maureen charlebois , canada health infoway

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Canada Health Infoway Transforming Practice & Improving Care Across Canada Presentation to the Home Care Summit Ireland’s Future Health Summit, May 27, 2016 Maureen M. Charlebois Chief Nursing Executive & Group Director Clinical Adoption – Canada Health Infoway

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Page 1: Maureen Charlebois , Canada Health Infoway

Canada Health Infoway Transforming Practice & Improving Care Across

Canada

Presentation to the Home Care Summit Ireland’s Future Health Summit, May 27, 2016

Maureen M. Charlebois Chief Nursing Executive & Group Director Clinical Adoption – Canada Health Infoway

Page 2: Maureen Charlebois , Canada Health Infoway

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CANADIAN CONTEXT• Federal government sets

and administers national health care principles

• 13 provincial/territorial governments plan, finance, manage, evaluate their health services

• 700 + hospitals and 2,500+ long-term-care homes

• 400,000 + GP’s, specialists, nurses, pharmacists and allied health professionals

Page 3: Maureen Charlebois , Canada Health Infoway

VisionHealthier Canadians through

innovative digital health solutions

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Page 4: Maureen Charlebois , Canada Health Infoway

Approach – strategic investment model$2.098 billion in approved projects to date; 387 active or completed projects

Solution deployment projects in each jurisdiction

CommonBlueprint & Standards

Twelveinvestmentprograms

Programcriteria

Programeligiblecosts

Projectsizing andestimation

Approved projects for investment

1. Registries2. Diagnostic Imaging Systems3. Drug Information Systems4. Laboratory Information Systems5. Interoperable EHR6. Telehealth7. Public Health Surveillance8. Patient Access to Quality Care9. Innovation and Adoption10. Infostructure11. EMR and Integration12. Consumer Health Solutions

Page 5: Maureen Charlebois , Canada Health Infoway

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THREE WAVES OF DIGITAL HEALTH INNOVATION

• Building blocks

• Digital tools for clinicians

• Empowering patients

Page 6: Maureen Charlebois , Canada Health Infoway

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Knowing the Plan for Canada

CE_Plan_Small.wmv

Page 7: Maureen Charlebois , Canada Health Infoway

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THE FIRST WAVE

LABORATORYINFORMATION

SYSTEMS85%

DIAGNOSTICIMAGING IN HOSPITSLS

100%

DISPENSED DRUGS62%

CLINICALDOCUMENTATION

100%

PATIENT &PROVIDER

REGISTRIES100%

• Foundational infrastructure for digital health: investments in six core components of an electronic health record

• Leadership in architecture, standards, privacy

• Pan-Canadian strategy

Page 8: Maureen Charlebois , Canada Health Infoway

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THE SECOND WAVE: DIGITAL TOOLS FOR CLINICIANS

• Electronic medical records

• Expansion of telehealth

• Public health surveillance

Source: 2015 Commonwealth Fund International Survey of Primary Care Physicians

Page 9: Maureen Charlebois , Canada Health Infoway

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THE THIRD WAVE: EMPOWERING PATIENTS

• Improving the patient experience

• Enhancing patient safety

What Patients say they want access to: Online Appointment Booking

E-consultations/visits Online lab results/views

Online prescription renewal

Page 10: Maureen Charlebois , Canada Health Infoway

Access to results drives value for patients

10Source: Impacts of direct patient access to laboratory results – Final Report 2015

Page 11: Maureen Charlebois , Canada Health Infoway

Change Management Framework

Benefits Evaluation Framework

Clinical Engagement Strategy

Clinical Adoption: Accelerate Adoption & Benefits Realization

Page 12: Maureen Charlebois , Canada Health Infoway

Pan-Canadian Benefits Realization

Page 13: Maureen Charlebois , Canada Health Infoway

Overall impact on Quality of Care – Clinicians Perspective

Sources: 2014 Infoway-CNA National Nurses Survey, 2014 Infoway National Survey of Community Pharmacists and National Physician Survey (2014) * % Not sure or No Reponses not reported

Page 14: Maureen Charlebois , Canada Health Infoway

Transformative Leadership • Change leadership is the strategic, systematic approach that supports

people and their organizations in the successful transition and adoption of electronic health solutions.

