eHealth Ontario Watch how access to diagnostic images and reports benefits health care providers and their patients

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Digital Health Success Stories

Diagnostic images and reports from across the province now available to health care providers With the recent launch of the Diagnostic Imaging (DI) Common Service, health care providers can now view diagnostic images and reports performed at facilities across the province, in one place.  In August, the service was made available to all authorized users in the Greater Toronto Area as well as in northern and eastern Ontario through the ConnectingOntario ClinicalViewer.  It’s also now available at two hospital organizations in south west Ontario, providing additional patient data to ClinicalConnect users who currently see reports and images and produced within their own region, and is being rolled out to more sites in the coming months. Thanks to this integration, health care providers can now obtain a more complete picture of their patient’s health, regardless of their location.   Watch the video above to see how health care providers like Dr. Koff benefit by having quick access to their patients’ diagnostic images and reports. This helps to eliminate the need for patients to carry around CD’s containing their DI information to specialist’s offices. It also eliminates the need to mail or fax test results, and the costly duplication of scans. Most importantly for patients, this network allows specialists at one facility to access images performed at other locations, allowing for more informed, timely medical decisions.

Help Us Share This Story Help others see firsthand how our work today is enhancing delivery of patient care in Ontario. Our mission is to foster an electronic health care system that puts the patient first, by leveraging existing systems and building new ones to connect health care providers with their patients' medical information.

Survival at the front lines of the health-care quagmire

Very interesting article in the Hamilton Spectator on silos in electronic health records in Ontario:

https://www.thespec.com/opinion-story/8651966-survival-at-the-front-lines-of-the-health-care-quagmire/

Anyone read the Clark report on eHealth Ontario?

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Clark report recognizes eHealth Ontario – and ehealth in Ontario The recently conducted Ed Clark review concludes that eHealth Ontario and its partners have created clear and compelling value for the health care system and recognizes the progress that’s been made. In his report, Mr. Clark makes a number of recommendations to maximize the value of current assets, derive more value for the system and patients alike, and improve the delivery and oversight of the digitization of health information in the province. While some of these recommendations apply solely to eHealth Ontario delivering its future mandate, many are aimed at the broader health care sector that is involved in digitizing health care across the province. Read the report

ImmunizeCA app helps people keep track of vaccinations

Ottawa Hospital researchers have developed a free app to help Canadians store, manage and access immunization information.

Dr. Kumanan Wilson of the Ottawa Hospital Research Institute said the ImmunizeCA app will also alert users if there's an issue in their area, such as the recent measles outbreak in Ottawa.

"So that would be in the outbreak section, they would see how close they are to the where the report is," he said.

"They could see if their family is up to date. They may say, 'Oh, time to get Johnny vaccinated. It's time to get catch up the vaccine.'"

The app is privacy-protected and not accessible to any health agency.
It's meant to empower people to control their own health by helping them keep track of when vaccinations, boosters and flu shots are due, Wilson said.

Wilson said the concept could also be reworked for similar public health applications.
"So another place I think it could be really helpful is in blood donations. And I think the blood donor app would be a really great idea to do booking online for their appointments, track donations, be notified when they can donate again," he said.

The Public Health Agency of Canada funded the app. It's available to residents in every province.

ImmunizeCA can be downloaded from iTunes, GooglePlay or BlackBerry World.

COACH Privacy Guides now available for Healthcare Organizations from eHealth Ontario

I knew eHealth Ontario was licensing the patient portal guidelines from COACH, because I was working with the COACH Expert Group that was writing them when it was announced. The recent news announcement that all 3 privacy and security of personal health information guidelines are being offered for free to Healthcare organizations in Ontario is wonderful.  I am now working on updates to the 2011 EMR guideline and the special edition of implementing the EMR with a COACH Expert Group again. Unfortunately, I am not as much as an expert this time because a lot of it is about legislation - not my speciality.  I knew more about patient portals at the time.  If you work in healthcare, you can apparently download them for free here.  So far, however, the download has not worked for me.  Not sure what the problem is.  Maybe it recognized my name and somehow knew I already have copies of these:
http://www.ehealthontario.on.ca/en/privacy/guides/

Privacy Guides

The 2011 Guidelines for the Protection of Health Information is an easy-to-use guide that covers topics such as accountability, consent, collection and security safeguards. This guide reflects the core principles of the Canadian Standards Association Model Code for the Protection of Personal Information and the content is aligned with Canada Health Infoway requirements and standards (international and national) such as the ISO 27002 Security Management Standards.

