Connecting South West Ontario Implementation Underway!

May 8, 2014

Welcome

Welcome and Introductions

Murray Glendining Co-Chair, cSWO Steering Committee

President and CEO, London Health Sciences Centre

eHealth Ontario Remarks

Alice Keung Chief Operating Officer

Co-Chair, cSWO Steering Committee David Rounthwaite Chief Executive Officer Designate

cSWO Program Overview

Glenn Holder cSWO Executive Lead

What is cSWO ?

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• Healthcare …silos of providers and organizations …minimal integration of information or services

• unacceptable wait times

• sub-optimal outcomes

• patient safety concerns

• system inefficiencies

• spiraling costs

• Healthcare must become more individual-centered and consumer-driven:

…accessible …integrated …community-based …multi-disciplinary …promote wellness and …self-managed care

…Enabled by eHealth services which provide enhanced

…sharing of information …communications …coordination …between providers and with individuals

Connecting South West Ontario

• eHealth Ontario’s regional eHealth program for South West Ontario

Connecting South West Ontario

• eHealth Ontario’s regional eHealth program for South West Ontario

….created in partnership with the four Local Health Integration Networks and health service providers of South West Ontario ….through an extensive planning exercise involving all stakeholders

Connecting South West Ontario

• eHealth Ontario’s regional eHealth program for South West Ontario

The Program’s immediate priority is the deployment of

eHealth Services which …make an individual’s electronic health care information …from across the continuum of care …accessible in a timely and secure fashion …at any point of care in South West Ontario

Connecting South West Ontario

• eHealth Ontario’s regional eHealth program for South West Ontario

• Services will be used by more than 46,000 health care professionals at approximately 3,500 organizations in South West Ontario

• 3.6 million residents in South West Ontario will have an integrated electronic health record (~100% of local population)

• This is approximately 30% of Ontario’s population.

SWO Health Care Organizations Utilizing cSWO Program

• 68 hospitals (100%)

• 4 CCACs(100%)

• 18 PHUs(100%)

• 2,900 primary care providers

(Physician Offices,

Community Health Centres, Family Health Teams)

• 530 community health

providers (CMHA,LTC,CSS)

Connecting South West Ontario

• eHealth Ontario’s regional eHealth program for South West Ontario

• Alignment is key to success

…with clinical and system priorities of Local Health Integration Networks and health service providers

…With architectures and standards of Ontario’s eHealth Blueprint

Connecting South West Ontario By enabling enhanced models of care, the cSWO Program will Result in Significant and Pervasive Benefits:

Better Care

Improved Safety

Improved Access

Improved Value

Deployment & Program

User Experience

Quality

Timeliness/Value

Strategic/System

Other

1

2

3

4

5

6

Connecting South West Ontario By enabling enhanced models of care, the cSWO Program will Result in Significant and Pervasive Benefits:

Better Care

Improved Safety

Improved Access

Improved Value

Deployment & Program

User Experience

Quality

Timeliness/Value

Strategic/System

Other

1

2

3

4

5

6

IMPROVED VALUE:

Improved patient and user experience

Reduced duplication of laboratory & diagnostic tests

Reduced costs of managing paper records and efficient transfer of accurate information

Improved productivity with cost re-allocation/shifting, possible cost savings

IMPROVED ACCESS:

Improve the breadth and depth of information available for patients across the continuum of care

Better access to services through enabling improved navigation across the healthcare system

Improved provider communications & care transitions across the continuum

IMPROVED SAFETY:

Improved access to important infection control information to protect clinicians and patients

Fewer medical errors

Reduced exposure to inappropriate and duplicate procedures/tests, medication errors, etc.

Where is cSWO at ?

Clinical and System Priorities

• These defined cSWO Program implementation priorities and requirements

• These will drive adoption and realization of clinical and system benefits

• Significant focus on community sectors

1

Transitions and

pathways

from acute care

to community care

2

Integrated,

community-based,

patient-centered

care networks

cSWO Program Plan and Strategy

• Theme 1 – Rapid delivery of value by addressing clinical and system priorities through leverage and integration of existing assets

• Theme 2 – Establish capacity for sustained delivery, expansion and innovation

cSWO Program Governance and Delivery Model

Information Contribution

cSWO Program Management London Health Sciences Centre

cSWO Solution

Delivery Partners

cSWO Change Management & Adoption

Delivery Partners

eHealth Ontario

LHINs

Service/ Information Utilization

Working Groups

Funding, Governance & Management

Delivery

Participating HSPs

Steering Committee

Clinical Advisory Committee

Integrated EHR Services A rich, clinically-relevant set of patient information will be accessible through Regional Clinical Viewer (ClinicalConnect) (and a subset through HRM)

