Transcript PowerPoint - Diagnostic Accreditation Program

Investing in BC eHealth
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Diagnostic Accreditation Program Conference | Presentation by Jim Mickelson, Executive Director – Western Canada|
Canada Health Infoway | May 12, 2008
Gartner “Hype” Cycle
Visibility
Technology
Trigger
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Peak of Inflated Trough of
Expectation Disillusionment
Maturity
Slope of
Enlightenment
Plateau of
Productivity
Computers make it easier to do a lot of things,
but most of the things they make it easier to do
don't need to be done.
- Andy Rooney
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Gartner “Hype” Cycle
Visibility
Technology
Trigger
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Peak of Inflated Trough of
Expectation Disillusionment
Maturity
Slope of
Enlightenment
Plateau of
Productivity
I have not failed. I've just found 10,000 ways that
won't work.
- Thomas Edison
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<<Province X>> to develop information network
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The <<Province X>> government has signed a 5-year
contract with <<Company y>>. for the development of a
health-information network that will link authorized
professionals across the province and provide fast access to
patient information such as prescriptions, treatment and
immunization history, and laboratory and x-ray results. The
government believes the $100-million cost of the computer
system will be recovered quickly through increased efficiency,
reduced health care fraud and the creation of new preventivecare programs.
-CMAJ – June 1, 1996
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Infoway releases technology blueprint that
will guide and accelerate the development of
interoperable electronic health records in
Canada
Montreal, July 29, 2003 - Canada Health Infoway today released its
electronic health record solution blueprint (EHRS Blueprint). The
Blueprint is a fully validated, scalable business and technical
architecture that will guide the development of EHR solutions in
Canada. It represents a major milestone toward achieving Infoway's
mission of accelerating the implementation of these systems in support
of improved quality of care and patient safety.
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The need for EHR
in Canada
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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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Great expectations
What Canadians expect from their health care system:
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Accurate information that moves with them
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Communication between their various health care providers
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Protection of their privacy
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Input into decisions
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Elimination of undue risk
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Timely access/results
EKOS survey of 2,000 Canadians, 2003
EKOS survey of 2,500 Canadians, 2004
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Interoperability challenges
700 hospitals
40,000 general practitioners
315,000 nurses
29,000 specialists
26,000 pharmacists
1,600 long-term care facilities
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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
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
healthcare 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
Capital cost: $10 billion to $12 billion
Benefits:
$6 billion to $7 billion in savings annually
Quality
• Better continuity of care improves disease and
case management
• Appropriate care adheres to standards
• Prevention of adverse events and public health threats
Productivity
• Provides time savings
• Avoids unnecessary diagnostics, procedures and visits
• Optimizes coordination of human resources
Improving quality improves health,
reduces the burden on the system,
and ensures optimal
use of capacity.
Improving the productivity of health
care saves costs and makes optimal
use of available human and other
resources.
Access
•
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•
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Timely delivery of care
Increased interpretations by remote specialists
Improved 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
Increased patient access and use of their health record
Reduced wait times
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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
Mission:
Goal:
To foster and accelerate the
By 2010, every province and territory and the
development and adoption of
populations they serve will benefit from new
electronic health information
health information systems that will help
systems with compatible standards
modernize their healthcare system. Further, 50
and communications technologies
per cent of Canadians will have their electronic
on a pan-Canadian basis with
health record readily available to their
tangible benefits to Canadians.
authorized professionals who provide their
healthcare services.
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Infoway programs
Ten investment programs totalling $1.636 billion
End-user Adoption
and Setting the
Future Direction
Healthcare
Applications and
Innovation Projects
Innovation and Adoption – $60 million
Innovation and Adoption - $60 million*
Telehealth
$100 million
The Electronic
Health Record
Registries and
Domain Repositories
Architecture
and Standards
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Public Health
Surveillance
Patient Access
to Quality Care
$135 million
$50 million
Cancer
Primary Care
Chronic Diseases
Mental Health
Interoperable EHR – $365 million
Registries
Drug Systems
$134 million
$250 million
Laboratory
Systems
Diagnostic
Imaging
$170 million
$340 million
Infostructure – $32 million
December 2007 = $1.332 billion
245 projects **
Phase 0/1 Projects
Phase 2 Projects
System in place
•Approximately $150 million invested in BC
20 ** Includes 93 pan-Canadian projects not shown
Progress to date
Jurisdictional Progress to March 31, 2008
Domain
Jurisdiction
Client
registry
Provider
registry
DI
Drug
Lab
iEHR
PHS
Complete
AB
Adoption
BC
Implementation
PE
Planning
SK
Forecast
NL
MB
ON
NS
QC
NB
NT
YT
NU
Percent Deployed at Mar.31, 2008
71
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64
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30
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0
Note:
1.
“Percent Deployed” is the percent of the Canadian population covered by the solution
2.
To depict both full and partial progress “Percent Deployed” is calculated as 100% of the jurisdiction population if the project is complete
and 50% of the jurisdiction population if the project is in the adoption phase
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Status:
British Columbia
Investment Summary
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Deciding on the Right Investments
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EHR Architecture
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Infoway DI Investments in BC

