Thursday, September 27, 2007

BEYOND GOOD INTENTIONS: Accelerating the Electronic Health Record in Canada

Summary of Main Themes and Insights from a Policy Conference Held on June 11-13, 2006 in Montebello QC.

An Electronic Health Record (EHR) is a secure and private lifetime record of an individual’s key health history and care. It creates significant value, providing a longitudinal view of clinical information. The record is available electronically to authorized health care providers and the individual anywhere and anytime in the support of care. This record is designed to facilitate the sharing of data – across the continuum of care, across healthcare delivery organizations and across geographical areas.

Healthcare is the world’s most information intensive industry. Every day this industry produces massive volumes of data, which, properly used, can improve clinical practice and outcomes, guide planning and resource allocation, and enhance accountability. Electronic health information is fundamental to better health care. There will be no quantum leap forward in health care quality and efficiency without high quality, user-friendly health information compiled and delivered electronically.

The eHealth revolution is also the key to enhanced protection of privacy. Only in an electronic world is it possible to ensure that identifiable patient records are accessible to providers on a need-to-know basis. Access to all or parts of an EHR can be protected, and the identities of those who have looked at an EHR are known. Such protection is impossible with paper records, particularly in hospitals and other institutions.

Building a first-rate health information system may have as great an effect on 21st century health care as Medicare did in the 1960s and 1970s. But we have a long way to go to realize its potential. Canada’s health care system still manages information with old technologies and practices, some of which literally originated in the 19th century (94% of physician visits in Canada involve paper records; most prescriptions are handwritten). The production of information has grown exponentially, but the capacity to process, analyze, and deploy it to good effect has not kept pace. We have been, by international standards, cautious in our approach and limited in our ambition. As the title of the conference implies, our intentions are good. The challenge is moving beyond good intentions to pan-Canadian implementation.

The task of building an information network that patients, providers, managers, and policy-makers can use to improve decision-making at all levels is daunting. The health information agenda competes with innumerable other claims on resources. The payoff from investments in health information may be years away, while waiting lists are on the front page of today’s newspaper. Neither the public nor providers put better health information and tools high on top of their priority lists. Nor is implementation risk-free: Perfection is unattainable, cost estimates are notoriously unstable, and failures are inevitable.

On the surface then, there are many reasons to adopt a wait-and-see attitude and proceed incrementally. Yet the evidence is increasingly clear that the health care system is not as safe as we once thought it to be, is less efficient than we should expect and less evidence-based than should be acceptable. It is implausible to anticipate major improvements on these dimensions in the absence of electronic health information at various levels.

Most health information conferences are held by, and for, those who have already embraced the eHealth revolution and are immersed in the technical details. The challenge is not to convince the enthusiasts – the many champions and early adopters who have promoted the cause of an EHR as an essential part of contemporary practice. It is to enlist the support of senior-level decision-makers who set overall policy and hold the purse strings, and for whom the EHR is not necessarily a top-of mind issue. Canada Health Infoway and the Health Council of Canada recognized that securing an EHR for every Canadian depends on persuading top-level decision-makers of its importance and providing them with a realistic account of what it will take to put it in place.

These realities created a need for a conference pitched at just the right level for senior decision makers --- including Ministers and Deputy Ministers of Health and Finance, CEOs and VPs of regional health authorities and major organizations, and senior health information executives. These leaders, it was assumed, would want the unvarnished truth about what an EHR could accomplish the challenges of implementation and the experiences of various jurisdictions. They would want the opportunity to ask tough questions. Above all, they would want to know whether and how the EHR would help the recipients and providers of care.

Canada Health Infoway’s mandate is to provide a fully interoperable EHR for 50% of Canadians by 2009. The Health Council of Canada has called for 100% coverage by 2010. Newfoundland anticipates a fully functional, province-wide EHR by 2009. The Premier of Alberta has promised an EHR for every Albertan by 2008. Based on performance to date, these are enormously ambitious and, perhaps, unachievable goals. But the sense of urgency has been upgraded; in the words of one presenter, that urgency has to be spread beyond the converted to a wider constituency.

