Longwoods Health Informatics

SIMS Partnership to revise structure and change the name to the GTA Health Information Collaborative (HIC).

2010-04-05T12:25:00.001-04:00

(Toronto, March 2, 2010) - An information management and information technology (IM/IT) partnership between 16 health care organizations in the Greater Toronto Area is getting a facelift. With the increasing size of the SIMS Partnership, members have elected to revise the group's structure to a more formal 'association' and change the name to the GTA Health Information Collaborative (HIC). A sub-set of the group that shares IM/IT resources will continue under the SIMS Partnership name and as a major IM/IT delivery partner for the region.
"This is the next step in the evolution of our growing IM/IT partnership," said Barry McLellan, Chair of the GTA HIC and President and CEO of Sunnybrook Health Sciences Centre. "As health care organizations across the GTA collaborate further on these types of projects, we can only stand to improve the experience for our patients. SIMS provided a great foundation for this important step in our development and this association continues to move in the right direction for the Ontario health care system."

Since its inception in 2004, the SIMS partners have worked on integrating projects across all participating organizations, which consist of acute, rehabilitation, community, complex continuing and long-term care facilities. The group has leveraged IM/IT as a key enabler for health system improvement, increasing electronic charting capability, streamlining and standardizing referral processes and improving the use of information to support patient safety, better access to care and more optimal use of health care resources.

The SIMS Partnership's collective success and commitment to improve patient care has benefitted each partner organization as well as the broader health care system.

"Through SIMS, we worked together to improve and achieve the seamless transition of care for clients across the health care field, securely exchanging client information as needed between acute care, cancer care, CCACs, long-term care facilities, community providers and rehab," said Camille Orridge, CEO of the Toronto Central Community Care Access Centre. "As we have grown, we realized we needed a renewed structure to maintain the momentum. The association continues on this path - meeting the needs of our clients."

Governance for the association will be provided by CEOs of all member organizations and a selected Chair. The GTA HIC will continue to drive high quality clinical and service collaboration and integration in the GTA, enabled by the IM/IT expertise provided through the SIMS Partnership and the resources of the other individual organizations.

To date, the association's members include Bridgepoint Health, Central Community Care Access Centre, Humber River Regional Hospital, North York General Hospital, Providence Healthcare, St. John's Rehab Hospital, St. Joseph's Health Centre, St. Michael's Hospital, Sunnybrook Health Sciences Centre, Toronto Central Community Care Access Centre, Toronto East General Hospital, Toronto Rehabilitation Institute, Trillium Health Centre, University Health Network, West Park Healthcare Centre and Women's College Hospital.

For further information, please contact:
Patti Enright, Senior Communications Advisor,
Shared Information Management Services (SIMS)
Tel: (416) 340-4800 ext. 4097
E-mail: Patti Enright.

The Academy of Canadian Executive Nurses (ACEN) invites you to a 2-hour discussion focused on Transforming Care.

2010-01-15T16:33:00.001-05:00

On Friday, February 5, 2010, from 1 p.m. to 3 p.m. Toronto time . . . . three keynotes speakers will share their insights and contribute to a discussion led by Mary Ferguson Paré of the University Health Network. The program has been designed by Dr. Ross Baker of the University of Toronto and he will provide the context and introduce the session.

Your hosts are ACEN members and Dr. Mary Ferguson Paré and Dr. Ross Baker.

You do not have to be an ACEN member to participate in the webcast.

We have three noted guest presenters. Details below.

THIS IS A WEBCAST made available to all users by BAXTER

[We do have 20 seats left at the University Health Network in Toronto where the actual presentations are hosted. We will fill those seats on a first come basis.]

Here are registration details:

The Academy of Canadian Executive Nurses (ACEN) presents:

Transforming Care

University Health Network
Room 1EN 429/430
University Health Network, Toronto

AND

By WEBCAST

Time: 1 p.m. to 3 p.m. EST

If you would like to participate in-person at the University Health Network (only 20 seats available) Click here to REGISTER (note we can only accept another 20 people at the conference site. First come | first served.)

