tag:blogger.com,1999:blog-4384692836709903146.post5558622277226376049..comments2024-03-27T09:55:23.143-07:00Comments on Dispatch from the Digital Health Frontier: The Canadian eHealth ConferenceJohn Halamkahttp://www.blogger.com/profile/04550236129132159307noreply@blogger.comBlogger1125tag:blogger.com,1999:blog-4384692836709903146.post-3788735813866451502012-06-06T06:13:19.210-07:002012-06-06T06:13:19.210-07:00John,
Thanks so much for your insights. I could n...John,<br /><br />Thanks so much for your insights. I could not agree with you more. We are doing many of the things you suggest. The balance are in the next generation of our eHealth strategy which is in development and we hope will be funded. Our CEO, Richard Alvarez, shared that strategy with the audience the day after you spoke.<br /><br />Here are my responses to each of your numbered points:<br />1. Procurement does present some challenges, especially since most of health care is in the public sector. On the other hand, we are facilitating many innovation projects. To date, Infoway has approved $25.5M for 27 projects. We have also launched some challenges, with some still underway, to highlight and stimulate innovation. In 2011, Infoway hosted its first public Challenge, called the ImagineNation Ideas Challenge. Canadians were asked for bold new ideas to transform health care using information technology. Through the ImagineNation Outcomes Challenge, Infoway is challenging Canadian health care professionals to demonstrate the use and growth of e-solutions in their practices or organizations through this team-based Challenge. The challenge is focusing on four key areas:<br />- e-Scheduling<br />- Patient Access to Information<br />- Clinical Synoptic Reporting<br />- Medication Reconciliation<br /><br />I really liked your mention of agile development and deployment for BIDMC. In my recent talks I have promoted “apps for infostructure”. These are small and more agile deployments over big, monolithic procurements and deployments. These “apps” are solutions or callable services for certain functions. An example: incremental deployment of discrete CPOE services rather than a big, monolithic deployment (including process re-engineering, change management and training).<br /><br />2. Actually, we have not spent any of our investment on acute care. Rather we have focused our efforts on the interoperable EHR which is designed to share data across the continuum of care. These data include medication orders and dispenses, allergies and intolerances to medications, lab results, DI images and reports, clinical reports (e.g. discharge summary), encounter history and problem lists. Recent investment has focused on EMRs for GPs and community-based specialists, and EMRs in ambulatory care. For all three, emphasis has been on connectivity to the EHR. We do lag in patient portals and engaging families, but that work has started in some of the more advanced provinces like Alberta. The key theme of our new strategy is “Enhancing the Patient Experience” which encompasses everything else you suggest.<br /><br />3. We do have a concept similar to Meaningful Use, called Clinical Value. Some of our investment dollars are tied to clinicians using their EMRs effectively based on certain features/functions such as access and viewing of lab results and e-prescribing. There is accountability for clinical use, but not as high a percentage of the dollars is tied it as in the US. We envy you for that approach and the legislation backing it up. We don’t have that legislative stick, only the carrots.<br /><br />4. Infoway does develop national strategies in consultation with our stakeholders. As you point out, health care is a provincial/territorial responsibility. Each is in a different place (i.e. current state) and each has slightly different priorities for their eHealth investment. Thus, Infoway is quite flexible on what they do and when they do it, albeit our interest to invest is within the framework of our Board approved strategies.<br /><br />5. We do have a certification program and have had for a few years. It is growing now. A percentage of our investment dollars for the outpatient/ambulatory EMRs are tied to the vendor completing certification. Those criteria include functionality and interoperability with the interoperable EHR, along with privacy and security.<br /><br />Thanks so much for you remarks. We do study and learn from others. I love Doug Fridsma’s view on that: “We know we will make mistakes. We just want to make different ones by learning from others”.<br /><br />Dennis Giokas<br />CTO<br />Canada Health InfowayDennis Giokashttp://www.infoway-inforoute.canoreply@blogger.com