cSWO EHR - Information Available through ClinicalConnect

Data Source Patient

Demographics

Admissions / Visits /

Encounters Laboratory Radiology

Transcribed Reports

Medication Allergies /

Alerts Assessments Immunization

Medical History / Current

Conditions

Care Plans

Hospital Sector

Acute Care HIS HIS HIS, OLIS HIS, SWODIN,

DI/CS HIS HIS HIS

Cancer Care HIS HIS HIS, OLIS HIS, SWODIN,

DI/CS HIS HIS HIS

Complex Continuing Care HIS HIS HIS, OLIS HIS, SWODIN,

DI/CS HIS HIS HIS

Rehabilitation HIS HIS HIS, OLIS HIS, SWODIN,

DI/CS HIS HIS HIS

Community Sector

Community Care Access Centres CHRIS CHRIS CHRIS CHRIS

Community Mental Health and Addictions

IAR IAR IAR

Long Term Care IAR IAR IAR

Community Support Services IAR IAR IAR

Primary Care

Family Health Teams EMR to CDR EMR to CDR OLIS SWODIN, DI/CS EMR to

CDR EMR to

CDR EMR to CDR

EMR to CDR

EMR to CDR

Community Health Centres EMR to CDR EMR to CDR OLIS SWODIN, DI/CS EMR to

CDR EMR to

CDR EMR to CDR

EMR to CDR

EMR to CDR

Other Primary Care EMR to CDR EMR to CDR OLIS SWODIN, DI/CS EMR to

CDR EMR to

CDR EMR to CDR

EMR to CDR

EMR to CDR

Other

Public Health Laboratories OLIS

Community Laboratories OLIS OLIS

Community Radiology SWODIN,

DI/CS SWODIN, DI/CS

Electronic Medical Record Services • Regional Clinical Viewer (ClinicalConnect) Integration

• HNHB – All hospitals / HNHB Regional Cancer Program – 100% • WW – All hospitals – 100% • SW – Alexandra Marine and General Hospital, and Huron Perth

Healthcare Alliance complete, other SW hospitals underway • ESC – Bluewater Health complete, other ESC hospitals underway

• All four Community Care Access Centres – 100%

• Expanded data set

• Ontario Laboratory Information System (OLIS) connected

• Family Doctors Receiving Hospital Information • Electronic Medical Record Download/Hospital Report Manager

Readiness project live in the ESC

• Primary Care Data Repository Pilot planning underway

Change Management & Adoption Capacity

• The cSWO Program has built on the existing capabilities and relationships of a network of CM&A Delivery Partners for:

• Ongoing health service provider engagement and communications

• eHealth deployment and adoption planning

• Health service provider readiness assessment and gap remediation • Data sharing agreements • Privacy and security • Health Information Management/Data Quality

• Coordinating/supporting deployments

• Facilitating clinical and system change management

CM&A Delivery Partners • Erie St. Clair: TransForm

Shared Service Organization

• South West: South West Community Care Access Centre

• Waterloo Wellington: The Centre for Family Medicine Family Health Team

• Hamilton Niagara Haldimand Brant: Hamilton Health Sciences

Looking Ahead

• Continue with planned EHR integrations and implementation of eHealth Cornerstone Solutions

• Execute change management and adoption plans

• Initiate Benefits Measurement Program

• Implement ongoing planning/prioritization processes

• Transition to long-term sustainable Program Model

• Respond, Evolve, Innovate

Marzena Cran, RN Education & Development Clinician Hamilton Niagara Haldimand Brant Local Health Integration Network eHealth Office

cSWO Change Management & Adoption Delivery Partners

TransForm Shared Service Organization

Paul Audet Chief Information Technology & Security Officer and eHealth Lead

South West Community Care Access Centre

Nancy Dool-Kontio

Senior Director, Strategic Planning and Integration

South West Successes To Date

• Leveraging existing strategic and operational partnerships in the health care system throughout the entire SW region: • 30 Hospitals • Primary Care • 73 Community Agencies • 36 Mental Health & Addiction Agencies • 78 Long Term Care Homes • 9 Public Health Units

South West Successes To Date

• Working collaboratively with other system-wide initiatives:

• Partnering for Quality

• Health Links

• Access to Care

• South West Self-Management

• SWO eHealth Coordinating Committee

South West Successes To Date

• Demonstrating established expertise in project management, change leadership and performance measurement

• Leveraging insights from Partnering for Quality EMR Needs Assessment to match identified gaps in information access/information management with suitable cSWO solutions

• Readiness Assessment pilot

The Centre for Family Medicine Family Health Team

Dale Maw cSWO Project Director

Waterloo Wellington Successes To Date •The Centre for Family Medicine FHT has been

deploying ClinicalConnect to health service providers in the WWLHIN since April 2012 through a cSWO Foundation Project called Project Cultivating Adoption of Regional eHealth (CARE) • 34 Health Service Provider organizations signed up as ClinicalConnect Data

Sharing Agreement Partner • Over 3300 user accounts registered to use ClinicalConnect • The first Long Term Care Facility, Nurse Practitioner Led Clinic, and Midwifery