If you would like to participate directly by webcast Click here to REGISTER

If you would like your hospital to participate in this event, please contact your hospital's onsite OTN Coordinator. SITE COORDINATORS: Please register your site here

Out of Province: Please contact the Ontario Telemedicine Network at: scheduling@otn.ca to register for the event. Include the following reference number 9146668

ACEN 2010 ANNAUL MEETING FACULTY

TRANSFORMING CARE AT THE BEDSIDE: Patricia Rutherford, RN, MS, Vice President, Institute for Healthcare Improvement

PRESENTATION: Will present IHI’s program: Transforming Care at the Bedside (TCAB), a national program of RWJF and IHI, that engages leaders at all levels of the organization to: Improve the quality and safety of patient care on medical and surgical units | Increase the vitality and retention of nurses | Engage and improve the patient’s | family members’ experience of care | Improve the effectiveness of the entire care team

BACKGROUND: Manages IHI's programs in

· Clinical office practice redesign

· Improving access and flow in specialty practices

· Optimizing care coordination and transitions in care, and the

· Transforming Care at the Bedside initiative.

· Co-investigator for the STate Action on Avoidable Rehospitalizations (STAAR) initiative.

· process improvement, innovation, and idealized design

· large-scale performance improvement initiatives.

RELEASING TIME TO CARE: Marlene Smadu, RN, MA, PhD, Associate Dean College of Nursing,

University of Saskatchewan

PRESENTATION: Will discuss Saskatchewan’s initiatives related to The UK-based program is called "Releasing Time to Care: The Productive Ward". It empowers nurses, and other members of care teams, to look at how their ward is organized and to make changes that allow them to spend more time with patients.

BACKGROUND:

· Chair CPSI Education and Professional Development Committee

· Vice Chair, Saskatchewan Health Quality Council

· Member of the Quality Worklife-Quality Healthcare Collaborative.

· Focus on health human resources, aboriginal health, health policy and knowledge transfer

WORK REDESIGN: Patricia O’Connor, RN, MSc(A), CHE, Associate Director of Nursing, MUHC

PRESENTATION: Will present the impact of Work Redesign on the quality of care and the work environments

BACKGROUND: Commonwealth Fund Harkness Associate in Health Policy & Practice Neurosciences Assistant Professor, School of Nursing, McGill University

· Guest faculty member of the Canadian Patient Safety Institute’s Safer Health Care Now National Falls Prevention Collaborative

· Fellowship – the EXTRA Program with CHSRF

· Fellow in the Canadian College of Health Service Executives.

· Past President of the Academy of Canadian Executive Nurses.

WE WOULD LIKE TO THANK BAXTER FOR THEIR GENEROUS SUPPORT TO ENABLE THIS INTERNATIONAL WEBCAST.

Baxter Worldwide > Canada

Getting a Dialogue Started

2010-01-12T12:32:00.003-05:00

The comments below from Dominic Covvey are posted as a starting point for a discussion on ehealth and where we find ourselves today in the rollout of electronic records at all levels (within physician’s offices, regional health authorities, provincial and national strategies). Several recent auditor generals’ reports - one on ehealth in Ontario (http://www.ehealthontario.on.ca/pdfs/News/AG_Report_en.pdf) and the other at the federal level on electronic health records and the role of CHI (http://www.oag-bvg.gc.ca/internet/docs/parl_oag_200911_04_e.pdf) provide background material for some of the concerns over consultants and their fees, accountability, achievement of targets, and the costs of implementing an EHR.

An initial human resources ‘sector scan’ undertaken jointly by CHIMA, COACH, ICTC and ITAC Health has also provided a snapshot of the number of qualified professionals in health informatics and health information management, or the ehealth workforce more generally, and shows there is both a skill shortage (available workers who need to upgrade skills to incorporate knowledge of health information technology and informatics) and a labor shortage (a general lack and availability of skilled ehealth workers) (https://www.echima.ca/media/documents/HIHIM_report_E_web.pdf). The latter study concludes that “There is a serious risk that labour shortages and skills shortages will constrain the successful implementation of EHIS technologies in Canada…System-based, human resources planning measures should be a priority to ensure that the substantial investments that governments at all levels are making in EHIS technologies deliver the promised benefits.”

