healthy legacy

Building a healthy
legacy together
Presentation by Shelley Lipon,

Executive Regional Director, Canada Health Infoway
to ICTAM
October 28, 2009
Expectations
What Canadians expect from their health care system
2
Strengthening health care
The key elements of the transformation include:
• Patient centred care
• Collaborative teams
• Redesigned business processes to improve access
• Evidence based care
• Relevant data capture and analysis
• Timely feedback and education
Using EHR & EMR systems as a

catalyst and enabler
3
The benefits and value of electronic health
information technologies
• Reduced wait-times for diagnostic imaging services

• Improved availability of community based health services ACCESS
• Reduced patient travel time and cost to access services
• Increased patient participation in home care
• Improved interpretation of diagnostic and laboratory results

• Decreased adverse drug events
• Decreased prescription errors QUALITY
• Increased speed and accuracy in detecting
infectious disease outbreaks
• Increased access to integrated patient information

•
•
Reduced duplicate tests and prescriptions PRODUCTIVITY
Reduced physician prescription call-backs
• Reduced patient and provider travel costs
Capital cost: $10 billion to $12 billion 4

Benefits: $6 billion to $7 billion annually
Canada Health Infoway
• Created in 2001
• $1.6 billion in federal funding
— An additional $500 million allocated in 2009 Federal
Budget
• Independent, not-for-profit corporation
• Accountable to 14 federal/provincial/territorial
governments
Mission:
Fostering and accelerating 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.
Infoway will build on existing initiatives and pursue 5
collaborative relationships in pursuit of its mission.
Infoway approach
• Collaborate with health ministries and other partners
• Co-invest with public sector partners (75:25 formula)
• Leveraged investment
• Engage clinicians
• Form strategic alliances with the private sector
• Manage risk and ensure quality solutions
• Measure benefits and adjust
• Privacy safeguards
• Strategic investor
6
Points of care
Homecar
e Emergenc
Clini
y
c
Services
Communit Pharmac
y y
Care
Centre
Laborato
ry
Speciali
st
Clinic
Hospital Diagnost
Emergenc ic 7
y
EHR architecture
JURISDICTIONAL INFOSTRUCTURE
Registries Data Ancillary Data EHR Data Data
& Services & Services & Services Warehouse
Client
Registry Immunization PHS Shared Drug Diagnostic Health
Laboratory
Management Reporting Health Record Information Imaging Information
Provider
Registry
Location
Registry Business EHR Message Normalization Terminology
Rules Index Structures Rules Repository
Longitudinal Record Services
Security Mgmt
Privacy Data Configuration
Data
Common Services
HIAL
Communication Bus
Radiology
Public Health Pharmacy Lab System Hospital, LTC, Physician EHR
Center
Services System (LIS) CCC, EPR Office EMR Viewer
PACS/RIS
Public Health Pharmacist Radiologist Lab Clinician Physician/ Physician/ Physician/

Provider Provider Provider8
POINT OF SERVICEProvider
Investment model
Upon ratification of the Federal Funding Agreement,
Infoway’s commitment will total more than $2.1 billion in 12
targeted investment programs.
9
Signposts of success
• Availability and quality of

care
• Patient safety
• Patient empowerment
• Continuity of clinical care
10
Progress across Canada
(June 30, 2009)
1
1
3 1 1
2 1
3 1
4 3 1
2 3 3 1
6 2 1 2 1 1
2 3 5 1 3 1 1 2 1 1 2 1 1
1 1
3 2 1 1
2 3 4 1
3 1 5 2 1 4 1
1 8 1 1 1 2
2 1 1 1 2 1 2
3 1 1
10 2
9 3 1
1 2
1 6 10 1
1 1 1
1 3 2 1
286 active and completed projects with 4 1 1
an estimated value of $1.594 billion as 6 2
1 1
at June 30, 2009. Over 85% of 2 2
investments in implementation or
11
adoption phases
Progress across Canada
12
Forecasted progress to March 31, 2010
13
Health information and technology priorities
Vision 2015
1
Finish what started in electronic health records and public

health surveillance
Foundational
2
Elements
Implement electronic medical records in physician

offices and physician order entry systems in hospitals
Deploy Wait Time Management Solutions
Implement Consumer Health Solutions to support

Additional
Elements
selfcare
5
Integrate Chronic Disease Management Solutions, starting
with diabetes
14
Budget 2009
Recapitalization of $500 million to:
50% goal EMRs
Clinical systems Jobs

integration 15
Infoway’s e-health
certification
service
Certification services
• Infoway launched its Consumer Health Platform
Certification Service in February 2009
• Ensures investments made in consumer health
technology solutions are complementary to
existing investments in EHR infostructure
• Additional areas of focus in near term:
— Consumer health solution applications
— Electronic medical record systems
— Hospital information systems
17
Associated benefits
• For health care organizations:
— Certified (trusted, interoperable) software solutions
• For e-health software vendors:

— Innovative product differentiation
— Certified ―once‖ in Canada
— Valuable Infoway recognition
18
Focus of certification services
Criteria consist of two classes:
Solution – refers to aspects Management – refers to

of privacy, security and how organization manages
interoperability that need to risk, data, system security,
be assessed, as well as as well as third party
functionality (limited) solutions and services
19
Why now?
• Secure sharing of health information among providers
and patients is key enabler of health care renewal in
Canada
• Information sharing for providers will happen primarily
via EHR and EMR technologies
• Within two years virtually every jurisdiction will have
data repositories connected to HIALs and capable
of sharing EHR data via messages to point-of-
service systems
— Portfolio of pan-Canadian standards needed to enable
interoperability between point-of-service systems and

EHR infostructure exists today
20
Challenges to overcome
• E-health brand tarnished
• Project slippage
• Slower than expected clinician uptake
• Adequate funding not available
• Failure to deliver viable,
interoperable EHR solutions
• Privacy and security
breaches
• Insufficient skilled human
resources
• Failure to demonstrate
expected benefits 21
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
• Saving lives 22
Thank you

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Building a healthy

Presentation by Shelley Lipon,

Using EHR & EMR systems as a

• Reduced wait-times for diagnostic imaging services

• Improved interpretation of diagnostic and laboratory results

• Increased access to integrated patient information

Capital cost: $10 billion to $12 billion 4

Longitudinal Record Services

Public Health Pharmacist Radiologist Lab Clinician Physician/ Physician/ Physician/

• Availability and quality of

Finish what started in electronic health records and public

Implement electronic medical records in physician

Deploy Wait Time Management Solutions

Implement Consumer Health Solutions to support

50% goal EMRs

Clinical systems Jobs

— Electronic medical record systems

— Hospital information systems

• For e-health software vendors:

— Certified ―once‖ in Canada

— Valuable Infoway recognition

Solution – refers to aspects Management – refers to

interoperability between point-of-service systems and

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