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Central LHIN
2016-2017
eHealth Strategic Plan
Presentation to Central LHIN Board of Directors
June 2016
Contents
1. eHealth 2.0 – update on the Ministry’s Vision
2. Central LHIN’s eHealth Plan – Alignment with eHealth 2.0• Hospital Report Manager & ED Notification
• Telemedicine & Telehomecare deployment
• Coordinated Care Tool
• eConsult
3. International Context – The Commonwealth Fund’s Findings &
Alignment of Central LHIN’s eHealth Plan
4. Next Steps & Next Year
5. Appendix – Central LHIN’s full 2016/17 eHealth Plan
2
4
Ministry Vision - eHealth Strategy 2.0 in a
nutshell
The goal of this strategy is to make technology an integral and
routine part of Ontarians’ healthcare experiences.
We will build capacity in the system for planning and funding digital
health technology as a commodity like any other. The intention is to
make this Ontario’s last “ehealth” strategy in that from now on we will
weave technology into the core fabric of future health system
strategies.
Ministry Priorities
1. Hospital Information System (HIS)
2. Hospital Report Manager (HRM) & eNotification
3. Telemedicine and Telehomecare deployment
4. Care Coordination Tool (CCT)
5. eConsult
6. Regional Integration (Connecting Ontario)
7. Ontario Laboratories Information System (OLIS)
7
The Ministry’s funding of LHIN eHealth activities is intended to ensure that provincial eHealth
priorities are successfully delivered in partnership with provincial eHealth delivery organizations
including eHealth Ontario, OTN and OntarioMD. The following outlines the 7 provincial ehealth
priorities for 2016-17:
10
Description:Hospital Report Manager (HRM) enables physicians using Electronic Medical Records
(EMRs) to securely receive electronic hospital reports into their patient’s medical record
within 30 minutes of transcription.
eNotification will notify the CCAC and Primary Care (through HRM) when patients: present
to the hospital Emergency Department (ED), are discharged from the ED, are admitted to a
hospital inpatient unit, and are discharged from the hospital inpatient unit.
Deliverables:• CLHIN to work with OntarioMD and Primary Care Providers to increase adoption of HRM through
engagement and conferences.
• CLHIN to work with OntarioMD and the OACCAC to accelerate hospital adoption of eNotification
• Implement eNotification at Markham Stouffville Hospital, Central LHIN’s pilot site, by Q2
• Investigate expansion to other hospitals
Increase adoption by 120 Clinicians (baseline 861, target 981 Clinicians) resulting in
approx. 58% of CLHIN primary care practitioners receiving reports through HRM.
Implement eNotification at 2 Central LHIN public hospitals (baseline 0, target 2 Hospitals)
eHealth Strategic Initiatives – ProvincialHospital Report Manager (HRM) Adoption & eNotification
Central LHIN Lead: Daniel Mainville
11
Description:
THC allows clients, via electronic telemetry monitoring, to input and transmit their vital health
information from their home to a remote monitoring care team. THC provides opportunities
for proactive client coaching and education as well as rapid response from the care team to
an emerging health crisis.
Deliverables:
• Central LHIN will continue to monitor adoption of the existing THC Program and expand
use in more (3-5) congregate settings.
• Central LHIN will investigate and potentially pilot the use of remote monitoring in priority
areas such as: Palliative Care, Post-Acute and Chronic Disease Management (Diabetes)
• Central LHIN will participate in OTN sponsored quantitative and qualitative evaluation
being done by THETA. Quantitative evaluation will assess impact on utilization of health
services pre and post THC enrollment.
Achieve 100% of THC enrollment targets (920 patient enrollments across the LHIN)
eHealth Strategic Initiatives – ProvincialTelehomecare (THC)
Central LHIN Lead: Karen Blackley
* (UofT – Toronto Health Economics and Technology Assessment collaborative).
12
Description:Telemedicine equipment is used by health service providers to deliver care to patients via two-way
videoconferencing (virtual assessments) and store forward technology. Our goal is to imbed telemedicine into
models of care, where appropriate, to improve the patient experience and enhance health system capacity.