I have provided links to these documents and Dominic Covvey’s comments to get the dialogue started. What are the problems and more importantly how can we address them? We hope that this blog will form a forum for discussion, commentary, sharing of ideas, and feedback.

“Related to what some have termed the “ehealth debacle”, I am sure that there are at least as many opinions regarding causal factors as there are people opining. However, an understanding of our situation and what we are trying to do through ehealth certainly leads to some reasonable hypotheses about why things are not entirely copacetic. Consider the following possibilities: (1) the lack, or inadequate quality, of oversight, (2) less than full accountability, (3) the sometimes ‘bum’s rush’ to get ehealth projects underway and get EHR components in place…although perhaps not always the right components given true needs, (4) the ‘fire hose’ of funding from which only consultants seem to be able to drink, (5) the absence or weakness of the business case for, and of the evidence of the proven value of, ehealth with the consequent challenge of deciding in what to invest, how much, and what’s enough, (6) the reticence to recognize the magnitude of the ehealth challenge and what we will need to invest to realize our dreams, and (7) the dearth of fully qualified ehealth professionals. I personally believe that each of these contributes to the current embarrassing situation. A perhaps very important factor is that we have not yet recognized the magnitude and dimensionality of the challenges we face…in other words, we don’t, or aren’t willing, to fully comprehend the problem we are confronting.”

A $32 million University-Based Training Program Funding Opportunities Announcement was released December 17th. National Coordinator for Health Information Technology (ONC)

2010-01-02T18:09:00.000-05:00

A $32 million University-Based Training Program Funding Opportunities Announcement was released December 17th. Through a competitive process, eight or more 4 year institutions of higher education will receive grants to establish programs that will rapidly increase the availability of graduates in vital highly specialized health IT roles over the course of three years.

Please note that the Office of the National Coordinator for Health Information Technology (ONC) will be hosting a Technical Assistance call for potential University-Based Training Program applicants on Tuesday, January 5th from 3:00 PM to 4:00 PM EST.

Interested parties are encouraged to join the call using the following information:

To participate:
• https://www.livemeeting.com/cc/dt/join?id=P4Z656&role=attend&pw=7B%29CMkR
• Audio
o Dial in number: 877-601-4720
o Participant passcode: 1414879

For detailed information on the University-Based Training Program visit http://healthit.hhs.gov/universitytraining.

There will be time reserved for a Question and Answer session. Please be advised that the TA call will be a listen only event as questions can only be accepted electronically. You are encouraged to submit questions in advance to university-based-training@hhs.gov. During the call, questions will be accepted via the questions tab in the Live Meeting environment.

A previous technical assistance call was held in December 23, and a PowerPoint slide presentation from the call is available at http://healthit.hhs.gov/universitytraining.

Visit http://healthit.hhs.gov/hitechgrants for information on additional HITECH funding opportunities.

First Time Users:
To save time before the meeting, check your system to make sure it is ready to use Microsoft Office Live Meeting.

________________________________________
Manage your Health IT Subscriptions:
• Update your preferences or unsubscribe

GovDelivery, Inc. sending on behalf of the U.S. Department of Health & Human Services • 200 Independence Avenue SW • Washington DC 20201 • 1-877-696-6775

E-health revolution; Island doctors and nurses first in B.C. to have instant access to patients' histories

2009-12-23T17:24:00.000-05:00

Times Colonist (Victoria)
Wed Dec 23 2009

Byline: Richard Watts

A state-of-the-art medical-information system is speeding up service and improving care for patients across Vancouver Island.

Doctors and nurses on the Island are the first in B.C. to have the ability to instantly access a patient's medical history, including hospital visits and prescriptions, through an electronic healthrecords system that, after a year of being in use, is saving time and money, and improving care.

