what is spire? and what is the spire expansion/hrm re ... overview... · expansion/hrm re-platform...

A Healthier Tomorrow

What is SPIRE? And What is the SPIRE

Expansion/HRM re-platform Project all about?


SPIRE History • SPIRE (Southwest Physicians Interface with Regional EMR’s) has been sending

report electronically for since 2009

• Phase one of the project was to send HL7 messages from LHSC to physician EMR’s for LAB’s, DI reports, Discharge Summaries and Medical Transcribed Notes (MDOC’s)

• As the project grew and benefits tracked, phase 2 – 4 expanded to Huron Perth Alliance and Grey Bruce in the SW LHIN with the inclusion of medication discharge summary notes

• Currently there are 440 physicians connect in the SW LHIN receiving reports from 3 hospital hubs connect to a total of 27 hospitals

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SPIRE Benefits • Alternative to SPIRE is to send reports via Faxing. This causes a number of

potential issues and the data is not stored electronically unless an office either scans or re-keys the data into the EMR. Both a time consuming task for staff at the EMR

• SPIRE sends the data electronically so reports can be loaded into the EMR database and automatically attached to the patient records in the EMR

• This provides the physician with the ability to analyzed/chart the data, paste components of the report details into alerts and is stored in the system without the need for a paper copy

• Physicians and their offices are seeing great benefits to the SPIRE connection

• “Best thing to come from eHealth ever”

• “Speeds the time required for me to review reports and saves me an hour a day”

• “2 ½ inches of paper saved a week”

• Dr. Tim MacDonald “The spire interface has provided such rapid DI reports - It was helpful this morning to send a potential ectopic pregnancy for an emergent consult.”

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SPIRE/HRM – Provincial Alignment • cSWO Foundational Element

• Alignment to provincial standardization for LHIN’s 1 & 2

• HRM (Hospital Report Manager) – OMD pilot project connecting 4 hospital group

• HRM uses the Orion Rhapsody product that has been licensed for Ontario

• SPIRE and HRM combining to create a full production grade solution

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Current environment

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Extraction Process to build HL7

report


report


report

EMR

EMR

EMR

EMR

EMR

EMR

EMR

EMR

EMR

Xenos Report Engine

Mirth Report Engine

Xenos Report Engine

Gre

y

Bru

ce

Huro

n

Pert

h

South

SFTP server

SFTP server

SFTP server


SPIRE/HRM – Scope

• Connect all hospitals with in Erie St. Claire and Southwest LHINs to the HRM platform.

• Reconnect all current SPIRE physician connections in the SW LHIN in place today to the HRM download facility

• Increase the number of physician connects in SW LHIN to a total of 580+ and to an additional 130 physician connects (at a minimum) in ESC LHIN

• Connect 3 Independent Health Facilities to send DI reports through HRM to any physician connected to HRM

• Align to the provincial standard for OMD’s spec 4.0 certified outbound XLM file transfer so that physicians can receive data from any HSP connected to HRM (example North Simcoe Muskoka)

• Be the first environment to adopt the HRM platform in a fully hosted Production environment with eHealth Ontario

• Include Medication Reconciliation Summaries as a report type

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SPIRE Expansion/HRM Project

• Build a production Environment at eHealth Ontario’s Data Centre • Align to a standardized HL7 report format for all sending HSP facilities

across LHIN’s 1 & 2 • Modify HSP’s environments to send out messages to HRM • Update all the current physician offices to download from HRM • Connect 3 Independent Health Facilities so that their DI reports can be sent

electronically to Physician offices • Integrate new report types like Medication Reconciliation from HSP’s • Align to a single outbound message format (XML) • Align to Spec 4.0 from OMD • Integrate a standardized Change Management process

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SPIRE/HRM – hosted at eHealth Ontario

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HRM – OntarioMD

CDR Prep

Com

mon I

nte

rface

s In

bound

North Simcoe HSP (OntarioMD-HRM)

Com

mon I

nte

rface

s O

utb

ound

HRM – SW LHIN

Grey Bruce HSP

Huron Perth HSP

South (London) HSP

Physician’s office




CHIS (ESC LHIN) HSP’s


Project Timeline

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Q4 11/12 Q1 12/13 Q2 12/13 Q3 12/13 Q4 12/13 Q1 13/14

Develop Orion environment, connect

Healthcare groups, test interface

Connect HRM to all current 320 Physicians and expand

by an additional 75

Phase 2 items and an additional 75 physician offices

Phase 3 items

Q2


Future – Change Management Process

• As we rollout the new environment and connect additional organizations we will provide a Change Management and adoption process

• Current SPIRE rollouts in the South (London) area have been very successful in part due to the Change Management process in place. Within the project we will be expanding our Change Management model to the other zones in SW LHIN as well as Erie St. Clair LHIN.

• We will have a dedicated resource in each region to support the Change Management process and facilitate the implementation of the SPIRE/HRM interface.

• The Change Management Resource is responsible for the full implementation from start to finish ensuring all necessary agreements are signed, readiness assessments/workflow & change analysis completed, testing & validation onsite as well as ensuring final signoffs are received and full adoption achieved.

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Change Management Process

Steps to execute

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• Update/Align current documentation including agreements, testing strategy and signoff from all zones in the SW LHIN with OMD’s

• All current 320+ physicians in the SW LHIN will need to review, approve and signoff on the documents. As well each office will be reconnected to HRM for SPIRE download and this process will need to be retested.

• Due to the future increased volume of reports, and the fact that this could be the only electronic source, it is critical that we validate the connection is 100%


Relationship to other LHIN Initiatives

Improved information flow supports improved coordination and collaboration between healthcare groups, potentially beneficial for other LHIN initiatives.

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What is the HSP responsible for?

Signing the connection agreement

CHIS will handle of the connection details and support for message delivery

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