PROVINCE OF ONTARIO INTEGRATES ELECTRONIC HEALTH ACTIVITIES UNDER ONE AGENCY

TORONTO, Sept. 29 | McGuinty Government Appoints Dr. Alan Hudson as Chair of eHealth Ontario

The Province of Ontario has appointed Dr. Alan Hudson as the Chair of eHealth Ontario, a restructured agency responsible for all aspects of eHealth in Ontario including creating an electronic health record for all Ontarians. eHealth Ontario will bring together the Ministry of Health and Long-Term Care's eHealth program and the province's Smart Systems for Health Agency (SSHA) under one banner.

Three key eHealth priorities have been identified for the next few years including a Diabetes Registry, an eHealth Portal to centralize health information on an easily accessible web site, and ePrescribing which will eliminate hand written prescriptions and reduce medication errors.

Dr. Hudson - who is leading the government's efforts to reduce wait times in emergency rooms and for key procedures - will chair the Board of Directors for eHealth Ontario, which will have individuals from the broader health, business and information technology sectors.

"This is an exciting time for eHealth in Ontario," said Dr. Alan Hudson, Board Chair for eHealth Ontario. "Combining thought leaders from the Ministry and Long-Term Care and the broader health sector means we now have the expertise to make electronic health records a reality for the people of Ontario."

The ultimate goal of the eHealth strategy is to create an electronic health record (EHR) for all Ontarians by 2015. An electronic health record will provide patients and providers with the ability to access, share and use health information. It will improve health care delivery, increase patient safety, reduce ER wait times and create a more effective health care system.

"eHealth Ontario will enable us to transform Ontario's health care system as we know it," said David Caplan, Minister of Health and Long-Term Care. "With its broad mandate, eHealth Ontario will deliver a comprehensive, patient-focused, secure and private electronic system that will improve the way patients receive care."

QUICK FACTS
- eHealth Ontario is mandated to work with the Office of the Chief Information and Privacy Officer, Ministry of Government Services, to ensure that the protection of personal health information.

- The Ontario government created SSHA in 2003 to improve patient care through a variety of initiatives, including network hosting and secure e-mail. The agency has created the foundation for many of the eHealth activities underway today.

BACKGROUNDER
The McGuinty government named Dr. Alan Hudson, Lead of Access to Services/Wait Times with the Ministry of Health and Long-Term Care, as board chair of eHealth Ontario - a restructured agency responsible for all aspects of eHealth in Ontario including creating an electronic health record for all Ontarians.

Also named as board members are J. David Livingston, President and CEO of Infrastructure Ontario; Matthew Anderson, CEO of the Toronto Central Local Health Integration Network; Heather Sherrard, vice-president of clinical services at the University of Ottawa Heart Institute; and Ken Deane, Assistant Deputy Minister, Health System Accountability and Performance Division, Ministry of Health and Long-Term Care.

---
Read original article.

Healthcare Posturing: Where the parties stand on your health

Progressive Conservative Party
The Harper government has not yet released its electoral platform, but has pointed to its record as proof that it's committed to a "publicly funded, universally accessible health-care system."

The Conservatives say they have invested $612 million in new funding to help provinces slash patient wait times. The government has provided $400 million to the Canada Health Infoway (a non-profit organization) to develop electronic health records, and thus reduce some medical errors. The party also says it has boosted funding for new training spaces to address the shortage of doctors and nurses but hasn't provided any figures on its website.

The Liberal Party
Liberal leader Stéphane Dion has pledged $900 million to establish catastrophic drug coverage. The idea is to ensure that Canadians living with a life-threatening or chronic illness wouldn't have to worry about paying out of pocket for costly medications that are not covered under provincial plans.

The Liberals are also promising to invest $420 million to create a "doctor and nurses fund" to address the acute shortage of health professionals. The fund would be used to train more doctors, nurses and medical technicians as well as providing financial support to assist foreign-trained health professionals in obtaining their Canadian certification more quickly.

The New Democrat Party
The NDP is betting that Canadians will like its plan to spend $1 billion over the next five years to educate and graduate more doctors and nurses. Overall, the NDP hopes its plan will swell the ranks of doctors by 1,200 positions as well as adding 6,000 nurses to hospitals and clinics. The plan would also encourage more medical students to stay in family practice rather than pursue a career as a specialist. What's more, the NDP has called for universal prescription drug coverage and measures to cut drug costs at source.