If you've spent time in a Vancouver Island hospital since 2002, the e-health system will have a record of it. If you've had a medical test performed in a lab attached to one of those hospitals, the results will be there. In fact, if you've been treated at any of the 138 Vancouver Island Health Authority facilities on the Island (from hospitals to health units and seniors' care centres), doctors and nurses can pull up your history on a computer station.

"This electronic health-care record is a one-patient, one-record solution," said Catherine Claiter, chief information officer for the Vancouver Island Health Authority. It "contains all lab results,diagnostic images [X-rays] and records, transcribed documents like [consultation] reports,[operating-room] notes, discharge summaries, a complete medication profile."

It means that instead of a patient's medical history being stored on paper charts at various facilities -- with bits and pieces in each place -- the entire file is now accessible via computer at every facility.

Gone are the days when a doctor might have to interpret a patient's explanation about a previous visit to a different hospital. A patient might say, "I don't know what they did. They put me in a tube."

But now the electronic chart can tell the doctor the patient had a CT scan, not an MRI, and can even provide the resulting images.

"So many people have complex medical histories and they can't keep this information," said emergency room physician Dr. Jim Goulding, who says the system has improved his abilities "infinitely."

Previously, "you had to wait for an old chart and that old chart might be volumes of old charts and it could take you a half hour to find one piece of paper." The e-health system is unmatched by anything in the other four B.C. health regions.

None of them have one centralized records system, said Claiter and chief medical information officer Dr.Mary-Lyn Fyfe. Instead, data systems are often fragmented between communities and even individual hospitals have differing systems that can't link up.

Still, it hasn't come cheaply -- to date, it has cost about $67 million. The system began in 2001,with a project named VYSTA. After five years of software development and hardware purchases costing about $50 million, the VYSTA project had linked up the four South Island hospitals: Victoria General, Royal Jubilee, Saanich Peninsula and Lady Minto.

The subsequent rollout to the rest of the Island finished up in 2008 and cost $17 million.

While VIHA won't put a price tag on how much money has been saved through the e-health system -- VIHA chief executive officer Howard Waldner has only said it saves "millions of dollars" -- it is making a clear difference to staff workload. In particular, it frees up nurses to provide more direct care to patients -- studies show nurses spend at least 30 per cent of their days on the phone, chasing paper, or tracking people down looking for information.

Donna Saltman, operations manager for the emergency room at the Victoria General and a registered nurse, described the new bundling of information into one system as a "huge step forward."

"It helps plan the care in the emergency room, and it may influence in the future," said Saltman. Claiter and Fyfe also credit the system for eliminating "doubling up" of tests in separate facilities. If new tests are ordered, their results can be compared with older results.

And the system also works seamlessly with the provincial PharmaNet program, introduced in 1995 to link every pharmacy in the province and record all medications handed out.

"That's a big deal," said Claiter. "Oftentimes patients come in unconscious or they are not able to report to us what medications they're actually using, and now we can get one-click access.

"Previously it was phone calls, trying to get hold of a community pharmacy -- 'Can you look up on PharmaNet?' -- or even calling in a pharmacist to come and look it up," she said.

And the system overcomes geographic distances.

Previously, when a general practitioner on the North Island was seeking a transfer for a patient to a specialist's care in Victoria, there could be problems of language, terminology and even perception. The specialist would be demanding various test readings while the GP was leafing through stacks of paper.

But with the e-health system, both physicians can access a patient's chart at the same time and come to a more reasoned conclusion about care.

"A specialist will say, 'Let's both go on Power Chart, let's look at it,' " said Fyfe. "And then they say, 'You know what? This person is really sick. I agree with you. I'm going to pull out all the stops to make sure this patient gets transferred.'"

Claiter points out in conversations like this, "the data tells the story."

"In the non-electronic world, what could have happened in that situation is that record, that history, would have been locked in an office on a paper chart," she said. For privacy's sake, the data system is digitally locked behind multi-step computer firewalls, requiring various passwords and authentication. And it runs from a main server, secure, in an earthquake-resistant building.

The next step will be an electronic clinical documentation project to write up ongoing care requirements, outlining things like the potential for a patient to suffer a dangerous fall. That's expected to come in 2011, first in the new patient-care tower of Royal Jubilee Hospital and then on the rest of the Island.