• 2011 Guidelines for the Protection of Health Information
  A comprehensive resource on privacy and security best practices that helps health care professionals protect the PHI that they require to do their day-to-day work. This resource is designed as a stepping stone to help health care organizations address common concerns, avoid confusion and prevent misunderstandings related to the protection of PHI.
• Privacy & Security for Patient Portals 2012 Guidelines for the Protection of Health Information Special Edition
  Developed for use by those designing, implementing and maintaining a patient portal system, this helpful guide is appropriate for organizations of all sizes—from a physician’s office to a large hospital. Topics include: choosing a portal model, Canadian privacy legislation and privacy and security risks/controls related to patient portals.
• Putting it into Practice: Privacy and Security for Healthcare Providers Implementing Electronic Medical Records COACH Guidelines for the Protection of Health Information Special Edition
  Provides health care providers with up-to-date privacy and security considerations and best practices related to the procurement, implementation, setup and maintenance of an electronic medical record system in a community practice setting.

eHealth Ontario Diabetes Registry is no more

A variation of this article in whatever edition of the Toronto Star I saw, was headline news.  The story line in the current online edition says"Diabetes Registry obsolete, ehealth tells liberals". The headline I saw on the shelves in the grocery store at around 10:00am this morning was something like "eHealth Ontario Axes Diabetes Registry". The twists and turns in this story are many and varied.  I remember the eHealth Ontario procurement and spending scandal in 2009 mostly because I had just starting working towards a graduate degree in eHealth (or Health Informatics) at the time and I was beginning to feel a lot of regret about the name of my degree. The real concern here should be about people who have diabetes and the epidemic this is now becoming globally - not some provincial political hot potato, or football, or whatever metaphor pleases you.

I was studying the clinical efficacy of using personal health records to manage diabetes, looking for systematic reviews of the literature in the Cochrane Collaboration.  They were not many because they are not many clinical trials involving diabetes and electronic medical records (let alone personal health records).  Yes I looked on the clinical trials registry site as well - clinicaltrials.gov   and found a rare few clinical trials, mostly involving large hospital systems that had electronic health records in the United States. I had learned in my courses that clinical trials present the highest form of medical evidence, exept for meta-analysis or systematic reviews, which is a composite study of all the best clinical trials.

It was when I was studying the project management issues in a mobile application for managing type II diabetes, that I came upon the understanding that clinical efficacy should precede business opportunity. See the COMPETE studies at McMaster. In healthcare, the return on investment is improvement in quality of life, but why spend millions on a system because it is believe to be clinically helpful, when the evidence for the actual efficacy is not in yet.  There were experiments and studies that did show promise for this, and maybe they showed promise because they were all small studies and easy to manage.

We were aware that a smartphone or mobile solution for persons with diabetes tracking and managing their condition always seemed to involve a triage person or nurse practitioner who monitored the data flows from the patients.  York University's Department of Health is now started a course of training for Health Coach Professionals, which was part of the subject of my last blog post on a consortium of academics, business and health organizations to develop the open source OSCAR EMR and it's companion PHR call MyOSCAR.  It is this kind of triage person who I think could really help fill the gap between the patient with diabetes using the smartphone or the computer, and the personal health record or electronic medical record where data measurements and journaling provide the tools necessary to self-manage the condition.  A coach is really needed to get people to exercise, eat well, adhere to regimes of all sorts, etc.

Later in 2011 when I was researching the system architecture of personal health records systems in Ontario and their relationship to the national blueprint architecture of the Canada Health Infoway, that main benefit for using them would evolve in the prescription model that physicians currently have with their patients.  A personal health record system could be prescribed to a patient, because of the clinically proven benefits of using them to manage the condition. Again, this involves the evidence based medicine preceding the business model or expediency.  As well, the prescription model maintains the traditional trust between physician and patient, and as far as I know, diabetes is not something you want to try and handle on your own, without professional guidance and help.

When in 2010 we learned eHealth Ontario was going to create a Diabetes Registry for all Ontarians, I for one thought they really did not know what they were getting themselves into.  It is not that I am proved right, it is just that technology projects are often started for the wrong reasons, and pulling the plug on them, before trying to fix the short comings, is the right thing to do.  Wished it could have turned out better for the eHealth Ontario people, CGI, and I suppose the Liberal government, who I know have the patients in Ontario and their health in mind first.

Drummond report on Information Technology in Healthcare

Just had a chance to scan through the Drummond report. This is the state of the Ontario economic. It is almost 500 pages, so I don't know when I will ever read it all. This section on information technology in healthcare resonated with me. I agree with it. Not only is it a way to save money, but it is also the right approach to the appropriate use of the technology. They say that the largest civilian software project failire in history was the national health service architecture in the UK for health records. My own research discovered that the best results will come when the patient and physician are working close together, and the electronic medical record is only stored locally. It doesn't mean the data is locked in a silo. The record can be programmed or make accessible through XML, HL7 or other interoperable standards. Standards neeed to start locally though, not from a national architecture. http://www.fin.gov.on.ca/en/reformcommission/chapters/report.pdf

Information technology (IT) is not used enough by physicians and other health care professionals across the system in a way that allows different disciplines and services to integrate their activities. Extensive use of IT is key to pushing the health care system to operate in a co-ordinated fashion. History has shown that huge IT projects are unwieldy. Most gains will come from local and regional records, so electronic record-keeping should begin with FHTs and hospitals; these could then be connected and expanded from this base. It is imperative, of course, that everyone use compatible systems that can communicate with each other.