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Health Informatics goes Mainstream: Meeting Public Expectations for a Better Healthcare System Shelagh Maloney, Lydia Lee, Marion Lyver 1 COACH: Canada's Health Informatics Association Agenda About COACH Making the Case for e-Health


  1. Health Informatics goes Mainstream: Meeting Public Expectations for a Better Healthcare System Shelagh Maloney, Lydia Lee, Marion Lyver 1 COACH: Canada's Health Informatics Association

  2. Agenda � About COACH � Making the Case for e-Health � Consumer Demands & e-Health � EMR Adoption and Healthcare Transformation 2 COACH: Canada's Health Informatics Association

  3. About COACH � Canada’s Health Informatics Association – established 30+ years ago � An association of individuals interested in advancing the practice of health informatics in Canada � Multidisciplinary membership including representatives from IT, care providers, vendors, consultants, governments and students � Governed by a volunteer Board of Directors 3 COACH: Canada's Health Informatics Association

  4. COACH Mission and Vision � COACH’s Mission – To promote the understanding and adoption of health informatics within the Canadian health system through professional development, advocacy, and a strong and diverse membership COACH’s Vision Taking health informatics mainstream 4 COACH: Canada's Health Informatics Association

  5. COACH Strategic Goals Four Strategic Goals � Strengthen the membership of COACH � Enhance the Practice of Health Informatics as a Profession � Be an advocate for health informatics � Ensure COACH has the resource capacity to meet future challenges and seize opportunities 5 COACH: Canada's Health Informatics Association

  6. COACH Making the Case for e-Health 6 COACH: Canada's Health Informatics Association

  7. From their health system, Canadians expect….. � Timely access to services � Care to be provided in a safe and effective manner � health providers to communicate with one another � To be included care decisions � A system that will be there for them, for their children and their grandchildren � That the confidentiality and security of their personal health information will not be compromised 7 COACH: Canada's Health Informatics Association

  8. Current pressures on today’s health system � The population is aging Increased burden of chronic disease – � Resource pressures are intensifying Health care costs are a growing proportion of provincial budgets – Health human resources are becoming more scarce – � Care settings are shifting From acute, to ambulatory to home and community services – � Technology is changing the way we work and play � Consumerism is growing Patients expectations of and demands on the system are changing – 8 COACH: Canada's Health Informatics Association

  9. Are we meeting these expectations? “The most remarkable feature about twenty-first century medicine is that we hold it together with nineteenth century paperwork.” US Secretary Tommy G. Thompson, Washington, D.C., May 6, 2004. Up to 24,000 deaths each year result from preventable • adverse events in hospitals 37-43% of Canadians recommended for influenza protection • are not vaccinated ~ $15 billion worth of prescriptions are written by hand • annually ~ 2 million Canadians don’t have access to a primary care • provider ( need to confirm # and reference for this statement) 9 COACH: Canada's Health Informatics Association

  10. The Good News � Information Technology is recognized as a significant enabler in meeting growing expectations of the health system � Most industrialized countries have recognized the need to implement electronic health record solutions quickly to improve the quality and safety of patient care and system efficiency � It is estimated that the savings to the health system would be approximately $5B per annum if the benefits of ehealth were realized � In Canada, all levels of government agree about the benefits of e- health and have committed to moving the agenda forward 10 COACH: Canada's Health Informatics Association

  11. EHR: Overall benefits & value � �������������������������������������������������� � �������������������������������������������������������� ������� � ������������������������������������������������������� � �������������������������������������������� � ������������������������������������������������������������ � #���������������������������� ��� �!" � #���������������������������� � ����������������������������������������������������� ���������������$� � ��������������������������������������������������� � ����������������������������������������� %�&#��!�'�!" � ���������������������������������������$� � ����������������������������������������� ��

  12. ��������������������������� Infoway was established by the First Ministers of Canada’s federal, • provincial and territorial governments in 2001 Infoway is a not-for-profit corporation • Funded by the Government of Canada • Infoway ’s members are Canada’s 14 federal, provincial and • territorial Deputy Ministers of Health Independent Board of Directors • �� 12 COACH: Canada's Health Informatics Association

  13. ������ ������� Mission: To foster and accelerate the development and adoption of • electronic health information systems with compatible standards and communications technologies on a pan- Canadian basis, with tangible benefits to Canadians �� 13 COACH: Canada's Health Informatics Association

  14. Infoway Business Plan Nine Program Project Approved Projects Common Program Investment Eligible Sizing and Blueprint Criteria for Investment Programs Costs Estimation 1. Registries 2. Diagnostic Imaging Systems 3. Laboratory Information Systems Solution deployment 4. Drug Information Systems projects in each jurisdiction 5. Public Health Surveillance 6. Telehealth 7. Interoperable EHR 8. Innovation and Adoption 9. Infostructure 14 COACH: Canada's Health Informatics Association

  15. COACH Consumer Demands & E-Health 15 COACH: Canada's Health Informatics Association

  16. Consumer Demands on the Healthcare System are Catalysts for Transformation Patient safety Computerized Provider Order Entry Rising costs of care Professional shortages Chronic Disease Management Need for self-care 16 COACH: Canada's Health Informatics Association

  17. Safety: The Burning Platform for CPOE Canadian Adverse Events Study – Estimated 70,000 events/y in Canadian Hospitals – Judicious application of new technologies � Communication � Coordination Baker GR, Norton PG, et. al. CMAJ May 25, 2004. 17 COACH: Canada's Health Informatics Association

  18. Non-intercepted serious medication errors (those with the potential to cause injury) fell 86 percent ( P = 0.0003). 18 COACH: Canada's Health Informatics Association

  19. 100% of e-Orders are Legible & Complete ����������������� �������������������������������������������� Source: University Health Network, Shared Information Management Services. 19 COACH: Canada's Health Informatics Association

  20. Medication Order Processing Cycle: Total Cycle Time From Physician order entry to RX* verification From Physician order entry to RX* verification ���� ���� ���� Pre n = 456 ���� #���� ���� Post ���� n = 427 ���� ���� ��� Post Post ���� n = 858 ���� ���� ��� ������ ������!� ������ "���� Source: University Health Network, Shared Information Management Services. * End point occurs when Pharmacist/Nurse Reviews 20 Order, whichever occurs last COACH: Canada's Health Informatics Association

  21. Employers are Driving Safety in Healthcare: Leapfrog’s CPOE Standard � MD input of > 75% of medication orders. � Prescribing-error prevention software. � Inpatient CPOE system can alert physicians of at least 50% of common, serious prescribing errors. � MDs must electronically document a reason for overriding an interception prior to doing so. 21 COACH: Canada's Health Informatics Association

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