Information Sharing Strategy for Primary Care Home and Across the Continuum of Care Betty Da Silva Executive Director, Regional Care Solutions Information Management Information Technology Services (IMITS) Provincial Health Services Authority (PHSA) Feb 24, 2017 1
Agenda 1. Vancouver Coastal Health Context 2. Clinical Information Systems & Information Sharing Strategy 3. Primary Care Home EMR Integration Project : Year 1 Solution 4. Key Year 1 Project Deliverables 5. Project Work Streams 6. Clinical Engagement 7. Questions 2
Vancouver Coastal Health • Annual funding: $3.4 B • Population served: ~1,045,000 (25% of BC ’ s population) primary and secondary care; all of BC tertiary/quaternary specializations • Residents of Vancouver, Richmond, North Shore and Coast Garibaldi, Sea-to-Sky, Sunshine Coast, Powell River, Bella Bella, and Bella Coola • Number of staff: 13,000 full time/part time staff + ~3,000 volunteers • Number of physicians: 2,100 • Number of contracts with other health agencies: ~400 • Number of beds: ~9,000 acute, rehab and residential • Emergency Department: 1,100 daily visits • Home Care Nursing: 891 daily visits
VCH Overview – Operations Management Vancouver Community Vancouver Acute Providence Coastal Richmond Organized as Communities of Care (CoC) with numerous care delivery sites within each CoC. 4
Divisions of Family Practice within VCH Region Interdivisional Collaborative Services Committee 5
Patient Primary & Community HA Primary Primary Care Operating PMH Patient Medical Home Care network Care Home Services Model Context Specialized Community Services/Programs • Complex, Frail, Community Care Dementia, Palliative Services • Mental Health, Substance Abuse • Cancer Care Specialist Care • Surgical Care Services Specialized Diagnostics Hospital Care Provincial Medications Lab In-patient Services Pharmacies Medical imaging Emergency (HA & private) BCCA (HA & private) Ambulatory etc. 6
Primary Care Home: Current State Reality & Challenges • The Primary Care Home Models will be in flux for some time • N o “definitive” set of IMIT requirements at this stage • Need pragmatic, workable short-term solutions and flexibility to support short to medium term evolution of PCH model • Step-wise approach to achieve longer term vision; ongoing, nimble (agile) IMITS – PCH engagement to thoughtfully evolve the enabling solutions to support PCH health information sharing Year 1 Solution Approach 7
Clinical Information Systems & Information Sharing Strategy Acute & Community Primary Primary Specialists Ambulatory Care Care* Care – Private Improving patient outcomes and reducing unnecessary variation in care through Clinical System Transformation across the continuum PARIS IntraHealth Cerner Varied Varied v6.0 Profile EMRs EMRs VCH System Enablers for Quality Care Information Sharing Across the Continnum of Care * VCH/PHC funded Primary Care Clinics 8
Year 1 Solution Summary Existing Patient Information System Enablers Intrahealth Multiple EMRs Profile EMR HA Primary Primary PMH Patient Medical Home PARIS Care network Care Home Services Specialized Community Services/Programs • Complex, Frail, Community Care PARIS Dementia, Palliative Services • Mental Health, Substance Abuse Multiple • Cancer Care Specialist Care EMRs • Surgical Care Services Specialized HA: multiple Diagnostics Hospital Care Provincial Medications (CST future) Lab In-patient Services Pharmacies PharmaNet Medical imaging Emergency (HA & private) BCCA (HA & private) Ambulatory etc. Private: Multiple CISs Multiple CISs Multiple CISs multiple (CST future) (CST future) (CST future) 9
Information Year 1 Solution Summary 4. Enable patient access & interaction Patient Sharing Strategy 1. Establish standardized HA electronic Shared Care Plans in Primary Primary PMH PMH EMRs (private practice and Patient Medical Home Care network Care Home VCH) Services 2. Enable PMH Shared Care Plans (private practice and VCH), Specialized Community Services/Programs 3. Share useful VCH and other useful patient information patient information, • Complex, Frail, Community Care with PMHs (private to be shared with Dementia, Palliative Services practice and VCH) other care team • Mental Health, members Substance Abuse • Cancer Care Specialist Care • Surgical Care Services Specialized Diagnostics Hospital Care Provincial Medications Lab In-patient Services Pharmacies Medical imaging Emergency (HA & private) BCCA (HA & private) Ambulatory etc. 10
