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EHR as the Platform for Interoperability
Introduction: Simon Hagens, Canada Health Infoway
Susan Anderson, Orion Health
Perry Poulsen, Manitoba eHealth
Laura White, Provincial Health Services Authority
Moderator: Jim Mickelson, Canada Health Infoway
©Canada Health Infoway 2015
Electronic Health Records
Adoption and Benefits so far…
©Canada Health Infoway 2015
What does an EHR tell us?
3
Patient & clinician
demographics
Lab results, images
and clinical reports
Patient alerts, e.g.
allergies
Medication history
Health system
interactions
©Canada Health Infoway 2015
Active EHR User Growth
Notes:
1. Figures represent active users with access to two or more integrated provincial data assets (e.g., lab information system, drug information system, diagnostic imaging repository, etc.)
2. Active users have accessed the system a minimum of one time per month
3. This graph does not depict the number of users of individual data assets that are not integrated with other systems. 4. Users of point of care systems with data feeds from provincial assets are deemed to be active users of the EHR
4
250,000 Clinicians report
access to data from beyond
©Canada Health Infoway 2015
Per Capita Usage
AB
NS
MB
BC
SK
ON
QC
NB
NL
5
50-200%
30-50%
5-20%
Estimated Growth
Through 2015
©Canada Health Infoway 2015
Benefits
6
Deployment
• Limited
benefits
Early
• Impact on
information
quality
Medium-term
• Efficiencies
Longer-term
• Impact on
care
©Canada Health Infoway 2015
5%
3%
9%
13%
13%
Re-ordered a lab test
Re-ordered a diagnostic image
Patient time was wasted (eg.
waiting)
My time was wasted (eg. searching,
calling, waiting)
Forced to proceed with incomplete
information
Unconnected
Physicians
% of all encounters for each cohort with a specific impact generated by an information gap *All results statistically significant
7
Fewer Information Gaps & Consequences
2%
1%
5%
10%
4%
5%
3%
9%
13%
13%
Re-ordered a lab test
Re-ordered a diagnostic image
Patient time was wasted (eg.
waiting)
My time was wasted (eg. searching,
calling, waiting)
Forced to proceed with incomplete
information
Connected
Physicians
©Canada Health Infoway 2015
Manitoba’s EHR
Are we there yet?
Perry Poulsen, CIO, Manitoba eHealth
November 2015
eChart Manitoba – What we have
10
Dispensed
Medication
Immunization
Lab Results
eChart
Manitoba
Clinical Data
Repository
eChart Manitoba Clinical Viewer
Local Clinical
Systems
eHealth InfrastructureDiagnostic
Imaging
Reports
Other
Clinical
Information
Clinical Information Delivery Stored DataHealthcare
Organization
eChart ViewProvincial
Client
Registry
ADT
Systems
H
Where we are
“I can honestly say that eChart has
been one of the single most beneficial
innovations to the health care of
Manitobans from my perspective in
the last five years.” - -Tunji Fatoye, MD,
CCFP, Unit Director, Kildonan Medical
Centre
What we have seen
4,589 4,740 4,813 4,885 16.92 16.63 17.78 17.04 32.35% 33.29% 32.76% 33.04% 0.00 2.00 4.00 6.00 8.00 10.00 12.00 14.00 16.00 18.00 20.00 3,000 3,200 3,400 3,600 3,800 4,000 4,200 4,400 4,600 4,800 5,000Apr May Jun Jul
Active Users
Active Users Average Logins Per Active User % Active
Adoption
Error reduction
Efficiencies
ALBERTA PERSPECTIVE
Page 16 • 2015
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©Orion Health™ group of companies THINKING SOFTWARE FOR LIFEThe Meaningful Use Journey – Where is Alberta at …
Level 1
Data capture and
sharing
Level 2
Advanced
clinical processes
Level 3
Improved
outcomes
Increase implementation and adoption of EHR systems Capture structured data Increase exchange of health information Demonstrate care coordination across sites of care Empower patients with health information Drive use of real-time data at the point of care Use outcomes-focused clinical quality measures Utilize clinical decision support for prevention, disease management and safety
Page 17 • 2015
17
©Orion Health™ group of companies THINKING SOFTWARE FOR LIFE Consumer Health IT
- Patient Observations Recorded in EHR *
- Enabled Self Management
- Provider / Patient Communication
Interoperability / Exchange
- Provider exchange with other Providers
- Provider exchange with other organizations and
government
Quality Measurement Driving Quality
Improvement
- Alignment with Broader Quality Measurement
Strategies
A Look to the Future
Meaningful Use
Strategic Direction
* “We must integrate patient portals and LTC into our health records”
Dr. Chris Hobson, Canadian Healthcare Technology, September 2015
CareConnect: BC’s eHealth Viewer
Stats as of Sept 2015
Laura White, Executive Director, Clinical
Information Services, IMITS
eHealth Viewer -
Available Data
(October 2015)
CareConnect Systems -
Deployment
21