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Ontario Regional Blood Coordinating Network

ONTARIO LABORATORIES INFORMATION SYSTEM (OLIS)

PROGRAM REVIEW

Glen Dietz April 13, 2013

eHealth Ontario

Agenda

- Ontario’s eHealth Strategy - eHealth Ontario’s eHealth Blueprint

Repositories Registries Network and technical infrastructure

- OLIS - How blood transfusion needs might be addressed by OLIS and by eHealth blueprint

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Ontario’s eHealth Strategy

Facilitate the broader health system transformation identified in the Ministry’s action plan

Address the priorities identified in key provincial strategies and reports (e.g. the Walker, Baker, and Drummond reports)

Seeks to achieve: Integrated information across organizations

facilitate seamless patient transitions enable providers to more easily coordinate care

Provide more useful and complete record of patient information enhance clinician ability to diagnose and treat their patients

Provide tools and information to support improved preventative care Improve measuring and tracking of quality of care and patient access

To Accomplish These Objectives

Ontario has defined a comprehensive approach for procurement, development, and deployment of ehealth systems that will achieve the above objectives in a timely, responsible, and cost-effective manner

The key elements of this approach are: Leveraging existing infrastructure

The deployment of systems to enable community-based providers to implement more proactive and collaborative care models

Implement infrastructural components to capture and share patient information

Accelerate implementations to make priority clinical data available to providers to support immediate improvements to patient diagnosis and treatment

Primary Points of Focus

Drug Information System Client, Provider, User, Consent Registries Client, Provider, User Portals Integration Services Physician eHealth Ontario Laboratory Information System Consumer eHealth Diagnostic Imaging Panorama Chronic Disease Management Technology Services

eHealth Ontario’s eHealth Blueprint

Repositories

Shared health record

Encounters

Clinical documents

Drug registry based on Ontario Drug Benefit Program

Ontario Laboratories Information System (OLIS)

Diagnostic imaging Focus is on connecting existing DI/ PACS systems

Immunizations

Registries and Applications

Chronic Disease Management System (CDMS)

Client Registry (Enterprise Master Patient Index (EMPI))

Provider

User

Consent

Audit

Nomenclature

Network and technical infrastructure

OLIS

Purpose OLIS was established to facilita te the electronic exchange of a ll labora tory test

orders and results in Ontario by connecting hospita ls, community and public hea lth labora tories with clinicians.

OLIS will: Improve care: Access to all of a patient’s test results will enable clinicians to make well

informed treatment decisions Reduce duplicate tests: Access to all laboratory tests/ results for patients will reduce the

need to re-order laboratory tests for which results may already be available Reduce wait times: OLIS will eliminate delays associated with transmitting information

from laboratories to clinicians, which will reduce the time that patients spend waiting for results and subsequent care

Improve operational efficiency: Hospitals, laboratories and clinics will streamline their operations through the reduction of duplicate tests and reliance on paper based results

Benefits Improved care:

Enable clinicians to make more informed treatment decisions Fewer duplicate tests:

Reduce the need to re-order laboratory tests Shorter wait times:

Eliminate delays in transmitting information from laboratories to clinicians More comprehensive public health information:

Laboratory data is currently fragmented across many information systems and is recorded in a non-standardized fashion

By centralizing all of the province‘s laboratory data, OLIS is a valuable resource to health system planners, policy makers and researchers

Better operational efficiency: Hospitals, laboratories and clinics will streamline their operations

As a cornerstone system, OLIS will be available to integrate with other eHealth solutions and eventually form part of the electronic health record (EHR).

Scope

Connect 100% of the province‘s laboratories to transmit laboratory test results to OLIS

Data Collection: Connecting the province‘s remaining laboratories to OLIS. Currently the OLIS repository receives 62% of Ontario‘s lab test volume

Data Warehousing: Expanding and upgrading OLIS to align with the EHR strategy, and the eHealth Ontario blueprint as well as ensuring long-term system sustainability

Go-To-Market: Supporting the consumption of OLIS data by authorized users through a variety of channels

Data Collection

Currently, OLIS has collected 65% of the provincia l tota l test volumes through connection with 22 hospita ls and 6 community labs 97% of a ll community lab data

Our data collection model has evolved from engaging individual labs to working with regional business a lliances

In para llel, the OLIS program is reviewing data collection procedures, tools and methods used when engaging LHINs, hospita ls and labs. This review will a ttempt to identify efficiencies during the on-boarding of LHINs, hospita ls and labs tha t a re not yet sending a ll of their results to OLIS

The long term data collection stra tegy will a lign with the regional integra tion initia tives a t eHealth Ontario

Data Warehousing Focus on ensuring a robust and sustainable data repository is available for

increasingly larger volumes of data

Support future needs of the EHR

Numerous on-going initiatives to improve data accuracy, completeness, and timeliness: Validation activities to verify nomenclature mappings

Correction of historical data

Message validations to reduce rejected reports

Relaxing the parameters within the PID (Patient Identifier Segment)

Improved stakeholder agreements

Exploring possible regulation/ legislation changes

Investigation of tools that will improve the detection/ correction of data errors

Investigation of establishing data audit processes as an on-going activity

Data Stored in OLIS Repository

Number of Orders Number of Requests Number of Results In 1 month (January 2013) 1,999,388 12,558,689 28,933,720 In last 12 months * 22,953,355 158,386,064 335,242,326 Cumulative totals * 68,360,621 463,633,619 1,298,938,508

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* As of February 28, 2013

Clinical Use of OLIS Data

Through our go-to-market initiatives, the OLIS program has expanded access to OLIS data to over 10,000 clinicians The Ottawa Hospital

Grey Bruce Health Services

cGTA PRO Viewer

Clinicians access via EMRs: Optimed Med Access ABELMed Nightingale

electronic Child Health Network (eCHN)

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Blood Transfusion Services Needs

• How blood transfusion needs might be addressed by OLIS and the eHealth blueprint? • Sickle Cell Registry

• Chronic Disease Registry • Results of tests already included in OLIS

• Antibody Registry • Clinical Documentation • Results of tests already included in OLIS

• Hemophilia Registry • Chronic Disease Registry • Results of test already included in OLIS

Canada Health Infoway – Standards Collaborative Working Group 5 – Blood Bank Focus is on standardization of documentation of blood transfusion

Charting handled different in different clinical settings

Charting handled different in different hospitals

Variability of charting within clinical settings

No attempt at this time to capture: transfusion history, tissue or organ transplants

‘reportable’ adverse reactions to transfusion

testing of blood, tissue or organ donors

antibodies identified using coded entry

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