Practice using an EHR in Ontario • Focus on adoption and clinical change management • Research and focus on benefits evaluation and realization • Presented at national and international meetings including eHealth 2013 in

Ottawa, ITCH 2013 in Victoria, HIMSS13 in New Orleans

Waterloo Wellington Successes To Date

•The success of Project CARE is the foundation for Waterloo Wellington cSWO Phase 3 Planning

•Project CARE closed January 2014 and has been merged with the Waterloo Wellington cSWO Phase 3, Implementation – the work continues

• Since November 2013

• Follow up/refresher training and ongoing support for over 250 ClinicalConnect users

• Pharmacy data available in ClinicalConnect from Grand River and Guelph General Hospitals

• Pharmacy data tested for St Mary’s General and Cambridge Memorial Hospitals

• Since January 2014

• First Public Health Unit using ClinicalConnect

• 3 new organizations and 5 new hospital departments using ClinicalConnect

• 5 new organizations introduced to ClinicalConnect

• 3 new organizations applied for partnership status – including the first sports medicine clinic and a multi-LHIN long-term care organization

• Hospital Report Manager integration with the hospitals understood and moving forward

• Hospital to Ontario Laboratory Integration System (OLIS) Integration – hospitals & OLIS team engaged and moving forward

• April 2014

• Over 60 solo practitioners contacted regarding ClinicalConnect access

• Go forward plan: Keep doing what we’re doing

Waterloo Wellington Successes To Date

Hamilton Health Sciences

John Haywood Program Manager

• Recent Integrations • Private Lab Data from Provincial Lab Repository (OLIS) aggregated

with existing Hospital Labs

• Hospitals in Erie St. Clair and South West LHINs

• CCACs in Erie St. Clair and South West LHINs

• Additional Community Care Access Centre (CCAC) data from all four south west CCACs

• Patient header flag identifying Hamilton Niagara Haldimand Brant) Health Links patients

• Health Outcomes for Better Information and Care (HOBIC) Nursing Assessments

• Other Enhancements • Self-Service Password Manager for non-Hamilton Health Sciences users

• High Availability Infrastructure to support expansion

Other In-Progress Initiatives

• OLIS Data Collection project underway • Leveraging ClinicalConnect to feed HNHB hospital

labs to Provincial OLIS database vs. separate hospital integrations

• Integration between ClinicalConnect and South Western Ontario Diagnostic Imaging Network (SWODIN) • Pilot Go-Live for Joseph Brant Hospital and Norfolk

General Hospital images targeted for mid 2014

Meeting Business Service Requirements

• Expanded Training Services • Boot camps and support for Change Management & Adoption

Specialists

• Privacy Officers, Auditors, Local Registration Authorities

• Updated training materials

• Integrated training schedule

• Integrated Communications with Delivery Partners

• Implemented new communication process with Delivery Partners to share integration announcements

Meeting Business Service Requirements

• Additional resources in support of Service Delivery Planning, Project Delivery, Change Management, Privacy & Security, Electronic Health Record Support

• Affiliate Physician Process in place at Hamilton Health Sciences (HHS)

• Alternative for non-credentialed physicians in HNHB and WW to gain access to ClinicalConnect

• The Affiliated category is not intended to replace the current credentialing processes at HHS or other organizations in HNHB and WW LHINs, but rather offer an alternative method for physicians to obtain access to ClinicalConnect

• Process details have been shared and are available for other partners to leverage

• Currently several partners are adopting similar affiliate credentialing processes

HNHB Successes To Date

•Expanded Change Management team to roll out engagement strategy

• Onboarded additional health service providers since January • 6 Family Health Teams

• 2 Community Health Centres

• Developed confirmed list of Health Service Providers that meet criteria for deployment

• Successful in identifying 75% of primary care physicians

HNHB Successes To Date

Brant Six Nations Bridges Community Health Centre

St. Joseph’s Hospital Community Mental Health & Addiction

Halton Family Health Centre

Caroline Family Health Team Hamilton Family Health Team

Niagara Falls Community Health Centre

Canadian Mental Health Associations Hamilton Branch

West Niagara Mental Health Unit

• Stakeholder Engagement schedule developed and initiated

• Meetings with Primary Care and Community Sector providers, as well as Public Health Units, are underway

• 9 Kick Off Meetings in 2014

• Continued engagement with Solo Practitioners at local Academy Days

HNHB Successes To Date

•First group of readiness assessments completed for: • Primacare Family Health Team

• Caroline Family Health Team

• Grand River Community Health Centre

• Halton Family Health Centre

• Brant Community Healthcare System Mental Health & Addictions Services

• West Niagara

• 7 Solo Practitioners

• 157 Readiness Assessments in progress

HNHB Successes To Date

• Conducted Needs Assessment Survey and Workshop with participants from all LHINs in support of advancing Health Links initiatives

• Facilitating change opportunity by participating in HNHB Stop the Paper initiatives

Closing Remarks

Murray Glendining Please join us for refreshments.