Sharing information among all health care providers in a timely, secure, accurate, and complete way results in more informed and timely decisions. Within the circle of care, providers can collaborate so that everyone is working toward the patient’s goals with a shared plan of care. Patients have access to clinical consultations remotely through telemedicine technology. Travel or arranging specialized transit services are no longer barriers for appointments. Technology, such as tele-homecare, improves the monitoring of patient progress and information.
The 14 LHINs have developed a cluster-based delivery model provincially for the implementation of eHealth initiatives.
There are three clusters working together to coordinate and strategize eHealth opportunities:
- Southwestern Ontario.
- Greater Toronto Area.
- North East Ontario.
Ontario’s refreshed 2.0 eHealth strategy will provide an updated roadmap for eHealth in Ontario.
The eHealth initiatives within the overall roadmap and enable advancements of key priorities.
PLAN OF ACTION
- Optimize eHealth technologies (e.g.Telemedicine) for timelier access to services, reduced travel time and to avoid unnecessary transfers..
- Enhance Telehomecare to give people with chronic diseases the self-management and remote communication methods to receive the care they need, right in their home.
- Implement the regional clinical viewer, ClinicalConnect, to support high-quality, safe and timely care allowing an individual’s healthcare information to be securely available to healthcare providers across the continuum of care.
- Implement eHealth tools (e.g. Health Links Care Coordination Tool) to allow clinicians to collaborate with other care team members and maintain shared, coordinated care plans.
- Advance hospital reporting systems so that primary care providers, specialists and nurse practitioners anywhere in Ontario can receive patient reports electronically from participating hospitals or Independent Health Facilities.
- Enhance eHealth technologies (e.g. Integrated Assessment Records) to improve collaboration among health service providers involved in an individual’s care through access to timely and secure assessment information.
- Implement eConsultation and eReferral processes to reduce unnecessary referrals to specialists and give primary care physicians more timely access to specialists.
- Implement a system to improve timely access to surgery.
Access to Care supports people, specifically seniors and adults with complex needs, in their homes for as long as possible by providing effective and quality community support services.
- eNotification notifies hospitals and the CCAC when a CCAC client visits the hospital emergency department. This increases and improves communication with regards to a patient’s current status as well as triggering the need for a patient care plan adjustment.
- eScreener and Linked Referral identify patients with complex needs who are at risk of a challenging discharge from hospital. eScreener allows early identification of patients with high care needs. eReferral fosters early engagement with CCAC. Both services trigger an automatic electronic referral from Hospital to the CCAC for assessment resulting in a more timely and beneficial result for the patient.
eConsult provides primary care providers with access to a website where they can communicate with a specialist for input on patient care. Led by Ontario MD, the South West LHIN London region is the first of six sites across Ontario to join the eConsult Pilot Project, a provincial initiative launched in 2015. Currently there are 66 primary care providers and 28 specialists participating. This service, is similar in design to Telehomecare and managed by OTN. eConsult can help avoid referrals for traditional consultations where not needed nor applicable. The pilot phase for this project will end in September 2015. This effort to build access to Specialists is in alignment with the Ministry, OMA and Ontario MD’s provincial eConsult strategy.
Health Links is model of care where all healthcare providers within a community (family doctor, hospital, community care workers, etc.) work together to provide coordinated health care to patients – with the patient being at the center of the journey. Health Links will focus first on responding to the needs of complex patients to provide coordinated effective care and secondly with complex, high needs patients with multiple conditions who access the system frequently and at multiple entry points. Health Links coordinated care can result in individualized coordinated care plans and can improve patient care delivery and health outcomes, decrease hospital re-admissions and re-visits to emergency departments, as well as improve access to primary care, specialist care and community health care.
Hospital Report Systems are part of eHealth Ontario’s integrated Electronic Health Record for all Ontario residents. The systems enable primary care providers, specialists and nurse practitioners anywhere in Ontario to receive patient reports electronically from participating hospitals or Independent Health Facilities. They receive text-based medical record reports such as discharge summaries and transcribed diagnostic imaging reports from hospitals or IHFs directly into patients’ charts within their clinicians’ electronic medical records. Subscribers currently using SPIRE in the South West, a similar hospital report delivery service implemented in 2009, will transition to the provincial solution where they will have increased access to a broader geography beyond their nearby hospitals for reports. Hospital report systems is delivered through connecting South West Ontario (cSWO) program.