The system doesn't yet include information compiled by general practitioners operating in private practices, but those GPs can log in from anywhere and take a peek.

rwatts@tc.canwest.com

Welcome to the NIHI Health Informatics blog

2009-11-09T10:50:00.003-05:00

Welcome to the NIHI Health Informatics blog

The NIHI Health Informatics blog is devoted to the discussion of issues/topics related to the practice of, teaching of, and research in health informatics and provides for its community of users a meeting place

· to register issues, to articulate what they are about, to get input on them and to try to achieve consensus on them.

· for friendly debate.

· to raise the awareness of the HI community regarding important matters (articles, reports, events).

· to suggest collaborations or worthwhile projects and to find collaborators.

· to discuss key topics of interest to HI professionals in Canada

· to discuss key topics of interest to HI professionals across the world.

To make it easier to follow threads and discussions through the blog we ask that you label your post with a tag that identifies the area of interest, e.g. education, research, human resources, HI applications, funding, etc.

The blog will be moderated. I'll act as coordinator and blog poster for central Canada and I am looking for (or will ask ; )) for moderators from the east and west coasts so we can cover all issues that are of interest across the country.

This is a new experience for us and I'm sure we'll be learning as we are doing, but we invite all to participate and join in the discussion.

Candace Gibson

"Meaningful" Progress Toward Electronic Health Information Exchange

2009-10-01T15:54:00.001-04:00

"Meaningful" Progress Toward Electronic Health Information Exchange

A Message from Dr. David Blumenthal, National Coordinator for Health Information Technology

I recently reported on our announcement of State Health Information Technology Grants and grants to establish Health Information Technology Regional Extension Centers, as authorized under the Health Information Technology for Economic and Clinical Health (HITECH) Act provisions of the American Recovery and Reinvestment Act of 2009 (the Recovery Act).

Today I want to discuss the important term “meaningful use” of electronic health records (EHRs) – both as a concept that underlies the movement toward an electronic health care environment and as a practical set of standards that will be issued as a proposed regulation by the end of 2009.

The HITECH Act provisions of the Recovery Act create a truly historic opportunity to transform our health system through unprecedented investments in the development of a nationwide electronic health information system. This system will ultimately help facilitate, inform, measure, and sustain improvements in the quality, efficiency, and safety of health care available to every American. Simply put, health professionals will be able to give better care, and their patients’ experience of care will improve, leading to better health outcomes overall.

As many of you are aware, the HITECH Act provides incentive payments to doctors and hospitals that adopt and meaningfully use health information technology. Eligible physicians, including those in solo or small practices, can receive up to $44,000 over five years under Medicare or $63,750 over six years under Medicaid for being meaningful users of certified electronic health records. Hospitals that become meaningful EHR users could receive up to four years of financial incentive payments under Medicare beginning in 2011, and up to six years of incentive payments under Medicaid beginning in October 2010.

The HITECH Act’s financial incentives demonstrate Congress’ and the Administration’s commitment to help those who want to improve their care delivery, and will serve as a catalyst to accelerate and smooth the path to HIT adoption by more individual providers and organizations. The dollars are tangible evidence of a national determination to bring health care into the 21st century.

The Office of the National Coordinator for Health Information Technology (ONC) is charged with coordinating nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information. ONC is working with the Centers for Medicare & Medicaid Services (CMS), through an open and transparent process, on efforts to officially designate what constitutes “meaningful use.”

ONC has already engaged in a broad range of efforts to support the development of a formal definition of meaningful use. The HITECH Act designated a federal advisory committee, the HIT Policy Committee, with broad representation from major health care constituencies, to provide recommendations to ONC on meaningful use. The HIT Policy Committee has provided two sets of recommendations, informed by input from a variety of stakeholders. ONC and CMS have also conducted a series of listening sessions to solicit feedback from more than 200 representatives of various constituent groups and an open comment period where over 800 public comments were submitted and reviewed. The second set of recommendations on meaningful use was issued at a July 16 HIT Policy Committee meeting and details can be found at healthit.hhs.gov/policycommittee.