The sponsoring agencies spent a year planning the conference. The first hurdle was to attract the decision-makers; in this, the conference succeeded. The second was to assemble an international caliber program that would inspire the audience to stay through an intensive day and a half, and to engage with presenters and each other. They stayed, and they engaged. The third was to create a forum for frank and open dialogue. This we achieved by having all parties involved in all sessions, and promising to create a record of the proceedings that focused on substance and meaningful exchanges rather than on who said what in what context.

This summary is not a verbatim record of proceedings, but an analytic review of main themes and how the experiences and perspectives recounted at the conference apply to concrete issues in Canadian health care. The three questions uppermost in most decision-makers’ minds are:
o How does the EHR improve quality, efficiency, and overall patient care?
o What scale of investment is needed to make the EHR a reality for all Canadians?
o What are the implementation challenges, and what strategies have proven most successful?

A. Impact on Patient Care
A dominant theme throughout the conference was the impact of the EHR on patient care. Among the benefits cited were:
o Improved communication between providers, and between providers and patients. In Denmark and New Zealand in particular, the flow of information has grown exponentially.
o In New Zealand and England, the implementation of the EHR among various professions has created momentum for working in teams. The EHR has been a catalyst for accelerating this key element of health care innovation widely supported at the policy level throughout the world.
o Patient empowerment. In Denmark, people have access to their EHR. They can review information such as laboratory results and prescriptions to improve self-care – particularly important for chronic disease management. They can see which providers have viewed their records, which allows them to monitor privacy.
o Improved adherence to preventive measures. The literature suggests that electronically generated reminders for screening and follow-up increases adherence by 10% to 15%.
o Improved delivery of recommended care for various conditions. The Vanguard group in Boston delivered recommended care about 60% of the time in a baseline study. This improved to over 90% by combining team-based practice with the EHR.
o Nation-wide implementation of the EHR in the US, including e-prescribing with decision support tools built in, could reduce adverse drug events by two million annually, preventing 190,000 hospitalizations.
o According to the literature, introducing the EHR into the ICU reduces ICU mortality by 46% to 68%; complications by 44% to 50%; and overall hospital mortality by 30% to 33%.
o The use of e-prescribing in Denmark has reduced the medication problem rate from 33% to 14%, and laboratory systems have reduced tube labeling errors from 18% to 2%.
o Dr. Alan Ausford, an Edmonton physician and champion of the EHR, illustrated how on a typical day, e-health improves care and changes management of up to 20% of his patients in many ways, from ensuring medications are appropriate to respecting their end-of-life treatment choices.
o A major touted benefit of the EHR is chronic disease management (CDM). Some believe the benefits have already been demonstrated and there is consensus that the EHR is a necessary, but perhaps not sufficient, tool to improve CDM.
o There are some risks inherent in poorly adopted EHR technology. If decision support tools interrupt providers too frequently, the flow of care can be disrupted. Implementing systems too rapidly without attention to detail can cause unintended delays in the early stages of the transition.

B. Costs and Return on Investment
It is notoriously difficult to produce valid international comparisons of the amount of money invested in e-health in general, and the development of the EHR in particular. The IT infrastructure has many components, including fibre-optics and satellite networks, centralized and distributed servers, other hardware, software, upgrading and maintenance, technical support, etc. Some costs are fixed, others are variable. Both formal and informal training costs are difficult to estimate.

Many costs are shared, or borne by end users and not computed in jurisdiction totals. The most comprehensive and transparent data are likely those from England. The total investment since 2002 is an estimated $11.5 billion US; projected 10 year costs are $22.7 billion. Other major industries spend about 4% to 5% or more on information system development and support; the current estimated level in Canada is about 1.5%.

