Transcript Document

eHealth:
Contributing to
health care
quality,
accessibility and
productivity
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Sarah Muttitt , Vice-President, Innovation and Adoption, Canada Health Infoway October 30 2007
The paper jungle
In spite of spectacular advances in medicine, the
foundation of health care delivery in Canada is still
paper-based:
Each year, almost all of these records are hand-written
• 100 million physician exam records
• 400 million prescriptions
• 500 million lab and radiology tests
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Current challenges
PREVENTION
Poor compliance
with prevention
guidelines
• 37– 43% of Canadians
recommended for
influenza protection
not vaccinated
• 30–40% of women at
risk of cervical cancer
not screened
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DIAGNOSIS
Huge opportunity for errors,
poor customer service, and
repeat diagnostic tests
• $15 billion worth of
prescriptions are ordered
by hand annually
• 1 billion service events
scheduled manually
• 32 % of ER patients
missing required
information, leading to an
average increased stay of
1.2 hours
TREATMENT
AND RECOVERY
Wrong decisions being made
• One in nine patients receive
wrong medication or wrong dosage
• Up to 24,000 deaths each year
result from preventable adverse
events in hospitals, largely to
incomplete information - more
deaths than from breast cancer,
motor vehicle accidents, and HIV
combined
The need for health information
management
Providers, managers,
Consumerism is
growing
Pressures on
resources are
greater
patients, public are
demanding more
IT has potential to
enable solutions to
address pressures
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Population is aging
Care settings are
shifting
Where are we today?
According to an August 2007 study by the Conference Board of
Canada:
• Fewer than one-in-four Canadian primary care doctors use
electronic medical records to keep track of patients, the
lowest of all countries in the OECD
In a 2006 Commonwealth Fund survey, Canada ranked last:
Country
Netherlands
New Zealand
United Kingdom
Australia
Canada
5
Physicians who use EMRs
98%
92%
89%
79%
23%
Annual IT spending
Percentage of total budgets/revenues
5.4
4.5
4.7
4.0
Canada’s health care system
is so huge it would rank No.
10 on the Fortune 500. It is
more than three times the
size of the country’s largest
bank (compared to total
revenue). Yet Canada underinvests in health care IT
relative to other health care
providers and information
management industries.
3.4
2.9
1.5 – 2.0
Education
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US HC
providers
UK
health care
Calgary Professional
services
Regional
Health
Authority
US banking/
financial
services
HC IT spend
Canadian
jurisdictions
Canada Health Infoway
• Created in 2001
• $1.6 billion in federal funding to date
• Independent, not-for-profit corporation
• Equally accountable to 14 federal/provincial/territorial governments
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Mission:
Goal:
To foster and accelerate the
development and adoption of
electronic health information
systems with compatible
standards and communications
technologies on a pan-Canadian
basis with tangible benefits to
Canadians.
By 2010, every province and territory and the
populations they serve will benefit from new
health information systems that will help
modernize their health care system. Further,
50 per cent of Canadians will have their
electronic health record readily available to
their authorized professionals who provide
their healthcare services.
What is an EHR?
An electronic health record (EHR) provides each individual in Canada with a
secure and private lifetime record of their key health history and care within
the healthcare system. The record is available electronically to authorized
health care providers and the individual anywhere, anytime in support of high
quality care.
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Access to detailed data
Results and images
Patient information
Medical alerts
Medication history
Interactions
Problem list
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Immunization
EHR: Overall benefits and value
•
•
•
•
Reduced wait-times for diagnostic imaging services
Improved availability of community based health services
Reduced patient travel time and cost to access services
Increased patient participation in home care
Access
•
•
•
•
Improved interpretation of diagnostic and laboratory results
Decreased adverse drug events
Decreased prescription errors
Increased speed and accuracy in detecting infectious
disease outbreaks
Quality
•
•
•
•
Increased access to integrated patient information
Reduced duplicate tests and prescriptions
Reduced physician prescription call-backs
Reduced patient and provider travel costs
Productivity
Capital cost: $10 billion – $12 billion
Benefits:
$ 6 billion – $7 billion in savings annually
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March 2004 = $123 million
53 projects
Phase 0/1 Projects
June 2007 = $1.203 billion
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233 projects
Phase 2 Projects
System in place
Infoway benefit evaluation framework
The framework articulates the link between the systems in which
Infoway invests and the resulting benefits, providing a basis for
measurement.
NET BENEFITS
System quality
Functionality
Performance
Security
Information
quality
Content
Availability
Service
quality
Responsiveness
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Quality
Use
Use Behavior/
Pattern
Self Reported Use
Intention to Use
User
Satisfaction
Competency
User Satisfaction
Ease of Use
•Patient safety
•Appropriateness/
effectiveness
•Health outcomes
Access
•Ability of patients/providers
to access services
•Patient and caregiver
participation
Productivity
•Efficiency
•Care coordination
•Net cost
An expanding EHR circle?
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Infoway’s mandate is to increase the use of electronic health
records to improve the provision of patient care
As we move toward the next generation of health care, the
envisioned health infostructures will enable data collection and
potential sharing for secondary purposes
Whether it’s for health system management, quality improvement,
population health or health research, there are huge benefits to be
realized
The coming EHR world should streamline data collection, and
improve the pervasive availability of data and the timeliness of the
information
The EHR Blueprint
JURISDICTIONAL INFOSTRUCTURE
Ancillary
Data on the EHR Blueprint will have
EHR Data
The EHR solutions
based
the features to
& Services
& Services
allow other uses of clinically relevant data while protecting confidentiality
Client
Immunization
PHS
Shared
Drug
Diagnostic
Registry
of data and
the privacy
of patients
and providers
Laboratory
Management
Reporting
Health Record
Information
Imaging
Data
Warehouse
Registries
Data

& Services
Health
Information
Provider
The data warehouse is to facilitate the controlled disclosure of anonymized
personal health information for secondary use and prevents trolling through
Location
Business
EHR
Message
Normalization
Terminology
Registry
Rules in the
Index
Rules
the available data
EHR Structures
Repository
Registry
Longitudinal Record Services
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Relevant, reliable data, required for a given purpose, could be extracted
from the EHR, anonymized at the point of extraction, and stored in one or
Security Mgmt
Privacy Data
Configuration
more data warehouses where security is assured and audited
Data
Common Services
HIAL
Communication Bus
Public Health
Services
Public Health
Provider
POINT OF SERVICE
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Pharmacy
System
Pharmacist
Radiology
Center
PACS/RIS
Radiologist
Lab System
(LIS)
Lab Clinician
Hospital, LTC,
CCC, EPR
Physician/
Provider
Physician
Office EMR
Physician/
Provider
EHR
Viewer
Physician/
Provider
Thank you
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