Integrated Assessment Record
allows authorized users to view a consenting client’s assessment information to effectively plan and deliver services to that client. The record also allows assessment information to move with a client from one health service provider to another. Providers can access the records to view timely and secure assessment information to collaborate with other providers. Implementing this application is coordinated by Community Care Information Management along with LHINs and health service providers. In the South West LHIN, the majority of health service providers in community mental health & Addictions (CMH-CAP) and community support services (RAI CHA) have implemented the application. The current focus is to address use and develop best practices
Ontario Lab Information System is a cornerstone information system that connects hospitals, community laboratories, public health laboratories and practitioners facilitating the secure electronic exchange of laboratory test orders and results. Although all Hospital Information Systems in the South West LHIN are actively engaged in the system, Grey Bruce Health Services served as a provincial pilot site. The information system is one component of the overall provincial strategy to improve chronic disease management in Ontario and will contribute to fundamental improvements in patient care by providing practitioners with timely access to information that is needed at the time of clinical decision making.
Regional Integration (Clinical Connect) is foundational to eHealth Ontario’s commitment to integrate electronic health information for all Ontarians. The goal is to have an integrated Electronic Health Record and a Regional Clinical Viewer, ClinicalConnectTM
to support high-quality, safe and timely care where an individual’s healthcare information is securely available to healthcare providers across the continuum of care.
ClinicalConnect is a secure online portal that provides health care professionals, such as doctors, nurses, and pharmacists, with real-time immediate access to their patients' electronic medical information from local hospitals and Community Care Access Centres. This service reduces duplication of tests and procedures, improves transfer of information between patients and healthcare providers and increases better coordination and quality of healthcare.
The goal of resource matching and referral is to standardize referral processes, forms and terminology across the province. It is designed to be a powerful and dynamic enabler of best practice adoption starting with four specific pathways: 1) Acute to Rehabilitation, 2) Acute to Complex Continuing Care, 3) Acute to Long Term Care (LTC) and 4) Acute to In-home Services.
This enabler matches patients to the earliest available services that best meet their individual needs. It
improves the patient/client experience and ensures that all individuals have equitable access to safe and high quality services.
A Surgical Wait List Management System i
s an electronic, web-based solution with automated reporting to the provincial Wait Time Information System, real-time wait time management in surgeons’ offices, real-time business intelligence for surgical waitlist management at all levels of the organization, improved performance management and accountability as well as eScheduling from the physician office and paperless eBookings.
Currently, St. Thomas Elgin General Hospital is leading the way being the first adopter of an electronic surgical wait list management system in the South West LHIN.
Telehomecare brings chronic disease patients the care they need, right in their home using self-management and remote communication methods. Telehomecare Nurses monitor each patient's health status remotely offering education and health coaching to enhance the quality of life for patients living with congestive chronic heart failure and chronic obstructive pulmonary disease. The patient's primary care provider is kept informed with ongoing updates and continues to participate in their care.
Together, the goal is to inspire individuals to better manage their own health at home.
Diagnostic Imaging Common Service
The Diagnostic Imaging Common Service allows patients’ diagnostic images and reports to be shared and viewed from across Ontario, to hospital and community-based health care providers anytime, anywhere. Health care providers are able to access to diagnostic imaging reports regardless of their geographic location. Reports are available through eHealth Ontario’s “One” Portal. This helps to eliminate the need for physical transfer of test results and costly duplication of scans when a patient moves from one hospital to another.
For patients, this network allows for more informed and timely medical decisions because specialists at one facility can access diagnostic images and reports acquired at another.
Drug Profile Viewer
The Drug Profile Viewer provides authorized healthcare providers across the province with prescription drug claims information about Ontario Drug Benefit and Trillium Drug Program eligible Ontarians. The system is available 24 hours a day, seven days a week.
Emergency Neuro Image Transfer System
This system allows neuro specialists such as neurosurgeons, spinal surgeons, adult and paediatric intensivist neurologists at any one of Ontario's 13 neurosurgery centres to remotely examine scans and assess whether a patient with emergency neuro trauma needs to be transferred to another facility for acute care or other recommended immediate treatments. The system ensures Ontarians, regardless of geographic location, have access to a neuro specialist surgeon 24/7.
eShift is an innovative mobile tool that connects up to four enhanced-skill personal support workers working overnight shifts in the homes of clients with a remote registered nurse using a web-enabled iPhone. Enhanced-skill personal support workers and nurses use the device to share information securely through a web portal. The software developed for the project is intuitive and includes highly customizable clinical decision support tools, a reference library, chat and phone capability and supplies ordering features.
Partnering For Quality - Primary Care eHealth Coaching
In Partnering for Quality a team of eHealth coaches work with physicians and their teams from any primary care model. (For example: solo practitioners, Family Health Teams, Family Health Organizations, Family Health Groups, Community Health Centres, etc.) eHealth coaches focus on information management and the effective use of technology, an essential component of quality improvement and chronic disease prevention and management.
Partnering for Quality focuses on improving chronic disease prevention and management by using Ontario’s CDPM framework, strengthened collaboration between system partners, shared information, improved information management and active engagement with patients in self-care. It supports a quality improvement approach within primary care and broader system partners.