There is more published information available on the return on investment, albeit often in limited settings. Among the estimates shared by presenters were:
o The Booz Allen Hamilton study in Canada estimated savings of $6 billion annually with a fully developed EHR, which would cost about $1 billion a year for 10 years to implement.
o There are US estimates of $3 in benefits for every $1 spent on e-health in primary care.
o Nationwide these savings could translate to $44 billion annually.
o The Ontario Telehealth Network saved $5.2 million in travel grants alone in 2005-06, with 20 million kilometers of travel avoided.
o In Edmonton, the use of the telephone and fax for exchanging laboratory and other information plummeted as use of the computerized portals increased. In Denmark, the information systems have saved 50 minutes a day per family doctor, and reduced telephone contact between doctors and hospitals by 66%.
o Evaluations of telehealth home care and chronic disease management programs have shown among users of the services:
o 34% to 40% fewer emergency room visits
o Over 32% fewer hospitalizations and up to 60% fewer hospital days
o 47% reduction in long term care admissions.
o New Zealand anticipates fewer referrals to specialists because of better communications, with better capacity to control costs.

C. Implementation Stages and Strategies
Implementation is at varying stages around the world. At the national level, New Zealand and Denmark appear to have the greatest penetration, with 80% and more of family doctors using an EHR in their practices. The office-centred record is, again to varying degrees, linkable to external systems such as laboratory, imaging, and drugs. In Denmark, at least one county boasts 100% electronic access to hospital discharge letters; referrals to specialists; lab results; billings; prescribing; home care; and pharmacies.

No jurisdiction has achieved a fully automated, comprehensive EHR for its entire population. Hence, there are no definitively proven strategies for problem-free implementation. However, a number of insights emerged from the conference, including:
o The transition period is invariably difficult. The initial preferences of users (e.g., text-based rather than structured data entry) may change over time. Flexibility is therefore essential.
o Moving to an EHR in its fullest form is not just a technical innovation; it is a cultural transformation. Change management is vital, and failure to build in processes for effecting the transformation will reduce both uptake and impact. In the words of one presenter, all of us – providers and managers in particular – need to complete the transition from resistance to electronic information (historical position) to acceptance (current position) to addiction (cannot function without it).
o Implementation takes time, but can be accelerated once adoption and proven successes have reached a critical mass, or tipping point. At these stages, policy can drive faster change, for example, by making certain resources available only through electronic portals.
o The data elements are the core of any system, and spending time and resources on standardizing definitions and usage will go a long way toward creating information systems that yield valid and reliable measures of quality and performance.
o There will be far greater acceptance of provider-level IT if workflow is modified accordingly to gain improvements.
o Creating secure networks for communicating information in any form has proven to be hugely appealing to providers in almost every country. E-mail use grows very rapidly and is an effective vehicle for introducing providers to the world of electronic information.
o It is very important to structure contracts so that risks are appropriately shared, and purchasers do not pay for systems that do not work. The National Health Service in Britain (NHS) has taken a firm stance, and although it incurred delays because it changed a principal vendor, it did not take a huge financial hit.
o Leadership at all levels is crucial. Clinician leadership is essential but cannot be effective in isolation. There must be commitment from Boards and CEOs, the government, and the various sectors.
o Helping family doctors use the data generated by the EHR to analyze and improve their own practices will increase uptake. In Denmark, the counties fund data consultants who visit each practice one to two times each year to troubleshoot and help produce usable quality oriented information on treatment patterns, etc.
o If providers perceive “early wins” in the process, they will be more likely to invest their own money and agree to standards.
o Some strategies to enhance adoption among providers include clinical stories, peer-to-peer training, demonstration clinics, mentorship, and protected time.
o Giving patient’s access to their EHR is the wave of the future. Experience to date in Denmark and the US has been uniformly positive. If the patient is to be at the centre of the system, the patient has to be included in the information network and given the capacity to contribute to and use the EHR, and to communicate with the care team.

D. Lessons for Canada
Canada has five main priorities in health care:
1. Reduced wait times, not only in high profile areas such as hip and knee replacements and cancer care, but also in access to primary and specialty care as well as underserved areas such as mental health;
2. Primary health care, with interdisciplinary teams providing comprehensive, convenient care with an increased emphasis on health promotion and prevention;
3. Enhanced patient safety in the community and institutions;
4. Improved quality of care, particularly for people with chronic conditions; and
5. Improved efficiency and better value for money.

