system and a consolidated department of services. This will not only create a shared eHealth record, but will allow us to create common business process and shared workflows, allowing for improvement in health care delivery in the LHIN through integration.

GREEN = ACTIVEYELLOW = On-HoldBLUE = CandidateLEGEND:

Current CE eHealth Projects (continued)


9 DPV – Extended (TBD)Drug Profile Viewer was completed for all CE Hospital Emergency Departments in 2009. Subsequent phase would extend the DPV to other providers / sectors (likely beginning with CHCs and potentially LTC organizations. CE eHealth has requested sites as pilots within the CE LHIN.

10 Eclipse - Move to OACCAC (Lead)A Portfolio Project Management application used in the CE LHIN to support standardized project management process throughout and enable senior teams to see "rolled up" status on projects, funds, resources, and time. Instituted in the CE LHIN in 2008; this project will move the application from an end of life server with upgrade requirement s to a secure, new, web base, with formal technical support to the OACCAC (already house NSM enterprise edition.

11 Eclipse PPM - Support and Traction (Lead)The CE eHealth team support s standardized project management process and methodology throughout the CE LHIN provider community through continued development and management of the framework for centralized support and increase usage and knowledge within PM roles in the CE LHIN .

12 Education / Awareness (Lead)Part of the CE eHealth Team mandate is to provide awareness and education of eHealth to the CE LHIN. This project includes initiatives including technology education, technology initiatives awareness, and forums for increased understanding of technology as enabler to improved delivery of healthcare.

13 eReferral (Primary Care) (Lead)eReferral Primary Care is a pilot project to automate the referral process from Primary Care physicians to a specialist physician or specialty services. The objectives include: support for primary care decision making, a catalogue of available specialists and work, wait times and pre-requisites required to complete the referral.

14 Hospital IT Shared Services (TBD)The CEEC has agreed to pursue a Hospital IT Shared Services Model. CE eHealth will support a Steering Committee to develop the and implement the project.

15 Info Sharing Framework (multi-LHIN) (Support)

16 Joint Procurement – RFP (Support)CE LHIN Hospital IT Directors are joining with Lakeridge Health and Rouge Valley to tender an RFP to supply small technology (laptops, desktops etc.) This project objectives include: cost efficiencies, deployment of hardware support, asset management and greening methods for disposal of equipment..



17 MedSeek Portal (TBD)IM/IT Advisory Committee requested to pursue use in CE LHIN for hospitals. Currently used by Scarborough Hospital for LTC, and in new venture with RVH and LHC for Oncology. CE eHealth is developing proposal to make use of current licenses in CE LHIN, and use of Hamilton Health Sciences work with MedSeek.

18 Multi-LHIN Meditech Strategy (Support)Exploring Multi-LHIN Meditech strategy from financial and technical perspective with Champlain and Waterloo Wellington.

19 MVLS - Hospital - 6 Yr plan (Lead)MVLS is the Enterprise Microsoft Agreement that was a previous project in the CE LHIN. All hospitals have a purchasing agreement under a single license from 2009 - 2011. In addition the hospitals selected a single LAR to purchase and support all 9 hospitals. Microsoft has come to the IT directors (June 2010) to review and determine if the hospitals want to move to a 6 year agreement of enterprise desktop that would keep costs for Microsoft products static. This project will be revisited in October during hospital financial planning phases.

20 MVLS – Providers (hospital and non-hospital) (Lead)MVLS exists (year 2 of 3) for Hospitals. Regular review is undertaken on efficiencies, and gains with license and subsequent reseller contract. In addition, the project is designed to develop and provide an MVLS that other non-hospital health care providers can participate in and receive the cost benefits.

21 NPSTAT Tracking Tool Export (Support)Support for Nurse Practitioner program for one NP who currently enters all data into Practice Solution – CMS and eliminate the duplication into the Excel tool tracking NPSTAT work. This is a one time, short term project of support.

22 OLIS - Data Express Use – Review (Support)Exploring the possibility to expanding the work currently underway at TDIS project using Data Express solution to provide interface from hospital Health Information System to physician CMS.

23 OLIS - Meditech Interface (Support)Exploring the possibility to expanding the work currently underway at TDIS project using Data Express solution to provide interface from hospital Health Information System to physician CMS.

24 OLPP - Multi-LHIN Privacy Strategy (Support)CE eHealth is participating in a multi-LHIN project to develop a privacy framework for LHINS including: governance and oversight, Education, and Tools to support providers. CE eHealth team member is on the steering committee, and privacy and providers are on sub-committees.

25 ONE Mail (Support)Support to eHealth Ontario and the consultants working to extend secure email to providers. The CE eHealth Team helps identify providers and provides connection and contact information between eHO and the CE LHIN providers



26 Physician eHealth Adoption (TBD)The LHIN eHealth team recognized a need to support eHealth adoption within the LHIN to a) improve the awareness and readiness for physicians use of technology in their care delivery and b) to develop and increase the standards in technology to support collaboration and integration of physician used systems.

27 Regional SharePoint (Lead)CE LHIN eHealth Strategy (2007 - 2010) included the development of a regional SharePoint platform to collaborate and share information. Currently housed at TSH and in a "bare bones" initial stages, the site houses 12 committees or projects (including multi-lhin projects) to provide a central place to collaborate and share information. Phase II for the platform is being developed in 2010.

28 Shared Services (LSSO) (Support)

29 Streamlined LHIN Reporting (TBD)As response to the community consultation recommendations, proposal development to support community providers in streamlining the reporting required to the LHIN and to the Ministry.

30 TDIS – Phase I (Lead)Timely Discharge Information System (TDIS) pilot was the first phase of the project that enables the timely delivery of hospital reports from participating hospitals to patient’s primary care physicians within the community. The efficient exchange of these reports creates a smooth transition for patients leaving the hospital and improves the continuance of care amongst community physicians.

31 TDIS - Phase II (Lead)Phase 2 of TDIS involved the expansion of the project pilot to include additional LHIN hospitals: Ross Memorial, Haliburton Hills and Ontario Shores regardless of the legacy hospital information system; as well as potentially 1 CCAC and 2 CHCs. The project will encompass the expansion in the number of CMS vendors and thus participating primary care physician offices throughout the LHIN. A review and revision of the Privacy Impact Analysis and Threat Risk Assessment from Phase 1 will be required. Investigation, specification and costing of the non-MEDITECH interfaces will be required. Phase 2 will also include the implementation of Admissions/Discharge/Transfer notification at all LHIN hospitals

32 Wait Times System (TBD)

ce ehealth update - central east lhincentraleastlhin.on.ca/.../ehealth_-_board_presentation_.pdf ·...

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