CONNECTIVITY IN THE COMMUNITY
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- Rolf Vincent Stewart
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1 CONNECTIVITY IN THE COMMUNITY Peter Bascom, Chief Architect, Ontario Guy Fortin, Chief Architect, Ontario Association of Community Access Centre
2 What is the Electronic Health Record ()? The provincial will bring together all of the health information that follows a person through their life and care journeys 2
3 Architecture, Standards & Planning The path to the Interoperable Ontario s Blueprint The What Business View Information View Systems View Standards Provides a future state, high-level view of the Connectivity Strategy The How Defines assets as either strategic or tactical POS Connectivity Requirements Outlines the steps to go from the current state to the future state Roadmap The When and Who Describes when varying components of the Blueprint will be ready and by whom Includes: Business Outcomes View, High-Level Systems and Detail-Level Systems and Program View
4 Ontario s Action Plan for Health Right care, right time, right place How does the work of Ontario assist in delivering healthcare reform? We are helping to improve health system integration and accessibility by building Ontario s interoperable electronic health record. 4
5 The Connectivity Strategy How we move toward the Blueprint s future vision Informs strategic decisions Framework for discussion Practical guidance 5
6 Asset Inventory Description and purpose of assets from across the province Assets classified as Strategic or Tactical Online, searchable & comprehensive Updated quarterly 6
7 Flow of Information Source Systems Repositories and Registries Delivery Channels and Enablers 7
8 Integration Registry Registry Consent and Audit One client, one record e, care team Consistent control and review of access
9 Integration ONE ID Clinical Repositories Health Information Access Layer single signon Consistent availability and quality Consistent privacy and security controls 9
10 Future State Connectivity Overview ehr Systems Connecting SWO Connecting NEO/GTA ONE Portal Patient Integration Assets cgta cneo Health Registry (PCR) Registry Clinical Connect Consent - Service Privacy Audit POS Systems EMR Clinical Connection Engine ONE Portal Consumer Terminology Management De-Identification Services Service Registry XDS Registry Ontario Greater Toronto Area North Eastern Ontario SWO Agreements Subscriptions and Notifications ONEID Repositories MOHLTC Sources OLIS Prescribed Registry CHRIS (CCAC) CDR IAR DI Reports MOH - HIS IRR Analytics MOH-CPDB MOH-RPDB MOH- CAPE/CLAIM 10
11 Future State Connectivity Overview ehr Systems Connecting SWO Connecting NEO/GTA ONE Portal Patient Integration Assets cgta cneo Health Registry (PCR) Registry Clinical Connect Consent - Service Privacy Audit POS Systems EMR Clinical Connection Engine ONE Portal Consumer Terminology Management De-Identification Services Service Registry XDS Registry Ontario GTA Hial NEO SWO Agreements Subscriptions and Notifications ONEID Repositories MOHLTC Sources OLIS Prescribed Registry CHRIS (CCAC) CDR IAR DI Reports MOH - HIS IRR Analytics MOH-CPDB MOH-RPDB MOH- CAPE/CLAIM 11
12 Future State Connectivity Overview ehr Systems Connecting SWO Connecting NEO/GTA ONE Portal Patient Integration Assets cgta cneo Health Registry (PCR) Registry Clinical Connect Consent - Service Privacy Audit POS Systems EMR Clinical Connection Engine ONE Portal Consumer Terminology Management De-Identification Services Service Registry XDS Registry Ontario GTA Hial NEO SWO Agreements Subscriptions and Notifications ONEID Repositories MOHLTC Sources OLIS Prescribed Registry CHRIS (CCAC) CDR IAR DI Reports MOH - HIS IRR Analytics MOH-CPDB MOH-RPDB MOH- CAPE/CLAIM 12
13 Future State Connectivity Overview ehr Systems Connecting SWO Connecting NEO/GTA ONE Portal Patient Integration Assets cgta cneo Health Registry (PCR) Registry Clinical Connect Consent - Service Privacy Audit POS Systems EMR Clinical Connection Engine ONE Portal Consumer Terminology Management De-Identification Services Service Registry XDS Registry Ontario GTA Hial NEO SWO Agreements Subscriptions and Notifications ONEID Repositories MOHLTC Sources OLIS Prescribed Registry CHRIS (CCAC) CDR IAR DI Reports MOH - HIS IRR Analytics MOH-CPDB MOH-RPDB MOH- CAPE/CLAIM 13