Both implicitly and explicitly, the conference addressed all of these priorities and provided evidence and observations on how the EHR could contribute to addressing them. The following table applies the themes more directly to the Canadian context – a consolidation of what we know (with varying degrees of certainty) about the potential of full-fledged implementation. As the EHR becomes richer, with more elements and connectivity, the potential impact grows. In some areas, there is already solid evidence that the benefits can be realized. In others, the logical case appears persuasive, but there is a need for stronger empirical evidence.

The EHR by itself cannot guarantee improved performance. The culture must also change, and all health system stakeholders, including users of services, must be inclined and trained to convert the potential of health information into concrete improvements in quality and efficiency. The benefits of the EHR grow over time as providers in particular exploit its potential to enhance communications, improve safety and quality by using decision support tools, expand the network of trusted colleagues, and generate valid performance measures and comparisons. In other words, however indifferent the initial reaction and despite the inevitable pain of the transition phase, over time the human and capital investment generates a high rate of return. No one ever goes back to the pre-EHR world once exposed.

View the original posting.

Wednesday, September 19, 2007

National Clinician eHealth Support Network | A peer-to-peer initiative launched to Share e-health Experiences

Physicians, nurses and pharmacists from across Canada who are considering using e-health will soon benefit from the expertise of a network of colleagues, experienced in e-health, who will provide mentorship and help navigate barriers.

Clinicians (physicians, nurses and pharmacists) from nine provinces came together on September 15 to launch the Clinician eHealth Support Network: A peer-to-peer initiative, a group of health care providers who will provide hands-on support to colleagues in their respective jurisdictions to help them address challenges and uncover the opportunities and efficiencies that are associated with e-health.

"With more and more clinicians recognizing there are benefits emerging as a result of the use of e-health, the Clinician eHealth Support Network will connect peers to help answer questions and share experiences from a perspective they can relate to," said Richard Alvarez, President and CEO of Canada Health Infoway, the federally funded, independent not-for-profit organization which invests with public sector partners to accelerate electronic health records across Canada. "I commend the clinicians whose e-health leadership will benefit their peers by transferring the knowledge they've acquired. These peer leaders are paving the way for increased use of e-health among clinicians throughout Canada."

Members of the Clinician eHealth Support Network: A peer-to-peer initiative will support their clinician colleagues who are contemplating the use of electronic health record solutions by providing:
• Individual demonstrations of electronic health records technology
• Ongoing support and mentoring
• Assistance in goal setting, prioritizing
• Support offered on-site and remotely.

More information on the National Clinician eHealth Support Network.

Original Post from Canada Health Infoway | September 19, 2007, Toronto

Thinking Systems Corporation Releases Plug-in for Philips iSite PACS

St. Petersburg, FL (November 20, 2006)  - For Immediate Release

Thinking Systems Corporation, recognized as one of the nation’s most innovative medical imaging software developers and for its broad product portfolio that supports the spectrum of modalities, today announced the company’s release of its new plug-in for Philips/Stentor’s iSite PACS.

This plug-in was independently developed utilizing iSite’s open API (Application Interface). The new offering will provide comprehensive 3rd party PACS solutions to iSite users for all modalities, including PET/SPECT-CT fusion, nuclear cardiology processing and quantification analysis, general nuclear medicine processing and review, PET cardiac analysis, PET brain analysis, 3D/MPR, calcium scoring, cardiac CTA, orthopedic templating, echocardiography, general ultrasound, cardiac catheterization and angiography. The integrated platform enables enterprise-wide access to these modalities with cutting edge clinical applications.

“What makes this plug-in different from a generic iSite plug-in is that instead of being a passive plug-in, Thinking Systems provides comprehensive solutions, from interfacing to modality scanners, data conversion, data verification, HIS/RIS validation, data distribution, to image fusion, image reconstruction and quantification analysis,” said Xiaoyi Wang, president and co-chairman, Thinking Systems Corporation.           