Year 1 Solution Summary Existing Information Sharing Enablers Patient Note: CareConnect currently accessible within VCH primary, community & acute care (not in private practice) Intrahealth Profile EMR Multiple EMRs HA Primary Primary PMH Patient Medical Home Care network Care Home Services Specialized Community Services Programs CareConnect Note: absence of an Excelleris • Complex, Frail, Community Care PARIS (information operational solution to Dementia, Palliative Services distribution • Mental Health, electronically flow information from VCH to Substance Abuse from private practice to VCH private Multiple • Cancer Care Specialist Care practice) (patient summary, referral, etc.) EMRs • Surgical Care Services HA: multiple Specialized Diagnostics Hospital Care (CST future) Provincial Medications PharmaNet Lab In-patient Services Pharmacies Medical imaging Emergency (HA & private) BCCA (HA & private) Ambulatory Private: etc. Multiple CISs Multiple CISs Multiple CISs multiple (CST future) (CST future) (CST future) 11
Year 1 Solution Summary Information Sharing Patient Solution Approach Enable PMH Shared Care Plans (private practice and VCH), and HA Primary other useful patient Primary PMH Patient Medical Home information, to be Care network Care Home shared with other care Services team members • VCH- based PMH’s : CareConnect, cross-system interfaces • Private practice PMH’s: Specialized Community Services/Programs Share useful VCH • Provincial and EMR alignment patient information with • required (cannot be a VCH-only Complex, Frail, Community Care PMHs (private practice solution) – collaboration require Dementia, Palliative Services and VCH) • Mental Health, with DOBC, EMR vendors, other Substance Abuse HAs, MoH, etc. • Cancer Care Specialist Care • Conservatively, assume, year-2 • Surgical Care Services implementation (may be able to Excelleris : CareConnect: begin implementing in year-1, expand reports expand & notifications content, make depending on speed of provincial distributed to available to developments) PMHs private practice Specialized Diagnostics Hospital Care Provincial Medications Lab In-patient Services Pharmacies Medical imaging Emergency (HA & private) BCCA (HA & private) Ambulatory etc. 12
Key Year 1 Deliverables • Shared Care Plans established in VCH and private practice Patient Medical Home EMRs • Expansion of CareConnect content to include: • VCH Patient Medical Home Shared Care Plans • PharmaNet medication profiles • Other priority clinical content immediately available to existing CareConnect users in acute, community, primary care • CareConnect access expanded to private practice Patient Medical Homes (EMR-integrated) • Expansion of VCH reports and notifications distributed to Patient Medical Homes • Provincially agreed solution for making private practice Patient Medical Home Shared Care Plans available within health authorities • Initial VCH implementation, if feasible depending on provincial timelines • Patient access (clinical content & access models tbd) • Collaborate with LMC Health Information Management • eReferral solutioning 13
Primary Care Home Integration Enablers: Year 1 Summary Summary Patient Medical Home (PMH) (VCH and private practice) Core Client Information Sharing Across the EMR Continuum Patient Chart Shared Care Plan • Acute Encounters & Reports Community Care • Community Summary • VCH Primary Care PARIS Clinical Summary Community Care Record • Shared Care Plan • Medication Information Acute Care (PharmaNet, Intrahealth, PARIS) Clinical Information Systems (CST future) • Hospital Notifications Acute Care Record 14
Year 1 Work Streams Workstreams Key Linkages • VCH Proof-of-Concept Communities 1 Tactical Support for Proof-of- Concept Communities established • Doctors of BC Shared Care Plan project 2 Shared Care Plan Development Privacy - Records • Doctors of BC Shared Care Plan project 3 Implement Shared Care Plan Management - • VCH Proof-of-Concept Communities at VCH Communications - Sustainment • eCommunityNEXT 4 VCH Clinical Info Sharing • CST Project • DTES 2 nd Generation • eCommunityNEXT 5 Expand Reports Distribution • EMR vendor capability & Notifications • Workstreams 3 and 5 6 Expand CareConnect content
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