CMS is expected to publish a formal definition of meaningful use, for the purposes of receiving the Medicare and Medicaid incentive payments, by December 31, 2009. At that time, the public will be able to comment on the definition, and such comments will be considered in reaching any final definition of the term.

By focusing on “meaningful use,” we recognize that better health care does not come solely from the adoption of technology itself, but through the exchange and use of health information to best inform clinical decisions at the point of care. Meaningful use of EHRs, we anticipate, will also enable providers to reduce the amount of time spent on duplicative paperwork and gain more time to spend with their patients throughout the day. It will lead us toward improvements and sustainability of our health care system that can only be attained with the help of a reliable and secure nationwide electronic health information system.

The concept of meaningful use is simple and inspiring, but we recognize that it becomes significantly more complex at a policy and regulatory level. As a result, we expect that any formal definition of “meaningful use” must include specific activities health care providers need to undertake to qualify for incentives from the federal government.

Ultimately, we believe “meaningful use” should embody the goals of a transformed health system. Meaningful use, in the long-term, is when EHRs are used by health care providers to improve patient care, safety, and quality.

What’s next?

As stated above, the next step in our process is a notice of proposed rulemaking in late 2009 with a public comment period in early 2010. As this process unfolds, we will continue to talk and share experiences about transitioning to EHRs, and to help deepen understanding among physicians and hospitals about the use of EHRs. We will also present programs designed to help smooth the transition process, and identify activities physicians and hospitals can engage in now to promote adoption of EHRs. As efforts advance, we will turn our attention to other necessary supporting programs, some of which you will hear more about in the coming weeks, including defining what constitutes a “certified” EHR, which is one of the requirements to qualify for Medicare and Medicaid incentives.

In the meantime, what can providers do to move toward becoming “meaningful users” – even in the absence of a formal definition? Naturally, while understanding that the final definition will be adopted through a formal rulemaking process, it will be helpful to be as familiar as possible with the discussion of meaningful use criteria to date. (You will find that information posted at healthit.hhs.gov/meaningfuluse.)

Armed with an understanding of the discussion of meaningful use as it unfolds, providers can begin to consider how their own practices or organizations might be reshaped to enhance the efficiency and quality of care through the use of an electronic health record system. Be assured you will not be alone as you seek to adopt an EHR system. Through our recently announced collaborative HITECH grants programs and others to be initiated later this year, we will continue to support providers in moving forward. Additional details about the grants are also available in my previous update and at healthit.hhs.gov/HITECHgrants.

To some providers, particularly small or already stretched physician practices or small, rural hospitals, the path toward meaningful use may still seem arduous. To others, who would just prefer to stick with the “status quo,” it may seem like an unwanted intrusion. We believe that the time has come for coordinated action. The price of inaction – in adverse events, lost patient lives, delayed or improper treatments, unnecessary procedures, excessive costs, and so on – is just too high, and will only get worse.

There is much at stake and much to do. We must relieve the crushing burden of health care costs in this country by improving efficiency, and assuring the highest level of patient care and safety regardless of geography or demographics. By using current technologies in a meaningful way, as well as technology to be developed in the future, we will take great strides toward solving some of the most vexing problems facing our health care system and creating a new platform for innovative solutions to health care.

I look forward to providing periodic updates, and to continued interactions with all the communities that have so much to gain from this profound transformation.

Sincerely,

David Blumenthal, M.D., M.P.P.
National Coordinator for Health Information Technology
U.S. Department of Health & Human Services

This letter is part of a series of ongoing updates from the National Coordinator for Health Information Technology. The Office of the National Coordinator for Health Information Technology (ONC) encourages you to share this information as we work together to enhance the quality, safety and value of care and the health of all Americans through the use of electronic health records and health information technology.

For more information and to receive regular updates from the Office of the National Coordinator for Health Information Technology, please subscribe to our Health IT News list.

If you have difficulty viewing this message, please view it online. To ensure that you receive future correspondence, please add this email address to your list of secure addresses.