“Key to this plug-in is Thinking Systems’ ModalityBrokerTM, which bridges the modalities to iSite and powers Thinking Systems’ cutting edge clinical applications that can be invoked by both iSite Radiology and iSite Enterprise.”

THINKING SYSTEMS solutions are installed at over twenty sites across Canada and are proudly distributed by Alliance Distribution Network (ADN) Canada. For more information please contact your local ADN Canada sales consultant Toll-Free in Canada at 877-434-5311 or e-mail.  

Note: Any / all product names mentioned in this document may be trademarks or registered trademarks of their respective companies and are hereby acknowledged.

Monday, September 10, 2007

Province of Ontario | Local Health Integration Network (LHIN) Map

For more information about a LHIN, please choose the appropriate link below.
1. Erie St. Clair
2. South West
3. Waterloo Wellington
4. Hamilton Niagara Haldimand Brant
5. Central West
6. Mississauga Halton
7. Toronto Central
8. Central
9. Central East
10. South East
11. Champlain
12. North Simcoe Muskoka
13. North East
14. North West

For additional information please visit Ontario's Local Health Integration Network (LHIN) web site.

Cross-Canada eHealth race well underway | N.B. may be first to have linked medical records

FREDERICTON - By the end of 2009, all hospitals will be linked to 'one patient one record' system, with doctors and pharmacies joining later and positioning New Brunswick to be the first in the country to reconcile its medical records process.

Health Minister Mike Murphy announced on Friday that his department signed contracts for four major pieces of the province's e-health record system. He said the programs New Brunswick purchased are used successfully in other provinces. And while some other provinces are ahead in aspects of e-health, not one has all hospitals linked through a one patient one record system.

Don Sweete, the Atlantic Canada executive regional director for Canada Health Infoway, said New Brunswick's 2009 deadline is realistic. There are several provinces racing towards the 2009 target, he said, but it is difficult to say who will achieve the coveted system first.

"All provinces have made tremendous progress in moving forward with the interoperable electronic health programs," Sweete said. "New Brunswick's no different."

The system, which will be in place within three years, is expected to cost $36 million. The province will contribute $17.7 million, while Canada Health Infoway, a non-for-profit organization dedicated to develop health information systems, will pay the rest. Murphy said the contracts cover the basics of his e-health strategy, and will give hospitals across the province immediate access to any patient's extensive medical history.

"It is not the full e-health initiative that I have spoken at length of," Murphy said. "That is going to take several years more."

The long-term plan is to link all health care providers - from doctors' offices and pharmacies - to the hospital system. The entire strategy, yet to be thoroughly defined by the government, is expected to cost a quarter-billion dollars over the next 10 years. Murphy said the strategy is more efficient and will eventually save the system money.

"There will be far fewer clinical errors made by health care professionals with regard to drugs and allergies," he said.

Initiate Systems Inc. will provide a client registry for $1.9 million over two years. Orion Health signed a three-year agreement worth $4 million for a provider registry and the Interoperable Electronic Health Record system, which makes it possible to link, capture, store and view patient information in a central database. System integration and maintenance services costing $5.6 million over three years will be handled by xwave. Agfa Healthcare Inc. will receive $9 million over two years to create its Diagnostic Imaging Repository, used to consolidate images from X-rays and ultrasounds to MRIs and CT scans.

The independent Canada Health Infoway is funding all provinces and helping them to strategize and establish e-health systems. Sweete said the organization is 100 per cent behind the approach New Brunswick has taken.

Gary Folker, Xwave managing director of business development for health care, said the province has a well thought out and aggressive mandate.
"There's a lot of work that needs to be done to accomplish this," Folker said, adding that the province is well positioned to succeed.

Murphy said the province's "dead-last" standing in the country for an e-health strategy it has held up until a few months ago can be turned into an advantage.
"We have a road map now - we know where it's working and not working," he said. "By the end of 2009 we may very well be the first Canadian province to have all of our hospitals hooked up one patient one record."

But while New Brunswick is trying to the finish first in the country, Murphy said it will also establish the best privacy laws to accompany the system.
The government is working on those laws, and Murphy hopes they will be in place no later than spring.

