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e-Health & Portal OverviewApril 2009

Dale AndersonSenior Consultant, Stakeholder Engagement

Today’s Reality…

Hamilton Niagara Haldimand Brant LHIN

How We Bank

How We Travel How We Book Hotels


How we do Healthcare

Make anAppointment

Sit in WaitingRoom

See Doctor Call for Results

Lack of information management leading to severe impediments in care delivery

Patient treatment process and issues arising from poor information management

Poor compliancewith preventionguidelines

Huge chance of errors,poor customer service,repeat diagnostic tests

Wrong decisions

•37-43% of Canadians recommended for influenza protection are not vaccinated

•30-40% of women at risk of cervical cancer are not screened

•$15 billion in annual prescriptions are handwritten

•1 billion service events are scheduled manually by phone

•32% of ER patients were missing required info, leading to an average increased stay of 1.2 hours

•Estimates suggest 1 in 9 patients receive wrong medication or dosage

•Up to 24,000 deaths each year from preventable adverse events in hospitals, many due to incomplete information

This represents more deaths than from breast cancer, motor vehicle accidents,and HIV combined

Prevention TreatmentDiagnosis

E-Health Portal Platform


Gartner Group eHealth Value & Complexity

Clin

ical

& F

inan

cial

Val

ue

Complexity & Comprehensiveness

Level 1Static SitesPresence

Brochure-wareOverviews of services

Lists of physicians, jobs, etc.Maps & directions, FAQs

Level 2Dynamic Sites

Marketing

CMS solutionsHealth content & tools,

news feeds.Updatable directories

for physicians, classes, jobs, etc.Search features

CalendarSurveys

AnnouncementsDocument library

Level 3Transactional Portals

Integration

CMS integrated 3rd

party content.Discussion forumsSecure messaging

AppointmentsPrescriptions

ReferralsPatient Clinical Questions

Pre-registrationTest results

e-CRM/Self-serviceBill view/Payment

Pat. self-monitoringPat. health record

Medication trackingRisk assessments

Level 4Transformational

PortalsBusiness Process

Management

Workflow automation:Appointment scheduling

Alerts & remindersIntegration with

patient record.Physician mediated

messaging.Medical device uploads.

Triage; disease mgt. Self-directed care

Information therapyPersonalization & profile

management.Virtual office visits:

e-Visit/Follow-upSecond opinionReimbursement

Virtual business office:Patient financials

BillingInsurance

55%

mostof the

marketis here

5%

30%

10%


CONSUMERPortal Manager

Consumer Portal Manager

ePlatform

• Consumer-based content mgmt• Web-based communications • Relevant & reliable health info • Convenient class registration • Job postings with online response • Online shopping and e-cards • Personal Health Record • Reminders and alerts• Experience personalization • Sophisticated contact forms• Mapping and location • Highly flexible configurations• Easy to manage dynamic content• Dynamic taxonomies • Intuitive content channels• Customer Relationship Mgmt tools• “One to One” mktg capabilities


EMPLOYEEPortal Manager


Employee Portal Manager

e2Platform

• Employee-based content mgmt• Workflow enhancements • Staff Directory • Policies and procedures • Document sharing • Benefits and Enrollment • Internal job postings • Employee recognition • Cafeteria Menu • Classified Ads • Census Reporting • General Events and News • Department-specific information• Training Staff scheduling • Department calendar • Meetings with agendas, minutes • Team-building • Protocols, order sets, standing orders• Sophisticated Forms



PHYSICIANPortal Manager


Physician Portal Manager

e2Platform

• Physician-based content management• Single sign-on • Personalization • e-Consults • Authentication, SSL security• Access rights management • Mobile digital certificate• ADT • Lab / Lab Trending • Transcriptions• Transcription Signatures • Progress Notes (Edit and Enter) • Pharmacy • Face Sheets • Rounding reports • Physician to Physician messaging• Document Imaging• Telemetry• PACS Images• Cardiology Images, Info• Scheduling• Fetal Monitoring



PHYSICIANPortal Manager

PATIENTPortal Manager


Patient Portal Manager

e2Platform

• Patient-based content mgmt• Patient Self Service• Patient workflow enhancements• Secure access to physicians• View clinical data • Specific relevant health information • Online appointment setting • Pharmacy renewal • Lab results (context relevant)• Pre-Registration for surgery• eConsultations with Physicians• My Insurance, Pharmacies, Medications• My Personal Medical Record (secure) • Referral Requests• Bill look-up with payment option • Family Care secure sharing• Broadcast Messaging / 1 to 1 Marketing• Experience personalization• Disease Management


What’s Possible with Portal Integration

• Data is consolidated & available online• Consumers are engaged online• Employees are served online• Patients and Providers are connected

… supporting the circle of care

Provider Portal …

Problems We Faced

• Poor Information Access & Distribution

• Dispersed data sources• Patient Safety Risks• HIS Idiosyncrasies• Changing expectations

– patients, providers• Limited Physician use

of technology

• Lack of coordination among care providers, community physicians, homes for aged, other healthcare services

• Equity of Access – rural and urban

• Lack of focus on preventative healthcare

Results we were seeking

• Connection & Communication

• One Stop Shop• Clinically Relevant

Information & Added Value

• Engaged physicians• Ease of Use

• Workflow improvements

• Secure Remote Access

• Privacy & Auditing • Real time Information• Ability to adapt &

scale to community

What we have done• “ClinicalConnect” branded Provider Portal

– MEDSEEK is the vendor of the portal software & services

• Web based approach “One Stop Shop” Portal – Aggregates data from disparate systems

and data sources– Flexible -- Provider designed

“Meaningful” Clinical Views – Providers can personalize to fit their

needs or workflow– Secure and Real Time– Supports multiple web browsers– Audit Trails – Varied Users Hospital Physicians,