14 Future State Connectivity Overview ehr Systems Connecting SWO Connecting NEO/GTA ONE Portal Patient Integration Assets cgta cneo Health Registry (PCR) Registry Clinical Connect Consent - Service Privacy Audit POS Systems EMR Clinical Connection Engine ONE Portal Consumer Terminology Management De-Identification Services Service Registry XDS Registry Ontario GTA Hial NEO SWO Agreements Subscriptions and Notifications ONEID Repositories MOHLTC Sources OLIS Prescribed Registry CHRIS (CCAC) CDR IAR DI Reports MOH - HIS IRR Analytics MOH-CPDB MOH-RPDB MOH- CAPE/CLAIM 14
15 Future State Connectivity Overview ehr Systems Connecting SWO Connecting NEO/GTA ONE Portal Patient Integration Assets cgta cneo Health Registry (PCR) Registry Clinical Connect Consent - Service Privacy Audit POS Systems EMR Clinical Connection Engine ONE Portal Consumer Terminology Management De-Identification Services Service Registry XDS Registry Ontario GTA Hial NEO SWO Agreements Subscriptions and Notifications ONEID Repositories MOHLTC Sources OLIS Prescribed Registry CHRIS (CCAC) CDR IAR DI Reports MOH - HIS IRR Analytics MOH-CPDB MOH-RPDB MOH- CAPE/CLAIM 15
16 Future State Connectivity Overview ehr Systems Connecting SWO Connecting NEO/GTA ONE Portal Patient Integration Assets cgta cneo Health Registry (PCR) Registry Clinical Connect Consent - Service Privacy Audit POS Systems EMR Connection Engine Clinical ONE Portal Consumer Terminology Management De-Identification Services Service Registry XDS Registry Ontario GTA Hial NEO SWO Agreements Subscriptions and Notifications ONEID Repositories MOHLTC Sources OLIS Prescribed Registry CHRIS (CCAC) CDR IAR DI Reports CDPS Immunization Analytics MOH-CPDB MOH-RPDB MOH- CAPE/CLAIM 16
17 Future State Connectivity Overview ehr Systems Connecting SWO Connecting NEO/GTA ONE Portal Patient Integration Assets cgta cneo Health Registry (PCR) Registry Clinical Connect Consent - Service Privacy Audit POS Systems EMR Clinical Connection Engine ONE Portal Consumer Terminology Management De-Identification Services Service Registry XDS Registry Ontario GTA Hial NEO SWO Agreements Subscriptions and Notifications ONEID Repositories MOHLTC Sources OLIS Prescribed Registry CHRIS (CCAC) CDR IAR DI Reports MOH - HIS IRR Analytics MOH-CPDB MOH-RPDB MOH- CAPE/CLAIM 17
18 Future State Connectivity Overview ehr Systems Connecting SWO Connecting NEO/GTA ONE Portal Patient Integration Assets cgta cneo Health Registry (PCR) Registry Clinical Connect Consent - Service Privacy Audit POS Systems EMR Clinical Connection Engine ONE Portal Consumer Terminology Management De-Identification Services Service Registry XDS Registry Ontario GTA Hial NEO SWO Agreements Subscriptions and Notifications ONEID Repositories MOHLTC Sources OLIS Prescribed Registry CHRIS (CCAC) CDR IAR DI Reports MOH - HIS IRR Analytics MOH-CPDB MOH-RPDB MOH- CAPE/CLAIM 18
19 Future State Connectivity Overview ehr Systems Connecting SWO Connecting NEO/GTA ONE Portal Patient Integration Assets cgta cneo Health Registry (PCR) Registry Clinical Connect Consent - Service Privacy Audit POS Systems EMR Clinical Connection Engine ONE Portal Consumer Terminology Management De-Identification Services Service Registry XDS Registry Ontario GTA Hial NEO SWO Agreements Subscriptions and Notifications ONEID Repositories MOHLTC Sources OLIS Prescribed Registry CHRIS (CCAC) CDR IAR DI Reports MOH - HIS IRR Analytics MOH-CPDB MOH-RPDB MOH- CAPE/CLAIM 19
20 Clinical Domains Integration Assets Registry (PCR) Registry Integration Consent - Service Privacy Audit Terminology Management De-Identification Services Service Registry XDS Registry Agreements Subscriptions and Notifications ONEID 20
21 Settings Integration Assets Registry (PCR) Registry Integration Consent-Service Privacy Audit Terminology Management De-Identification Services Service Registry XDS Registry Agreements Subscriptions and Notifications ONEID 21
22 Community Community Access Centres Community Support Services Patient Home s Public Health Units Mental Health & Addiction Long Term Homes 22