"The legislation has to be developed hand-in-hand with these foundational pieces," Murphy said.

"If you don't have the proper mechanisms in place and the proper laws in place, then theoretically someone could push a button and see everything in your health care record. And that's never going to happen in New Brunswick."

MEGHAN CUMBY | FOR THE TELEGRAPH-JOURNAL | Published Saturday September 8th, 2007 | Appeared on page A1

Friday, September 07, 2007

New Brunswick | Tenders awarded for key components to e-health strategy

September 7, 2007, FREDERICTON (CNB) - Contracts have been signed for four major pieces in the province's e-health strategy, Health Minister Mike Murphy announced today. The systems are an Interoperable Electronic Health Record, a Client Registry, a Provider Registry and a Provincial Diagnostic Imaging Repository.

"These systems are key building blocks along the journey to a complete electronic health record that will ultimately link all patient information from across the health care system - from hospitals, from your family doctor, from your local pharmacy and elsewhere," Murphy said. "With this information, authorized health care providers will have access to individuals' health records to provide them with the care they need, when they need it."

"The progress we are celebrating today on the e-health front is a major step forward in the modernization of New Brunswick's health care system," said Richard Alvarez, president and CEO of Canada Health Infoway. "Information is central to quality health care. Today's announcement is about making that vital information quickly accessible to clinicians so they can get on with the job of caring for their patients."

The Interoperable Electronic Health Record is considered a foundational piece for the One Patient One Record (OPOR) system. It will provide the infrastructure and functionality required to link, capture, store and view relevant patient information.

The Client Registry system is essentially the one-patient component of the OPOR system. With this system, each patient will have a unique provincial identifier that will tie together patient information from various clinical systems.

The Provider Registry system will contain information on health care providers in the province.

The Provincial Diagnostic Imaging Repository will consolidate a patient's diagnostic imaging reports and images for procedures such as X-rays, CT scans, ultrasounds and MRIs, into a provincial repository. Once completed, the diagnostic imaging information will be retained for the life of a patient, will be available provincewide in a standardized format for the use of authorized clinicians, and will be stored in a centralized system with appropriate back-up.

Murphy said that the Department of Health has signed agreements with Initiate Systems Inc. for their Client Registry solution ($1.9 million over two years) and Orion Health for the Interoperable Electronic Health Record and Provider Registry systems ($4 million over three years). A third contract awarded to xwave for system integration and maintenance services is worth $5.6 million over three years. The contract to create a Diagnostic Imaging Repository has been awarded to Agfa Healthcare Inc., in the amount of $9 million over two years.

"What we are witnessing now is a new era unfolding for health care in our province," Murphy said. "The implementation of the OPOR system will revitalize our health system by improving access to vital clinical information which will aid in better clinical decision-making, and result in improved care for New Brunswickers."

The OPOR system will be implemented over a three-year period at a total cost of $35.9 million. New Brunswick has partnered with Canada Health Infoway, which is contributing $18.2 million to the project, with the remaining $17.7 million coming from the province. In total, it is estimated that New Brunswick needs to invest a quarter of a billion dollars over the next decade in electronic information and computer technology to improve the delivery and management of health care in the province.

About Canada Health Infoway (Infoway)
Canada Health Infoway is a federally funded, not-for-profit organization created to facilitate the development of electronic health information systems across the country. It works with provinces and territories to invest in electronic health projects, which support safer, more efficient health care delivery. These private and secure systems fully respect patient confidentiality, and provide health care professionals with immediate access to complete and accurate patient information, enabling better decisions about diagnosis and treatment. The result is a sustainable health care system offering improved quality, accessibility, productivity and cost savings.

View the original post by Canada Health InfoWay.

Thursday, September 06, 2007

Hamilton Health connecting around the world

Hamilton Health Sciences' orthopedic surgeon Dr. Justin deBeer was halfway around the world in Taipei, Taiwan but wanted to be able to keep tabs on his patients back in Canada. What in the past would have been a next to impossible proposition was actually done quickly and easily thanks to ClinicalConnect – a web-based portal for physicians that brings together data from three of the hospital’s most commonly used clinical software systems in an electronic health record format.