The Bloc Québécois
The Bloc Québécois has not made any specific campaign promises on health, other than vowing to defend the rights of Quebec. For example, the Bloc says it will continue fighting against conditions imposed by the federal government on funding transfers to Quebec for health, education and social programs. Health, since it's a provincial jurisdiction, is something that Bloc leader Gilles Duceppe "doesn't think is germane to the federal government to begin with," said Antonia Maioni, of McGill University.

The Green Party
The Green Party has issued a detailed "green paper on health promotion" with an emphasis on a cleaner environment. It has proposed an innovative policy of health tax shifting. The party would grant a "GST health benefit reduction" for goods and services that promote health like sports equipment and fitness centre fees. The Greens give no numbers on the percentage reduction. The party has also promised a corporate health tax reduction to companies that create "healthy workplaces." Again, no specific numbers.

--
Saturday, September 27 | Read original article.

REACHing for Leading-Edge Patient Care with e-Health

By Dan Germain, VP, CFO and CIO at the Credit Valley Hospital and former e-Health lead for the Mississauga Halton Local Health Integration Network (LHIN.)

In Ontario, very few hospitals can share their disparate Electronic Health Records (EHRs) between providers or with patients/clients. To facilitate sharing of patients’ EHRs among physicians and clinicians, The Credit Valley Hospital (CVH) joined William Osler Health Centre (WOHC) and Halton Healthcare Services (HHS) to establish an electronic clinical portal. Trillium Health Centre (THC) and Headwaters Health Care Centre (HHCC) have also entered into this partnership and will go live in the next few months extending the Rapid Electronic Access to Clinical Health (REACH) EHR initiative to all hospitals within two LHINs serving a catchment area of 1.8 million Ontario residents (about 5% of the total Canadian population). This existing collaboration between six physical hospital sites in the Peel and Halton regions and two LHINs – the Mississauga Halton LHIN (MH LHIN) and the Central West LHIN (CW LHIN) – is unprecedented and a landmark partnership in the Province of Ontario.

The REACH Clinical (EHR) Portal enables all associated sites’ clinicians to have instant access to longitudinal patient health information including but not limited to allergies and alerts, lab and diagnostic test results, diagnostic images and reports, pharmacy data, transcribed notes, scanned images, progress reports, and other important health-related information. A thorough Privacy Impact Assessment was also perforemed to ensure REACH meets all Ontario privacy standards.

At each constituent hospital, patient data is easily accessed today through our secure network solution and consolidated into one customizable, patient-centric view. Based on a federated data-model, patient data remains in its original format on its respective (legacy) vendor IT system, allowing for all systems to be leveraged across multiple domains, rather than replacing them. Additionally, using a federated data-model ensured implementation of the REACH clinical portal was extremely fast and inexpensive especially when compared to other more complex solutions. The partnership between REACH Hospital stakeholders not only enhances patient safety and satisfaction, it provides an intuitive web-based interface that is accessible anywhere.

The REACH portal was created using MEDSEEK in partnership with Agfa HealthCare, both leading providers of enterprise-wide e-Health solutions. This simple portal solution is also vendor-agnostic, so the system is compatible with almost all health information systems, diagnostic imaging vendors, and other suppliers. “Over 160 interfaces are available on a plug-and-play like basis,” says Dan Germain, Vice President, Chief Financial Officer and Chief Information Officer at CVH.

Dr. Paul Philbrook, CVH’s Chief of Family Medicine and Chair of the Central West – Mississauga Halton Community Family Medicine/Public Health Network of Physicians, along with his colleagues, championed the idea of allowing affiliated physicians the opportunity to access their patient records across all local hospital sites. He explains, “The REACH portal is a welcome advancement of access to patient information and integration locally. This will enhance patient care and safety.”

Germain, also former e-Health lead for the Mississauga-Halton LHIN, further explains, “The REACH portal was created for physicians and clinicians to improve patient care and provide real-time access to existing patient records across the region. Although more time is needed to determine the quantifiable benefits of such a solution, it is expected that the REACH Portal will assist in avoiding potential medical errors and offset the possibility that other critical information is inadvertently missed for elective, emergency admissions or outpatient visits. Saving just one life by using this system will pay for itself.”