23 Current State Connectivity: Community Health Community Service Hospital Coordinator <flow> Patient Patient Monitoring Device Content MyChart Integrated Coordination Assessment Tool (CCT) Record (IAR) Assessment Clinical Connect HIS LTC Case Health Partner Gateway LTC Case Reports Health Information & EMR Target OMD Hospital Report Manager (HRM) Source e Information DATIS Summary LTC Case LTC Case CCAC Hospital enotification (HRM ORU) Patient Monitoring Management System (PMMS) Card Assignments Health and Related Information System (CHRIS) LTC Case cgta ADT cgta CDR Medication Summaries Health Network System (HNS) CDR 23
24 Current State Connectivity: Community Community Access Centre Health Community Service Hospital Coordinator <flow> Patient Patient Monitoring Device Content MyChart Integrated Coordination Assessment Tool (CCT) Record (IAR) Assessment Clinical Connect HIS LTC Case Health Partner Gateway LTC Case Reports Health Information & EMR Target OMD Hospital Report Manager (HRM) Source e Information DATIS Summary LTC Case LTC Case CCAC Hospital enotification (HRM ORU) Patient Monitoring Management System (PMMS) Card Assignments Health and Related Information System (CHRIS) LTC Case cgta ADT cgta CDR Medication Summaries Health Network System (HNS) CDR 24
25 Current State Connectivity: Community Health Community Service Hospital Coordinator <flow> Patient Patient Monitoring Device Content MyChart Integrated Coordination Assessment Tool (CCT) Record (IAR) Home Contracted Service Equipment Supplier Long Term Home CCC/Rehab Clinical Connect Assessment Doctor HIS LTC Case Health Partner Gateway LTC & Reports Health Information & EMR Target OMD Hospital Report Manager (HRM) Source e Information DATIS Summary LTC Case LTC Case CCAC Hospital enotification (HRM ORU) Patient Monitoring Management System (PMMS) Card Assignments Health and Related Information System (CHRIS) LTC Case cgta ADT cgta CDR Medication Summaries Health Network System (HNS) CDR 25
26 Current State Connectivity: Community Community Support Service Agency Health Community Service Hospital Coordinator <flow> Patient Patient Monitoring Device Content MyChart Integrated Coordination Assessment Tool (CCT) Record (IAR) Assessment Clinical Connect HIS LTC Case Health Partner Gateway LTC & Reports Health Information & EMR Target OMD Hospital Report Manager (HRM) Source e Information DATIS Summary LTC Case LTC Case CCAC Hospital enotification (HRM ORU) Patient Monitoring Management System (PMMS) Card Assignments Health and Related Information System (CHRIS) LTC Case cgta ADT cgta CDR Medication Summaries Health Network System (HNS) CDR 26
27 Current State Connectivity: Community Health Community Service Hospital Coordinator <flow> Patient Patient Monitoring Device Content MyChart Integrated Coordination Assessment Tool (CCT) Record (IAR) Assessment Clinical Connect HIS LTC Case Health Partner Gateway LTC Case Reports Health Information & EMR Target OMD Hospital Report Manager (HRM) Source e Information DATIS Summary LTC Case LTC Case CCAC Hospital enotification (HRM ORU) Patient Monitoring Management System (PMMS) Card Assignments Health and Related Information System (CHRIS) LTC Case cgta ADT cgta CDR Medication Summaries Health Network System (HNS) CDR 27
28 Current State Connectivity: Community Health Community Service Hospital Coordinator <flow> Patient Patient Monitoring Device Content MyChart Integrated Coordination Assessment Tool (CCT) Record (IAR) Assessment Clinical Connect HIS LTC Case Health Partner Gateway LTC Case Reports Health Information & EMR Target OMD Hospital Report Manager (HRM) Source e Information DATIS Summary LTC Case LTC Case CCAC Hospital enotification (HRM ORU) Patient Monitoring Management System (PMMS) Card Assignments Health and Related Information System (CHRIS) LTC Case cgta ADT cgta CDR Medication Summaries Health Network System (HNS) CDR 28
29 Future State Connectivity: Community Health Patient MyChart Monitoring Device Patient Patient Monitoring Management System (PMMS) Content Summary Service cgta Clinical cneo Clinical Connect Coordination Tool (CCT) LTC Case LTC Case Community Integrated Assessment Record (IAR) LTC Case Hospital EMS Target Coordinator Assessment HIS Service System LTC Case Health Partner Gateway LTC Case Reports Health Information & Health and Related Information System (CHRIS) cgta ADT LTC Case EMR Hospital Reports CDR Credit Card Assignments Source POS Systems <<flow>> e Dispensed Drugs Information DATIS Integration Assets Registry (PCR) Registry Standard Terminology and Terminology Services Standard Terminology and Terminology Services Monitoring and control technology assets (MCTA) Consent-Service XDS Registry Agreements Registry Subscription Management Services Patient CDR Compensation Drug Profile System (CDPS) ONEID De-identification Services Drug Dispensations Service Registry Health Information Access Layer () 29