Hamilton Health Sciences worked with Medseek to design and implement the "ClinicalConnect" portal, but also engaged physicians from a variety of disciplines to offer input and drive the creation of the final product. Since Meditech is the most widely used information system at Hamilton Health Sciences, it was the first to be merged into the ClinicalConnect environment. ClinicalConnect offers a user-friendly view of the Meditech information, which ranges from admission information to lab results, and allows physicians to view the information simply by signing on to ClinicalConnect.

The next step involved adding views of patient records, stored in a system called Sovera. Currently the charts are scanned and merely displayed through ClinicalConnect, however, the portal does allow physicians to view the information and also indicates the number of chart deficiencies that need to be resolved. By the end of this year, physicians will be able to access Sovera directly through ClinicalConnect, which will enable them to interact with patient information in real time and directly resolve any chart deficiencies. In the future, physicians will have the option to e-edit and e-sign Meditech-based charts in the portal, and the updates will be passed back to the Meditech system. When this feature is available in the portal, it will also be available via PDAs.

Adding PACS to the system proved to be a tremendous enhancement, since it enables physicians to view X-rays from the same system that houses other clinical information about their patients. And by signing on to one system, physicians can access and interact with all of this information. They can also customize their views and pick and choose which information they want to see and when.

“Our ClinicalConnect portal gives physicians and other clinicians secure, real-time access to electronic patient records. Whether they are at the hospital or elsewhere, our physicians can quickly access all clinical reports, lab results, PACS images, pharmacy medication lists and much more,” said Dale Anderson, information and communications technology manager of projects and e-Health solutions at Hamilton Health Sciences.

As Hamilton Health Sciences expands the wireless network within its four sites, ClinicalConnect will become even more valuable. Already, some physicians have been piloting wireless applications of the system on PDAs in certain areas of the hospital. They’ve got access to all available patient information when they are seeing the patient. Patients are also able to ask questions about particular tests and procedures when they are with their doctor and do not have to wait for results to be retrieved from another computer or system.

The remote access to patient information through ClinicalConnect enables healthcare providers him to use remote Internet access to call up the patient’s information, including X-ray images and blood work, to check up on patients.

View a (Flash-based) overview of Hamilton Health Sciences "ClinicConnect” solution.

Originally published in Canadian Healthcare Technology, April 2007

Alberta’s Telestroke Program | Technology to improve stroke care to remote areas

Canadians living in rural and remote areas of Alberta will have better access to stroke diagnosis and treatment services through an investment of close to $1.1 million from Canada Health Infoway in the province-wide network that links stroke specialists and patients.

The Telestroke program will provide funding to participating health regions to expand the use of videoconferencing technology and other specialized equipment to enable direct medical consultation without the need to have the health professional and patient in the same place.

"Our Telestroke program has already demonstrated many examples of faster diagnosis and treatment, as well as improved outcomes for stroke patients in rural Alberta," said Dave Hancock, Minister of Health and Wellness. "This investment will build on our strong Telehealth network that bridges the physical distance between patients and specialist services."

The Telestroke program supports the Alberta Provincial Stroke Strategy, which is a collaborative partnership between government, regional health authorities and the Alberta Heart and Stroke Foundation to reduce the rate of strokes and improve acute treatment, rehabilitation care and outcomes for patients.

"Alberta's Telestroke program is one of many revolutionary initiatives that are modernizing patient care across Canada," said Richard Alvarez, President and CEO of Canada Health Infoway, a not-for-profit organization which invests with public sector partners to accelerate electronic health records across Canada. "This project will provide patients with quick access to stroke diagnosis and treatment closer to home, resulting in improved outcomes and increased efficiency."

Improving stroke care supports Premier Ed Stelmach's plan to improve Albertans' quality of life. Other priorities for the government are to: govern with integrity and transparency, manage growth pressures, build a stronger Alberta and provide safe and secure communities.

For more information, please visit Alberta's Telestroke Program website