To date, the REACH EHR portal is getting over 9,000 views per month within the Mississauga-Halton and Central West LHINs---with one-third of those views made by Physicians looking at patient data from other hospitals. Over 1,000,000 outpatient visits and 100,000 discharges per year are now available within the REACH portal at this time. “The clinicians who are accessing patient information via the REACH portal love it,” says Germain. The portal has the ability to consolidate information about a patient/client from other sources (e.g., Community Care Access Centre’s), but currently, the focus is to bring more hospitals on stream and ensure as much clinical data is contained in the portal as needed.

The Mississauga-Halton and Central West LHIN's are fortunate in securing both the commitment of all regional hospitals to join the REACH portal, and also engaging a vendor solution that was both comprehensive and transferrable outside the walls of any specific site. This collaboration between regional hospitals is a stepping stone toward the overall e-Health goals for the province of Ontario, for example, building a standardized methodology to identify each unique patient and then consolidate electronic health care data from a variety of sources (e.g. hospitals, private laboratories, pharmacies, nursing homes.) It should also be noted that Hamilton Health Sciences and the Scarborough Hospital are also using the Medseek portal (distributed by Agfa HealthCare in Canada.) Ottawa-area Montfort Hospital has also signed on, but have not gone live yet. REACH will be ready to plug-and-play into Provincial EHR Initiatives once available.

We keep hearing from patients that they want to be more involved in their own health care. "Providing patients with electronic access to their health record and wellness information– that’s our next goal,” says Germain. “We can make our collective vision happen a bit sooner – anything is possible." Now that our disparate Clinical Information can be accessed and leveraged, a REACH Patient Portal is on the horizon. Germain explains that this Patient Portal initiative will be especially beneficial to those managing chronic disease prevention and that it is imperative that that patients have access to their own health records in a secure manner, as well as access to reliable health and wellness information.

Dan Germain is the Vice President, Chief Financial Officer and Chief Information Officer at The Credit Valley Hospital.

---
Read Original Article.

CLINICAL INFORMATION ACCESS IMPACTS RADIOLOGY INTERPRETATION

September 18, 2008 | Clinical Studies

The majority of radiologists at eight academic medical centers are dissatisfied with their ability to access clinical patient information at the time of interpretation, according to results from a report published online before print in the Journal of Digital Imaging. The report also indicates that the lack of access to pertinent clinical patient data may be a critical element that limits the accuracy of the radiologist’s diagnostic decision-making process.

“Given the increasing volume of radiological exams, the decreasing frequency of direct communication with the referring provider, and the distribution of patient data over many clinical systems, radiologists often do not have adequate clinical information at the time of interpretation,” the authors wrote.

William W. Boonn, MD, and Curtis P. Langlotz, MD, PhD, of the department of radiology at the Hospital of the University of Pennsylvania in Philadelphia, designed the survey. Among its 27 questions were an assessment of the IT environment in which the respondent practiced, including how radiology orders were typically processed and how images were displayed for interpretation. In addition, opinions about acquisition and access to relevant clinical patient information, both at the time of the examination and in follow-up, were obtained.

A total of 139 radiologists responded to the survey, with the vast majority (90 percent) practicing in an academic setting. Slightly more than half (54 percent) were attending radiologists; the remainder of the survey cohort was comprised of radiology fellows and residents.

The survey found that 72 percent of the respondents reported that they frequently needed more clinical information about their patients than was available at the time of study interpretation. More importantly, 87 percent acknowledged that additional clinical information was significant and that this information could change or modify the interpretive report.

“Of the available sources of information, radiologists reported that outside radiology reports, admission notes and progress notes typically yielded their preferred clinical information,” the authors stated. “However, despite their desire for these information sources, they reported using them less than 15 percent of the time.”

More than half (53 percent) of the respondents indicated that their reasons for not seeking access to additional clinical information was that such efforts were too time consuming.

Obtaining follow-up data on patients proved to be equally problematic for radiologists. The authors reported that clinical follow-up information was predominantly obtained either through discussions with the referring clinician or through subsequent imaging or pathology reports.

“Our findings demonstrate that most radiologists want more clinical information when interpreting images and that this information would impact their report, but they are discouraged by the time it takes to access this information,” the authors noted. “In addition, current mechanisms for monitoring necessary patient follow-up are inadequate.”

Boonn and Langlotz observed that many hospitals have multiple different systems used to access clinical data, which presents challenges to radiologists through multiple logins and user interfaces. In addition, legacy systems may not be fully integrated throughout the healthcare enterprise due to nonstandard, proprietary interfaces.

