e-health & Portal Overview April 2009 Dale Anderson Senior Consultant, Stakeholder Engagement
Today s Reality
How We Travel How We Book Hotels How We Bank
Make an Appointment Sit in Waiting Room How we do Healthcare See Doctor Call for Results
Lack of information management leading to severe impediments in care delivery Patient treatment process and issues arising from poor information management Prevention Diagnosis Treatment Poor compliance with prevention guidelines 37-43% of Canadians recommended for influenza protection are not vaccinated 30-40% of women at risk of cervical cancer are not screened Huge chance of errors, poor customer service, repeat diagnostic tests $15 billion in annual prescriptions are handwritten 1 billion service events are scheduled manually by phone 32% of ER patients were missing required info, leading to an average increased stay of 1.2 hours Wrong decisions Estimates suggest 1 in 9 patients receive wrong medication or dosage Up to 24,000 deaths each year from preventable adverse events in hospitals, many due to incomplete information This represents more deaths than from breast cancer, motor vehicle accidents, and HIV combined
E-Health Portal Platform
Gartner Group ehealth Value & Complexity Clinical & Financial Value Level 1 Static Sites Presence Brochure-ware Overviews of services Lists of physicians, jobs, etc. Maps & directions, FAQs 5% 55% most Level 2 of Marketing the market is here Dynamic Sites CMS solutions Health content & tools, news feeds. Updatable directories for physicians, classes, jobs, etc. Search features Calendar Surveys Announcements Document library Level 3 Transactional Portals Integration CMS integrated 3 rd party content. Discussion forums Secure messaging Appointments Prescriptions Referrals Patient Clinical Questions Pre-registration Test results e-crm/self-service Bill view/payment 30% Pat. self-monitoring Pat. health record Medication tracking Risk assessments Level 4 Transformational Portals Business Process Management Workflow automation: Appointment scheduling Alerts & reminders Integration with patient record. Physician mediated messaging. Medical device uploads. Triage; disease mgt. Self-directed care Information therapy Personalization & profile management. Virtual office visits: e-visit/follow-up Second opinion Reimbursement Virtual business office: Patient financials Billing Insurance 10% Complexity & Comprehensiveness
Consumer Portal Manager CONSUMER Portal Manager e Platform Consumer-based content mgmt Web-based communications Relevant & reliable health info Convenient class registration Job postings with online response Online shopping and e-cards Personal Health Record Reminders and alerts Experience personalization Sophisticated contact forms Mapping and location Highly flexible configurations Easy to manage dynamic content Dynamic taxonomies Intuitive content channels Customer Relationship Mgmt tools One to One mktg capabilities
Employee Portal Manager EMPLOYEE Portal Manager CONSUMER Portal Manager e 2 Platform Employee-based content mgmt Workflow enhancements Staff Directory Policies and procedures Document sharing Benefits and Enrollment Internal job postings Employee recognition Cafeteria Menu Classified Ads Census Reporting General Events and News Department-specific information Training Staff scheduling Department calendar Meetings with agendas, minutes Team-building Protocols, order sets, standing orders Sophisticated Forms
Physician Portal Manager EMPLOYEE Portal Manager CONSUMER Portal Manager e 2 Platform PHYSICIAN Portal Manager Physician-based content management Single sign-on Personalization e-consults Authentication, SSL security Access rights management Mobile digital certificate ADT Lab / Lab Trending Transcriptions Transcription Signatures Progress Notes (Edit and Enter) Pharmacy Face Sheets Rounding reports Physician to Physician messaging Document Imaging Telemetry PACS Images Cardiology Images, Info Scheduling Fetal Monitoring
Patient Portal Manager EMPLOYEE Portal Manager CONSUMER Portal Manager e 2 Platform PHYSICIAN Portal Manager PATIENT Portal Manager Patient-based content mgmt Patient Self Service Patient workflow enhancements Secure access to physicians View clinical data Specific relevant health information Online appointment setting Pharmacy renewal Lab results (context relevant) Pre-Registration for surgery econsultations with Physicians My Insurance, Pharmacies, Medications My Personal Medical Record (secure) Referral Requests Bill look-up with payment option Family Care secure sharing Broadcast Messaging / 1 to 1 Marketing Experience personalization Disease Management
What s Possible with Portal Integration Data is consolidated & available online Consumers are engaged online Employees are served online Patients and Providers are connected supporting the circle of care
Provider Portal
Problems We Faced Poor Information Access & Distribution Dispersed data sources Patient Safety Risks HIS Idiosyncrasies Changing expectations patients, providers Limited Physician use of technology Lack of coordination among care providers, community physicians, homes for aged, other healthcare services Equity of Access rural and urban Lack of focus on preventative healthcare
Results we were seeking Connection & Communication One Stop Shop Clinically Relevant Information & Added Value Engaged physicians Ease of Use Workflow improvements Secure Remote Access Privacy & Auditing Real time Information Ability to adapt & scale to community
What we have done ClinicalConnect branded Provider Portal MEDSEEK is the vendor of the portal software & services Web based approach One Stop Shop Portal Aggregates data from disparate systems and data sources Flexible -- Provider designed Meaningful Clinical Views Providers can personalize to fit their needs or workflow Secure and Real Time Supports multiple web browsers Audit Trails Varied Users Hospital Physicians, Pharmacists, Nurses, Community