Fraser Health

»One of Infoway’s first
investments
»Supported regional
PACS implementation
and a single repository
Interior Health
»Supported the
completion of the
regional PACS
implementation
and a single
repository

Provincial
»Plan being revised
to align with
provincial ehealth
priorities
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Key Findings: PACS Evaluations
Improvement in productivity
After one year of implementation, BC’s Fraser Health Authority had a 17% reduction in operating cost per
exam in a PACS environment in comparison to a pure film environment, ($37/exam vs $44/exam)
87% of Radiologists and 73% of Referring Physicians indicated that PACS has increased their reporting and
consultation efficiency
Across BC’s Interior Health Authority project sites (n=22), average Report Turn Around Time decreased by
41%
60%
Decrease in Report Turn Around Time following PACS Implementation
40%
20%
41%
51%
53%
Rural sites
Sites without on-site
Radiologist
0%
All sites
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Infoway Drug Investment in BC

eDrug
»Builds on “All Drugs All
People” repository of
Pharmanet
»Adds additional content
(e.g. in-hospital
medications)
»Adds eprescribing
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Infoway Lab Investment in BC

Provincial Lab Information System (PLIS)
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»Managed in
conjunction with the
BC iEHR project
»Planned to be the
first ehealth “clinical
domain” deployed
through the ehealth
infostructure
»Provides for a
provincial lab
repository
EHR Architecture
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Infoway Registries Investment in BC

Provincial Client and Provider Registries
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»Provincial Client
Registry to enable
accurate identification
of patients connected
with their EHR data
»Provincial Provider
Registry enables
accurate identification
of providers and for
them to be
appropriately connected
with EHR data
EHR Architecture
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Infoway iEHR Investment in BC

Provincial EHR Infostructure
»Enables sharing of EHR
data from multiple
domains
»Enables appropriate
privacy and security
»Includes “Secure
Health Record” –
clinically relevant data
not available in the
drug, DI, and Lab
repositories
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Other Infoway Investment in BC

Public Health Surveillance
»Panorama application implementation

Telehealth
»Clinical expansion and First Nations
telehealth expansion

Innovation and Adoption
»Patient Safety and Learning System
»Mental Health and Addictions Patient Flow
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2008–09 action plans
Forecasted Progress to March 31, 2009
Domain
Jurisdiction
Client Provider
registry registry
DI
Drug
Lab
iEHR
PHS
Complete
PE
Adoption
AB
Implementation
BC
Planning
SK
Forecast
NL
QC
MB
NS
NB
ON
NT
YT
NU
Percent Deployed at Mar.31, 2009
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Status:
76
63
79
59
51
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Note:
1.
“Percent Deployed” is the percent of the Canadian population covered by the solution
2.
To depict both full and partial progress “Percent Deployed” is calculated as 100% of the jurisdiction population if the
project is complete and 50% of the jurisdiction population if the project is in the adoption phase
The promise
• Increased patient
participation in care
• Well-managed chronic illness
• Improved access to care in
remote and rural communities
• Fewer adverse drug events
• Better prescribing practices
• Reduction in duplicate or
unnecessary tests
• Reduced wait times
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Thank you!
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