The pair believes that their survey indicates the critical need for an integrated application for the automatic identification, selection, retrieval and display of pertinent patient information at the time of interpretation. In addition, this application needs to provide alerts and reminders for patient follow-up.

“Together, these applications would have a significant impact on the satisfaction of radiologists, the quality of radiology interpretations, and thereby on the quality of care,” they wrote.

Read Original Article

PHR: WILL CONSUMERS REALLY HAVE A CHOICE? THE NEW ENTRANTS INTO THE PERSONAL HEALTH RECORDS (PHR) MARKET MAY PROVIDE COMPETITION.

Sept. 8, 2008 | By Barbara A. Cox and Marysol Imler

Since 2004, the US has been energized in trying to develop and provide personal health records (PHR's) for all consumers. During the last 4 years, many models have emerged. Several of the models have failed for a variety of reasons, including lack of a sustainable funding model. In addition, many of the interoperable health record models have not included the involvement of the individual consumer -- the person for whom these models are intended to be used by.

Over the last year, a new type of solution provider entered the PHR market. Different than the typical vendor that has been known to service the health industry, these solution providers are vendors known for addressing the consumer market. The new entrants (Google Health, Microsoft HealthVault and Revolution Health), may provide the type of competition and consumer controlled model that will help the industry evolve at a more rapid pace than what has been happening to date. With these new vendors, will control be transferred from the care provider to the consumer as it should be if health care is going to transform?

WINDS OF CHANGE
Are these products bringing about a refreshing change to the industry? While these products are much easier to use and implement than the traditional federated or scattered model of clinical data integration that has consumed the nation over the last 4 years, they appear to be in the first generation of product releases. Hopefully, the industry will see better things to come.

Microsoft, Google and Revolution Health are intended to support the consumerism wave in giving the individual a choice about the products they choose to use and the groups or people that can view their information. For an individual to receive full value for these products, they must have interoperability with that person's care providers' clinical systems. Unfortunately, the consumer is still limited by whether or not their own personal physician groups choose to participate with these products. Physicians and hospitals around the country are making choices on which platform to align with, and it is doubtful that an organization will choose to participate with multiple platforms.

Until the platforms achieve interoperability, a consumer will not truly have choice in the matter of determining which set of products they want to use. For instance, if your physician is associated with the Cleveland Clinic, you can receive the full value of having your data transferred into Google and populated with other services participating with Google, or you can choose to populate the data manually. Then, the individual is limited by the functionality provided by Google. Should you want to use a service that is associated with Microsoft HealthVault, you will be out of luck unless you choose to manually load the data yourself, which presents another set of challenges with providers regarding the accuracy of the data.

HOW ARE THE PHR PRODUCTS DIFFERENT?
Microsoft HealthVault is truly a platform. With this solution, business partners provide the application functionality. HealthVault is the keeper of the consumer demographics information and personal profiles to establish security and user identity. The consumer then chooses to use or buy services from a number of different vendors who provide value to the individual.

Google Health has a light-weight PHR embedded with its platform. The platform also has personal demographics and a personal profile for security and personal identity. While Google also has business partners in which an individual can choose to use, there is a limited supply of PHR solutions available.

Revolution Health is a robust PHR with a lot of educational content to add value for the individual. It is positioned as a tool to help employers and their employees. However, when conducting research, it was difficult to view the data integration possibilities with providers due to technical difficulties on the Web site.

CONSUMERS AND CHOICE
What will have to happen for consumers to have choice? The vendors and the care providers must evolve to support a consumer controlled environment. Consumers need to communicate to their care providers about the tools they want to use. The care providers will set up the link in their system and automatically send the clinical, administrative and financial data to the designated choice. For a seamless transmission of data to occur in a cost effective manner, the data transmission will need to follow strict standards that every vendor will adopt. Today's standards are left to the interpretation of the organizations interacting.

When the industry agrees to adopt a consumer control approach, then consumers will have choice. Until that time, the care providers are still in the driver seat, even with the new emerging consumer platforms that Microsoft HealthVault, Google Health and Revolution Health provide.

---
Read original article.
Barbara A. Cox is Senior Principal, Noblis Center for Health Innovation. Marysol Imler is a Consultant for Noblis Center for Health Innovation.

CANADIAN TERRITORY RECEIVES FUNDING FOR REGIONAL EHR INITIATIVE

September 12, 2008 | Nunavut, a territory in Canada, recently received funding for its electronic health record project from Canada Health Infoway -- a federally funded, independent, not-for-profit organization -- Healthcare IT News reports.