• The outcomes of ‘change leadership’ results in adoption and the full realization of benefits and clinical transformation.

A Focused Approach to change management that incorporates these six elements noted in the CM Framework helps to ensure alignment of activities, solution adoption and realization of benefits.

Change Management Framework

Clinical Adoption Framework

Page 15: Maureen Charlebois , Canada Health Infoway

Transforming Clinical Practice

‘‘Current Current State’State’Where are we now?Where are we now?

‘‘Desired Desired State’State’Where do we want to be?Where do we want to be?

Visible Clinical & IT Leadership Budget for Change Management Selected Change Approach/Methodology Engaged Clinicians & Informatics Specialists Communication Plan & Key Messages Workflow Analysis & Practice Process Redesign Role Specific Training & Education Ongoing Technical, Operational & Clinical Support Pre & Post Change Indicators & Evaluation

GAP Analysis:What type of support is required to get there?

Page 16: Maureen Charlebois , Canada Health Infoway

Why is change so hard?

16Amygdala – ‘Flight or Fight’

Stuck_on_an_escalator.wmv

Page 17: Maureen Charlebois , Canada Health Infoway

E-Integrated Care Plans…

…allows all appropriate/authorized health care providers from across the continuum of care and the patient, authorized family/significant other to have access and to contribute to an integrated plan of care that may include health conditions, goals, interventions and target dates for evaluation

Page 18: Maureen Charlebois , Canada Health Infoway

e-ICPs will help bridge the current information gap

Page 19: Maureen Charlebois , Canada Health Infoway

Improved interprofessional collaboration, transitions would be optimized and care planning would be based on patients’/family’s goals. Equal partners. Improved self care management.

Page 20: Maureen Charlebois , Canada Health Infoway

Safer, more sustainable healthcare system. There will be better health system use.

Page 21: Maureen Charlebois , Canada Health Infoway

Patient Focus Groups – Key Findings

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Page 22: Maureen Charlebois , Canada Health Infoway

Patient Value:

Confidence in the system and its ability to meet my/ my family’s needs, aid in the management of older family members.

Page 23: Maureen Charlebois , Canada Health Infoway

Pan-Canadian Clinical Peer Leader Networks Clinical Peer Leaders working with their colleagues providing clinical leadership, support, mentoring and coaching to facilitate learning and use of technology in practice.

Page 24: Maureen Charlebois , Canada Health Infoway

Transforming health care –clinical leadership• 96% of Peer Leaders ‘agree/strongly agree’ they are positively influencing their colleagues understanding and adoption of EMR/other technology systems in their practice settings• 89% of Peer Leaders ‘agree/strongly agree’ that the Peer Network is beneficial to clinicians

Page 25: Maureen Charlebois , Canada Health Infoway

These successes positioned Infoway as a strategic investor in eHealth within Canada

The Next Generation Strategy - Impact

Page 26: Maureen Charlebois , Canada Health Infoway

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TWO AMBITIOUS GOALS FOR 2016-2017

• Establish a multi-jurisdiction e-prescribing solution

• Expand telehomecare and patient online services

Page 27: Maureen Charlebois , Canada Health Infoway

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OUR SOLUTION• Will enable prescribers to

electronically transmit a prescription to a patient’s pharmacy of choice

• This will:• Reduce use of paper

prescriptions• Optimize existing

drug system investments

• Enhance patient safety

• Improve continuity of care

• Improve health outcomes for patients

Page 28: Maureen Charlebois , Canada Health Infoway

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TELEHOMECARE AND PATIENT ONLINE SERVICES

• Telehomecare is ready to be immediately scaled

• Improves quality of life for patients with chronic conditions

• Fewer emergency room visits and hospital stays

• Continue to invest in:• e-visits• e-renewals• e-booking• e-views

Page 29: Maureen Charlebois , Canada Health Infoway

ePractice

Connecting the TeamCommunication& Collaboration

Connecting to Evidence Based Information Knowledge Based Practice

Connecting to Quality Measures Data Analytics

Connecting the Patient Self –Management

Page 30: Maureen Charlebois , Canada Health Infoway

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Technologies are not simply inventions which people employ but are the means by which

people are reinvented.

We shape our tools and thereafter We shape our tools and thereafter our tools shape us. our tools shape us.