Deliverables:Central LHIN will develop a Telemedicine Strategy to build on recent implementations and successes. The
strategy will focus on:
• Monitoring and improving adoption with existing sites, particularly in Long-Term Care
• Expanding telemedicine use (PCVC and ‘Send Invite’) to support chronic disease management
• Supporting more health service providers to embed the use of telemedicine in the delivery of services
and clinical practice
• Using telemedicine for Central LHIN priority projects such as the delivery of better Palliative Care
• Expanding telemedicine use for underserved communities through available OTN programs – tele-
ophthalmology, tele-dermatology
Increase adoption by 15% from baseline (baseline: avg of 788 events/month as of Q4 15/16; target: avg of 906
events/month)
eHealth Strategic Initiatives – ProvincialTelemedicine
Central LHIN Lead: Karen Blackley
13
Description:The Ministry and its partners are developing a Care Coordination Tool (CCT) that will make
the patient's coordinated care plan accessible by providers in the circle of care, and
facilitate secure messaging between providers. The CCT is currently in a proof-of-concept
and evaluation stage.
Deliverables:• Central LHIN will work with the Ministry and Central LHIN’s proof-of-concept
participating Health Link (HL), South Simcoe Northern York Region (SSNYR), to
support and guide their use of the CCT.
• Central LHIN will monitor the evaluation of the CCT and Ministry identified interim
solutions to inform the implementation of the selected solution in future years.
SSNYR HL to enroll 480 new HL patients and complete Coordinated Care Plans (CCPs) for them.
eHealth Strategic Initiatives – ProvincialCare Coordination Tool (CCT)
Central LHIN Lead: Daniel Mainville
14
eHealth Strategic Initiatives – ProvincialeConsult
Description:An eConsult is an electronic exchange of information between a primary care provider (PCP)
and a specialist which provides the patient with faster access to specialist advice and
potentially reduces travel and patient anxiety. An eConsult solution also: facilitates PCPs
locating the right specialist the first time, monitors the status of the PCP’s request, provides
an audit trail of the case interaction with the specialist, and has the potential to avoid
unnecessary referrals.
Deliverable:• Central LHIN to work with OntarioMD and OTN to begin adoption of the OTN eConsult
solution.
Increase early adopter adoption by 25 Primary Care Providers (baseline 38, target 63)
bringing our eConsult early adopters to 4% of CLHIN primary care providers. Note that
once solution is integrated with EMRs adoption targets will be much higher.
Central LHIN Lead: Daniel Mainville
International Context
The Commonwealth Fund’s Findings &
Alignment of Central LHIN’s eHealth Plan
15
The Commonwealth Fund – Performance of International
Health Systems
• Report ranks 11 countries on 5 dimensions of performance and concludes
that the adoption and effective use of modern health information
systems is a requirement of a high performing system
16
The Commonwealth Fund – Performance of International
Health Systems – Alignment with Central LHIN’s eHealth
Plan
17
Coordinated
Care
Efficient
Care
Effective
Care
Patient Centred
Care
Equitable
Care
HRM & e-Notification √ √Telehomecare & Telemedicine √ √ √
Coordinated Care Tool √ √ √e-Consult √ √ √
Connecting GTA/Ontario √ √OLIS √ √ √
Integrated Assessment Record √ √EMR Adoption √ √
Resource Matching & Referral √ √ √
System Ranking Dimensions Used in Commonwealth Fund Report (not all inclusive)
The Commonwealth Fund – Performance of International
Health Systems findings:
Health information technology was deemed as an enabler in
providing:
Coordinated Care – to ensure appropriate follow-up treatment, minimize risk of
error and prevent complications
Primary Care receives notifications that patient has been in hospital
Primary Care receives information needed to manage patient’s’ care post-hospital within 2 days of
discharge
Information and knowledge exchange occurs between Primary Care & Specialist and other care providers
Efficient Care – an efficient system seeks to maximize quality of care &
outcomes given resources committed, while ensuring that additional investments
yield net value over time
No duplicate tests/assessments
Medical history available at time of care/appointment
Patient does not return to ER after hospital discharge for complications
Provider can electronically exchange patient clinical information with other providers18
The Commonwealth Fund – Performance of International
Health Systems findings:
Health information technology was deemed as an enabler in providing:
Effective Care – patients receive services that are appropriate for
preventing or treating a given condition
Patients and providers receive computerized reminder notices for
preventative and follow-up care
Patient-Centred Care – care is delivered with the patient’s needs and
preferences in mind
Although a theme in eHealth 2.0 (patient portals, mobile apps for access on
smartphones)…we’re not there yet
19
Health information technology was deemed as an enabler in providing:
Equitable Care - care does not vary in quality because of personal
characteristics such as ethnicity, geographic location and socioeconomic
status.
20
The Commonwealth Fund – Performance of International
Health Systems findings:
Telehomecare
Telemedicine e.g. tele-ophthalmology