Canada Health Infoway has provided 7.4 million Canadian dollars, or about $7.07 million, for the second phase of the territory's e-health program. The investment is part of an 11.6 million Canadian dollar, or about $10.9 million, effort between the territory and Infoway to support EHR adoption throughout the territory. EHRs will help Nunavut provide residents with faster access to care and reduce the turnaround time for diagnostic imaging.

Officials expect Nunavut's EHR system to go live by 2012.

--
Original Article.

Clinical Portal Vendor MEDSEEK leads in 2008 KLAS® Rankings

MEDSEEK Leads KLAS® Portals Segment as of August 22, 2008.

Birmingham, AL (PRWEB) September 4, 2008 -- MEDSEEK, a leading provider of enterprise portal management solutions, announced today it leads in KLAS® rankings for its Clinical Web Portal software solution.

KLAS® is an independent healthcare market research firm that gathers data about clinical portal solutions from CIO's, Directors, and other healthcare providers about software functionality, solution performance, technical support and service. According to the August 26, 2008 Platinum KLAS ® database, MEDSEEK has the highest current performance ratings, outscoring all other clinical portal solutions.

Peter Kuhn, President of MEDSEEK commented, "MEDSEEK's superior ranking in the KLAS ® report highlights our effort to provide comprehensive eHealth solutions." Kuhn added, "We frequently receive high praise from our clients on our ability to deliver complex installations on time and on budget. The KLAS rating validates our reputation as an organization that consistently delivers on our commitments."

The KLAS® database also reports anonymous comments from providers who are using the eConnect Clinical Portal solution: "The implementation process was very smooth. It was very well planned and organized and was executed according to that plan. The planning was very thorough and there were few surprises and gotchas along the way. The implementation staff MEDSEEK provided was very knowledgeable. They were excellent communicators. We were able to install the system on time and within budget.” (Quoted from a healthcare provider interviewed by KLAS, see KLAS® commentary August 26, 2008.)

"MEDSEEK eConnect is the perfect portal solution for our physicians who do not want to learn the complexities of using the PACS and hospital clinical systems. This product is a single sign-on system that helps doctors get to patient information quickly. We have heard nothing negative from the physicians. All of the feedback about using eConnect for pulling results has been good, and the doctors love being able to pull images by using a URL." (From the KLAS ® database, August 26, 2008.)

Michelle Wickham, Research Director for KLAS stated, "KLAS applauds those vendors who utilize KLAS® data to understand and respond to their customers' needs. We are pleased when the data shows that a vendor is performing well, and we plan gather data on an ongoing basis to continuously monitor vendor performance in this segment."

---
About MEDSEEK:
Birmingham, Ala.-based MEDSEEK provides healthcare organizations with Enterprise eHealth solutions to fully engage and strengthen relationships with key constituents - physicians, patients, employees, and consumers. By connecting information and communities to foster an enhanced experience with the organization, hospitals will improve community advocacy, revenue and patient acquisition/retention, physician relations, and clinical decision making.

MEDSEEK's comprehensive technology platform and strategic consulting services create the infrastructure and provide the thought leadership for hospitals to deliver the most powerful Portal solutions. With more than ten years' experience and 600+ hospital customers, MEDSEEK has the experience and expertise to meet the diverse needs of the healthcare community. MEDSEEK also maintains offices in California and Mississippi. In Canada, Medseek is distributed by Agfa HealthCare. For more information, visit MEDSEEK or call 888-MEDSEEK.

About KLAS:
KLAS is a research firm specializing in monitoring and reporting the performance of healthcare vendors. KLAS' mission is to improve delivery, by independently measuring vendor performance for the benefit of our healthcare provider partners, consultants, investors, and vendors. Working together with executives from over 4500 hospitals and over 2500 clinics, KLAS delivers timely reports, trends, and statistics, which provide a solid overview of vendor performance in the industry. KLAS measures performance of software, professional services, and medical equipment vendors. For more information, go to www.KLASresearch.com, email marketing@KLASresearch.com, or call 1-800-920-4109 to speak with a KLAS representative. The data referenced was retrieved Tuesday, August 26, 2008 and fluctuates daily. Copyright 2002-2008 KLAS Enterprises, LLC. All rights reserved.

---
Read Original Article