Manitoba eHealth Conference2012

How Does eHealth Support an Integrated Healthcare System?

R. Girard

Why Ask This Question Now?

What is “Integration”?

Integrated care is a concept bringing together inputs, delivery, management and organization of services related to diagnosis, treatment, care, rehabilitation and health promotion. Integration is a means to improve services in relation to access, quality, user satisfaction and efficiency”

- World Health Organization (WHO)

What is “Integration”?

Integration is a coherent set of methods and models on the funding, administrative, organizational, service delivery, and clinical levels designed to create connectivity, alignment, and collaboration within and between sectors (acute, community and long-term-care) to enhance quality of care and quality of life, client satisfaction, and system efficiency for patients with complex problems cutting across multiple services, providers, and settings.

- Spreeuwenberg, 2002

What is “Integration”?Integration is where one actively assembles components into a system. Some components may be integrated to complete system into a whole. Other components may stay somewhat standalone but are integrated using interfaces to connect those components to build out the system into a whole. A systems integrator typically has knowledge of all of the components, control over them and can assemble them into the system.

When doing interfaces, they would typically have responsibility for “both ends of the wire” so again the systems integrator has control. These components are seen as being tightly coupled. 

Interoperability is in the context of systems that are diverse and not under the control of one entity. Different organizations may own the components that need to interoperate, (e.g. a pharmacy system interoperating with a DIS). We often refer to these systems as loosely coupled. Interoperability is achieved by having a well defined contract for how the two systems will interact and what standards will be employed. The standards are not just about the data, but the sequence of interactions and the behaviours by both the caller and the system called.

- A conversation with Infoway

So… What is “Integration”?

The result of forming, coordinating, or blending into a functioning or unified whole

- Merriam Webster Dictionary

How Does eHealth Support an Integrated Healthcare System?

Or… More Importantly…

How would our patients and clients see this?

How would our providers see this?

How would our managers and stewards see this?

What Would Our Patients and Clients Say?

I save time…

I am safe…

I receive good service…

What Would Our Providers Say?

I save time… and my patients don’t waste their time

I practice safely… and my patients are safe

I provide good quality service… and my patients get this same good service wherever they go in the system

What Would Managers and Stewards Say?

We save time… our patients and providers are not wasting their time

We have a safe system… our patients and providers

We are doing a good job…

Imagine…

Each patient or client has access to a patient portal and connects to us via their smartphoneEach provider has a single log-in and has access to everything they need from there One EPR, one EMR, one EHR, collaboration tools,

secure messaging, knowledge and best practicesManagers and Stewards have access to a data warehouse and tools

HEALTH. CONNECTED.

A story about a journey…