Pharmacists, Nurses, Community


Multiple Patient Lists or Filters

Inpatient Lists

Full Patient Lists

Call Group Lists

Location Based Station Census

Emergency Rooms with Triage Times

User created Worklists

Schedule


Lab Views, Filters Graphing


Links to Diagnostic Imaging


Links to Document Imaging Archive


Pharmacy Medications

Various Filters Including Medications at Discharge

What we have done• Mobile Access – Blackberry,

iPhone, Windows

• Adopted by LHIN 4 as Unified View of Patient Data

• Acquired eID Matching Software for the LHIN

Blackberry


What we are doing now• Adding CCAC Home Care

Services Data• CCAC data with hospital

data = 360 degree view• Utilizing Patient Matching

software (eID) to positively link patients across systems

• Physician Sponsored Accounts– Providing the option where

privileged physicians can sponsor accounts for support staff.

• St Joseph’s Hospital Integration

CCAC Link



CCAC Benefits

• Integration between hospital systems and the CCAC client assessment system improves data quality and contributes to reducing potential patient errors.

• Hospital beds are emptied faster as the client moves to homecare quicker

• Status of CCAC patients and services available in the Provider portal

• The enhancement of the “SINGLE VIEW” or “ONE STOP SHOP” where providers/ specialists access to hospital and community based patient information enhances continuity of care


eID Patient Matching• Uses sophisticated

probabilistic matching algorithms to help standalone hospitals & multi-facility health systems evaluate data across all patient systems.

• eID can determine whether separate electronic records for the same patient exist within the hospital's (HIS) master patient index (MPI), so that duplicate records can be consolidated into one patient account

• Accurately associates records for a particular patient. Becomes a record locator tool, providing the ability to search across all available patient information systems

Data Consolidated fromMultiple Hospitals

What we are doing• EMR Download

• Capability to export transcribed notes & discrete lab results in standard HL7 format for import into any physician Electronic Medical Record

• “Automated pull”, simplistic with minimal steps. User preferences, defaults & business rules automate the process

• Download to Pprompt Diabetes System• Integrating Other Hospital Data / Extending

to LHIN• Privacy Impact Assessment / Threat Risk

Assessment


Patient List: Download patient(s) to Chart with Downloads link


Download Preferences (consistent with portal for setting preferences)


Downloads list with the new download marked with (NEW)


Download Labs button added to Labs List, check boxes next to lab names

Extending ClinicalConnect to LHIN3The Waterloo Wellington LHIN3 is involved in a Canada Infoway funded project. The project, “HealtheConnections” is a 2 year demonstration project that will implement an enhanced e-Health enabled model of care for diabetes. They will be deploying a Personal Health Record portal for the secure sharing of patient provided data.

ClinicalConnect aspects . . .

• The project will entail the sharing of acute data by connecting WWLHIN acute care hospitals to the ClinicalConnect portal operated by LHIN4

• In addition integration between the ClinicalConnect portal and the Family Health Team practice management electronic medical records systems will enable the downloading (at a minimum discharge summaries) into the primary care EMR’s

Other Initiatives & plansPortal Integration

• eCHN Link (Electronic children’s

network)

• Oncology Reports Integration

• Diagnostic Imaging Repository

(DI-r)

• OLIS

• Diabetes Systems & Repositories

• LTC / Nursing Homes

• Linkage with Right Level / Alternate Level of Care (Provide a centralized uniform system for the identification and rating of patients who are occupying beds for which there are services that the patient does not require. Improve the flow of patients through the continuum of health care in HNHB. ER WTIS to become one project with the ALC project)

• Link with Decision Support Data Warehouse and Business Intelligence Solution that will enable HNHB organizations to make evidence based planning and operational decisions using data that is less than 3 months old.

• North Hamilton Community Centres (Support Brantford and St Catherine’s)

• Advanced Web Design / Landing Pages to further integrate other information


Enhanced Interface


Physician Landing Page

How we measured successPhysicians /Clinicians Say….

• Easy to Use• Easier to Follow Progress of

Investigations & Medications• Discharge Follow-up less

frustrating• Fewer staff phone calls to

obtain results• Stat lab work better accessible

and in real-time• Links with Inpatient &

Outpatient Providers / Residents

• More informed comprehensive care

How we measured success• Engaged physicians and solicits &

identifies other opportunities • Steady Growth

• Over 2700 registered accounts (Hospital Physicians, Pharmacists, Nurses, Health Care support staff)

• Improved Connection & Communication…and Collaboration

– Improved information flow, within LHIN’s and across LHIN’s

• LHIN Adoption• Supporting Ontario e-Health Directions• Adds Values by leveraging existing

systems and technologies– Provider Portal Integration will support patient

portals

Patient Portal Opportunities


Diabetes Journal


Diabetes Follow-up


Online Decision Support


Web Chat


Type in symptom or choose symptom from list.

6500 clinical assessmentquestionnaires covering 30,000symptoms (95% primary care and85% of specialty care symptomsare covered).

E-Visit Followup


Renew a Prescription

Dale AndersonSenior Consultant, Stakeholder Engagement

Hamilton, Niagara Halidmand Brant LHIN CCAC Burlington - 6th Floor

440 Elizabeth St. Burlington, ON LR7 2M1

[email protected] 905-633-3899 x2952

Questions ?

mailto:[email protected]

e-health & portal overview - hnhb lhin/media/sites...updatable directories for physicians,...

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