Effective Exchange and Integration of Cancer Control Information with Community Partners

Brian Schmidt Don Henkelman Carol Rother Theresa Volk

The Vision

Cancer care information is fully integrated with community care

Bi-directional information exchange or sharing is transparent and automated

The processes to support the above are more cost effective than the current processes

The Challenges

The de-facto standard for information exchange still measures 8½ by 11 inches

Data standards are in the early stages of development

Cancer care information is managed by a provincial system, while community-care information is managed by Regional or local systems

The Regional and local systems are very heterogeneous

The Challenges (cont.)

The confidentiality of patient information & patient’s right to privacy must be maintained

The information highway is frequently a dirt road filled with potholes leading no-where

No one has any money – solutions must have very short development cycles and be cost effective

BCCA Strategy – Focus on Internal Systems

Build an Information Technology infrastructure that is state-of-the-art

Deploy across the entire enterprise Establish corporate-wide electronic communications Build a ‘killer-app’ that supports your core business

of patient care Build strategic partnerships with best-of-breed

vendors for operational support systems

BCCA Strategy – Focus on Change Management

Experience a re-engineering project Become a process-focused organization Have the courage to change Develop a culture of change

evolution not revolution Evolve to an integrated Electronic Health

Record

BCCA Strategy – Focus on Industry Standards

Personal Health Number HL7 DICOM Lab Test Standard Provider Registry H.320 & H.323 videoconferencing ISO 17799 Security Standard

BCCA Strategy – Focus on Existing Data Linkages

Automate the capturing of external reports Automate linkages to the client registry Automate the capturing of external images Attach external documentation to the electronic

record immediately upon receipt Support multiple patient identifiers

BCCA Strategy – Facilitate External Communications

Develop a web site directed to the health care professional Guidelines, protocols, manuals, generic support information

Support ‘community of interest’ groups Membership lists Group-specific documents Links to related information Information on conferences, lectures, etc. Access to CME

Leverage video, voice and data convergence

BCCA Strategy – Provide External Access to our EHR

Initially use ‘Windows’ clients over VPN From home or office

Extend to electronic document exchange over the Internet

Extend to full access to our existing EHR over the Internet Ensure patient confidentiality by leveraging

established patient-physician relationships

BCCA Strategy – Web Services Use Internet technologies to provide ‘cancer

services’ Services can be integrated into desktops or

applications by users or vendors Services can be accessed via a Cancer Agency

portal from any web application Requires standards, especially security &

authentication standards

The Ultimate Vision – The Fully Integrated Virtual EHR

Integration & management of clinical information from a variety of sources Care providers role defines the view on

integrated clinical information User is unaware how the information arrives

at the care-giver station

1st Step in the Vision – The BCCA Extranet Project

Goal of the project: Design and development of extranet application Provide health care professionals with secure,

authorized access to BCCA applications Primary purpose

develop communities of interest improve bi-directional exchange of information

Extranet Project Priorities

Develop the technical infrastructure

Provide access to e-Chart

Develop “communities of interest”

Develop the Surgical Oncology Network website

Provide electronic distribution of reports

Create applications to support on-line requisitioning, referral and ordering

Enhance our website to provide easy access to info for health care professionals

Technical Infrastructure

The goal is to develop a robust infrastructure to support the secure exchange of information with external stakeholders

Working with Ministry of Health Security Working Group to develop standards

Access to E-chart

Phase One: giving Agency physicians access to Agency applications from external locations using VPN technology

Phase Two: extending this access to community physicians

Long term: provide authorized physicians with immediate, online access to clinical information wherever secure Internet access is available (home, office, hospital)

Communities of Interest

Identify various communities with similar needs (e.g. Surgical Oncology Network, Tumour Groups)

Enhance 2-way communication, access to information between members

Create a template to standardize information management for communities

Surgical Oncology Network

Develop website for communication & information exchange for surgical oncology community

Facilitate Continuing Medical Education (CME) Develop model for authorized access to

information

Electronic Report Distribution

Distribution of electronic reports and clinical information to physician offices

Physician offices will no longer have to re-key information into their office systems

On-line Requisitioning, Referral and Ordering

Develop applications to allow physician offices to requisition tests or refer patients on-line

Result in decreased duplication of tasks & tests

Management of Information on our Website

Implementation of a Content Management System to support web site development

Develop one point of access to timely and accurate Cancer Agency information for health care professionals

Extranet Project Benefits

Decreased duplication of tasks, tests and information

Timely access to clinical documentation from community hospitals

Ability to view clinical information on-line and discuss a case with a BCCA oncologist

Potential for direct access to Agency services/applications

How can we work together?

Identify institutions and individuals who are interested in pursuing these opportunities with us

Visit the BCCA booth in the lobby and fill out a postcard with your contact information