Multiple Patient Lists or Filters Inpatient Lists Full Patient Lists Call Group Lists Location Based Station Census Emergency Rooms with Triage Times User created Worklists Schedule
Lab Views, Filters Graphing
Links to Diagnostic Imaging
Links to Document Imaging Archive
Pharmacy Medications Various Filters Including Medications at Discharge
What we have done Mobile Access Blackberry, iphone, Windows Adopted by LHIN 4 as Unified View of Patient Data Acquired eid Matching Software for the LHIN
Blackberry
Blackberry
Blackberry
Blackberry
What we are doing now Adding CCAC Home Care Services Data CCAC data with hospital data = 360 degree view Utilizing Patient Matching software (eid) to positively link patients across systems Physician Sponsored Accounts Providing the option where privileged physicians can sponsor accounts for support staff. St Joseph s Hospital Integration
CCAC Link
CCAC Link
CCAC Link
CCAC Link
CCAC Benefits Integration between hospital systems and the CCAC client assessment system improves data quality and contributes to reducing potential patient errors. Hospital beds are emptied faster as the client moves to homecare quicker Status of CCAC patients and services available in the Provider portal The enhancement of the SINGLE VIEW or ONE STOP SHOP where providers/ specialists access to hospital and community based patient information enhances continuity of care
eid Patient Matching Data Consolidated from Multiple Hospitals Uses sophisticated probabilistic matching algorithms to help standalone hospitals & multi-facility health systems evaluate data across all patient systems. eid can determine whether separate electronic records for the same patient exist within the hospital's (HIS) master patient index (MPI), so that duplicate records can be consolidated into one patient account Accurately associates records for a particular patient. Becomes a record locator tool, providing the ability to search across all available patient information systems
What we are doing EMR Download Capability to export transcribed notes & discrete lab results in standard HL7 format for import into any physician Electronic Medical Record Automated pull, simplistic with minimal steps. User preferences, defaults & business rules automate the process Download to Pprompt Diabetes System Integrating Other Hospital Data / Extending to LHIN Privacy Impact Assessment / Threat Risk Assessment
Patient List: Download patient(s) to Chart with Downloads link
Download Preferences (consistent with portal for setting preferences)
Downloads list with the new download marked with (NEW)
Download Labs button added to Labs List, check boxes next to lab names
Extending ClinicalConnect to LHIN3 The Waterloo Wellington LHIN3 is involved in a Canada Infoway funded project. The project, HealtheConnections is a 2 year demonstration project that will implement an enhanced e-health enabled model of care for diabetes. They will be deploying a Personal Health Record portal for the secure sharing of patient provided data. ClinicalConnect aspects... The project will entail the sharing of acute data by connecting WWLHIN acute care hospitals to the ClinicalConnect portal operated by LHIN4 In addition integration between the ClinicalConnect portal and the Family Health Team practice management electronic medical records systems will enable the downloading (at a minimum discharge summaries) into the primary care EMR s
Other Initiatives & plans Portal Integration echn Link (Electronic children s network) Oncology Reports Integration Diagnostic Imaging Repository (DI-r) OLIS Diabetes Systems & Repositories LTC / Nursing Homes Linkage with Right Level / Alternate Level of Care (Provide a centralized uniform system for the identification and rating of patients who are occupying beds for which there are services that the patient does not require. Improve the flow of patients through the continuum of health care in HNHB. ER WTIS to become one project with the ALC project) Link with Decision Support Data Warehouse and Business Intelligence Solution that will enable HNHB organizations to make evidence based planning and operational decisions using data that is less than 3 months old. North Hamilton Community Centres (Support Brantford and St Catherine s) Advanced Web Design / Landing Pages to further integrate other information
Enhanced Interface
Physician Landing Page
How we measured success Physicians /Clinicians Say. Easy to Use Easier to Follow Progress of Investigations & Medications Discharge Follow-up less frustrating Fewer staff phone calls to obtain results Stat lab work better accessible and in real-time Links with Inpatient & Outpatient Providers / Residents More informed comprehensive care
How we measured success Engaged physicians and solicits & identifies other opportunities Steady Growth Over 2700 registered accounts (Hospital Physicians, Pharmacists, Nurses, Health Care support staff) Improved Connection & Communication and Collaboration Improved information flow, within LHIN s and across LHIN s LHIN Adoption Supporting Ontario e-health Directions Adds Values by leveraging existing systems and technologies Provider Portal Integration will support patient portals
Patient Portal Opportunities
Diabetes Journal
Diabetes Follow-up
Online Decision Support
Web Chat
E-Visit Followup 6500 clinical assessment questionnaires covering 30,000 symptoms (95% primary care and 85% of specialty care symptoms are covered). Type in symptom or choose symptom from list.
Renew a Prescription
Questions? Dale Anderson Senior Consultant, Stakeholder Engagement Hamilton, Niagara Halidmand CCAC Burlington - 6th Floor 440 Elizabeth St. Burlington, ON LR7 2M1 anderdal@hhsc.ca 905-633-3899 x2952