EPRs and Central Cancer Registries

Transcription

1 EPRs and Central Cancer Registries NAACCR Informatics Workshop June 2002 Ian Brunskill CIO & VP Planning Cancer Care Ontario

2 Introduction Objectives Ensure co m m on understanding of terms What is an EPR? D escribe the context for Electronic Patient Records Discuss implications for central cancer registries Context Take Away

3 Cancer Care Ontario Provincial cancer agency serving 11 million residents of Ontario >50,000 cases of cancer R ange of services: primary prevention to bereave ment support 2,500 staffin 9 regional cancer centres and >100 points of service across large geographical area Ontario Cancer Registry is a progra m of CC O

4 Introduction Patient Record What is an EPR? Context Take Away The Patient Record is a repository of infor mation about a single patient. The main purpose of the patient record is to facilitate care. The patient record is the primary com m unications m echanis m for supporting continuity throughout the patient s inpatient and outpatient episodes of care. The Longitudinal Patient Record describes a lifelong view of a patient s health experience over time and across institutional and geographical barriers. Episodes of care are linked sea mlessly to provide essential patient infor mation for ongoing care and treatment decisions

5 Electronic Patient Record (Syste m) The electronic patient record syste m is the set of co mponents that co m prise the mechanis m by which patient records are created, used, stored and retrieved. a co mprehensive resource for patient care providing patient specific, access to knowledge bases and a set of co mputer based tools w hich enable care providers to better perform their work

6 WCH WCH C C S S I S Appointment Scheduling Appointment Scheduling WCH SMC Appointme nt Dictaphone Dictaphone Dictation Transcription Order (m anual transcriptio n) Sunquest Sunquest Labs Labs New R OACIS esult Appointme Order OACIS ntorder status CAI Enterprise CAI Interface Enterprise Engine Interface Engine SMC New R OACIS esult Appointme Order nt OACIS Order status IDX order status RIS RIS Billing Billing System Billing System OACIS Order Appointme nt SMC R esult OACIS Order status Clinical W orkstation Clinical W(Order orkstation Managem (Order ent) Managem ent) Data B ase Loader Data B ase Loader SQL DICOM PACs PACs DICOM DICOM SQL Data Repository Data Repository Im aging device Im aging device Im aging device Im aging device Im aging device Im aging device

7 Im age review and M anagem entsystem Viewstation H ospital CT im ages Dicom RT Treatm entplanning Helax Scanner Vidar CT Plain film Simulation film Im ages H ospitalim ages -CT Dicom RT Dicom RT treatm entplanning M editech 5.1 ADT HL7 RCC Registration and Scheduling MultiAccess Q Electronic C hart ec hart Treatm entplans RTP C onnectto Dicom RT-RT plan for Helax Simulator Siem en MevaSim IMRT generator Im Fast Simulation Simulation RTP link MLC Beam param eters Verify and Record Sequencerfor Mevatron Simulation R ecording SimSet IMRT Sequencerfor Prim us Verify and Record Prim eview Shape D efinition System MLC Fit Treatm ent Param eters Patient Treatm ent Param eters Patient Treatm ent Param eters Patient Treatm ent Param eters MLC param eters Patient Treatm ent Param eters MLC param eters Patient Lin Acc 1 Mevatron KD2 PortalIm ager (EPID) Beam View Lin Acc 2 Mevatron KD2 PortalIm ager (EPID) Beam View Lin Acc 3 Mevatron MX2 PortalIm ager (EPID) Beam View Lin Acc 4 Prim us MLC HD270 PortalIm ager (EPID) Beam View Lin Acc 5 Prim us MLC HD270 PortalIm ager (EPID) Beam View PIs PIs PIs PIs PIs Namer Radiation Therapy and Im age M anagem ent Archite ctu re im age interfaces N on dicom,serial Dicom standard HL7 m odules (connections between m odules notshown m odules

8 Levels ofinformation Architecture Executive Direction for IT (Strategic planning, decision making) IT Manage ment / Organization / Support Architecture Application Architecture (e.g. Patient registration syste ms, Specialist Clinical Modules, Hum an Resources systems) Data Architecture (e.g Data models, structures, controlled vocabularies) Services / Facilities Layer (e.g. LA N / W A N infrastructure, operating system s, platforms, networking technologies) Tool Type (e.g. Client server,intranet technologies, mobile, handheld, emerging technologies)

9 Levels of Specification Drivers (e.g. organizational strategic plan, K M plan, increased need for services, new centres) Principles (e.g clinical process auto mation, paperless and filmless) Processes (e.g. Ad ministrative, Clinical, Manage ment) Standards (e.g. technology, application, mini m u m set, identifiers) B uy List

10 Introduction The Canadian /Ontario Environm ental Context What is an EPR? Context Strategic drivers for EPRs within health care (Canada) Reduce medical errors Address health hum an resource shortages (best use, recruitment, retention) Improve clinical decision making at the point of care Recent initiatives within Canada $500-million for pan-canadian EPR $38-million for standards develop ment Client Registry HL7 standard balloting Every province is undertaking provider and / or patient registries Networking infrastructure beco ming a non-issue Take Away

11 The Canadian /Ontario Environm ental Context Cancer specific context Canadian Strategy for Cancer Control-Information M anage ment co m ponents Increased e mphasis upon integrated view of clinical and patient flow The most critical gap in is represented by surgery and syste mic therapy in hospitals (especially oral syste mic therapy) Barriers co m m o n to the health syste m Lack of hu man resources (current and future) Privacy

12 The Canadian /Ontario Environm ental Context Future Directions in Ontario Pathology Include oncology in national a mbulatory collection mandate and standards Modify incentive syste ms (volu me related funding)

13 Introduction Challenges for the central cancer registries What is an EPR? Context Policy direction for many develop ments is driven by health syste m / care issues and are occurring around disease registries Standards for messaging, vocabularies etc Privacy - rules may seriously limit ability of registries to function, and research to be undertaken Integration of Care Changing funding m odels Take Away What is the role of the consu m er?