30 Future State Connectivity: Community cv cv Province-wide Viewing c v Health Patient MyChart Monitoring Device cv Patient cv Patient Monitoring Management System (PMMS) Content Summary cv Patient Drug Dispensations Service cgta Clinical cneo Clinical Connect Coordination Tool (CCT) LTC Case Community Integrated Assessment Record (IAR) LTC Case LTC Case cv cv c v Hospital EMS Target Coordinator Assessment cv cv LTC Case Reports Health Informatio n HIS Service Health Partner & GatewayAssessmen System ts LTC Case Health Information Access Layer () cv Health and Related Information System (CHRIS) cgta ADT CDR CDR LTC Case cv EMR c v Hospital Reports Credit Card Assignments Source POS Systems <<flow>> e Dispensed Drugs Compensation Drug Profile System (CDPS) Information DATIS cv cv Province-wide comprehensive CDR Community Acute cv Integration Assets Registry (PCR) Registry Standard Terminology and Terminology Services Standard Terminology and Terminology Services Monitoring and control technology assets (MCTA) Consent-Service XDS Registry Agreements Registry Subscription Management Services ONEID De-identification Services Service Registry 30
31 Future State Connectivity: Community Patient Health Patient Monitoring Management System (PMMS) Content Patient MyChart Monitoring Device Summary Service cgta Clinical cneo Clinical Connect Coordination Tool (CCT) LTC Case LTC Case Community Integrated Assessment Record (IAR) LTC Case Hospital EMS Target Coordinator Assessment LTC Case LTC Case HIS Service Health Partner Gateway System Reports Health Information & Health and Related Information System (CHRIS) EMR CDR Source POS Systems <<flow>> Hospital e cgta LTC Dispensed Drugs ADT Case Reports Credit Card infrastructure services Assignments Wide-adoption of the provincial Information DATIS Integration Assets Registry (PCR) Registry Standard Terminology and Terminology Services Standard Terminology and Terminology Services Monitoring and control technology assets (MCTA) Consent-Service XDS Registry Agreements Registry Subscription Management Services Patient CDR Compensation Drug Profile System (CDPS) ONEID De-identification Services Drug Dispensations Service Registry Health Information Access Layer () 31
32 Clinical Experience Future state flow of information- All clinicians have all patient data from all sources, available and easily accessible, generating faster, better care in any setting Health information flow Drug History Lab history Image History Discharge erx orders Discharge Summary HIS Clinical Real time Admit / Discharge enotifications Discharge erx Discharge summary, plan Plan, CHRIS EMR PMS Acute Discharged into the Community Process Hospital Community
33 Benefits of Integration: To the Patient Community care data available to share with circle-of-care Home, Long Term, Mental Health &Addiction, Community Support Services, First Responders (e.g. EMS), Acute, Real-time sharing of changes in Patient s Community care status CCAC/CSSA: admit/discharge, service changes EMS: 911 Call To the Community Setting Access to comprehensive Patient care data from Acute and care settings Real-time receipt of Patient status change enotifications Acute : ED/in-patient admit/discharge Improved data integrity Registry, Service Registry, Consent Registry, etc. 33
34 Let s Connect For more information about OACCAC Book an appointment with us today and discover how we can help you develop your ehealth solutions architecture@ehealthontario.on.ca Download the Blueprint and visit the microsite: Sign up for our newsletter (Blueprint Bulletin) and if you haven t already discovered Ontario s Ehealth Blueprint the comprehensive framework for planning and delivery across the province it is now available online. 34
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