EMR and Integration April2011 Lynne Zucker En

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Electronic Medical Records(EMR) and Integration

Program Update

14 April 2011


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Electronic Medical Records (EMR) & IntegrationTodays agenda

Br ing ing i t

a l l t oge t he r

I n t e g r a t i o n

cha l lenges

EMR &

I n t e g r a t i o nProgram

EMR Use

Today


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Cl in ical and

A d m i n i s t r a t i v efunc t i ona l i t y

Source: BC Ministry of Health, EMR Project, RFP, 2007.

Practice Management

Patient registration

Appointment scheduling

Eligibility checking

Claims submission and billing

Accounts receivable

Health card scanning

Chart tracking

Patient tracking

Referral management

Elect r on i c Med ica l Record s

Patient triage, assessment, management

Care planning

Order/receive diagnostic imaging tests

Order/receive laboratory tests

Order medications

Receive medication profile

Manage medication renewal requests

Manage immunizations

Online dictation

Clinical workflow

Clinical decision support

Clinical messaging alerts

Patient communications

Electronic Medical RecordsTwo components


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Source: 1) 2009 Commonwealth Fund International Health Policy Survey of Primacy Care Physicians; 2) Mirror, Mirror on the Wall:How the performance of the U.S. Health Care System compares intenerationally; 2010 update; Commonwealth Fund

* Must include 9 of14 of the following functions: electronic medical record; electronic prescribing and ordering of tests;electronic access test results, Rx alerts, clinical notes; computerized system for tracking lab tests, guidelines, alerts toprovide patients with test results, preventive/follow-up care reminders; and computerized list of patients by diagnosis,medications, due for tests or preventive care.

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Automation of Physician OfficesEMR use in Canada


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Qualitative BenefitsEMR use by physicians in community settings

AccessAccess

QualityQuality

ProductivityProductivity

Improved referrals and patient self-

care

Decreased patient waiting time

Increased patient safety

Improved management of chronic diseases

Improved clinical outcomes

Improved care coordination

Cost avoidance through increased efficiency

Monetary savings in drugs, radiology and lab

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Goals of the EMR and Integration program

Focus investment at the points of care where the benefits of health

IT can deliver immediate value to patients and clinicians

Significantly increase the number of EMR systems in

community-based practices and out-patient settings

Target is 12,000+ additional clinicians using an EMR

Upgrade and connect EMRs so they are interoperable with the core

health information systems being developed across the country

Achieve increased clinical value for clinicians through the

advanced use of EMRs, e.g. accessing more complete medication

profiles, lab results, immunizations and hospital discharge

summaries

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Electronic Medical Records and IntegrationIn summary: the investment focus of ~ $340 million

Upgradeexisting clinical solutions

Electronic medicalrecords

Community pharmacysystems (e-prescribe)

Connect hospitalinformation systemswith ambulatory EMR

Deploymore clinical solutions

Implement upgraded

electronic medical

records incommunity and

out-patient settings

Achieveincreased clinical value

Derive clinical value

from the use of

electronic medicalrecords in

community care

settings

~35% ~65%

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Clinician does e-prescribing and receives a complete

medication history and automated medication alerts

into the EMR

Level 2

Enter encounter notes

Enter problem lists, allergies, immunizations

and vitals

Enter new prescriptions/renewals into the EMR,

which can be printed

Generate automated alerts and reminders

from within the EMR

Receive laboratory results into the EMR

Level 1

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Electronic Medical RecordsAchieving Clinical Value


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Building Community

National EMR Forum (jurisdictions)

Peer-to-Peer Networks (clinicians)

Medical Education Program (future clinicians)

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Addressing the Challenges

1. Highlighting and harmonizing regional variations in

implementation standards

2. Decreasing the development effort required for developers

to connect EMRs, EHRs and other systems

3. Simplifying the process of rolling out solutions across

multiple jurisdictions

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Addressing the Challenges

Design challengesWhere can all of the specifications and their variations

be found?

How can we reduce the variation amongst jurisdictions?

Development challengesHow can we simplify complex message structures?

Where can we find best-practice solutions?

How can we quickly test implementations across

multiple jurisdictions?

Implementation challengesHow can we create recognition for compliance with

jurisdiction and national standards?

HarmonizedDocumentation

HarmonizedDocumentation

Developer toolsDeveloper tools

National CertificationNational Certification

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One-stop shop

Easy to search

Highlightsjurisdictional

differences

Has led to

jurisdictional

harmonization

Addressing the ChallengesHarmonized documentation

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Messages used to connect these systems are extremely complex

Messages (and message sets) vary across jurisdictions

Developers need to test their solutions in each jurisdiction

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Addressing the ChallengesDeveloper tools

Canadianstandards

Localizedstandards

Code

Infoway DevelopersJurisdictions Developers

Message

Bui lder

Message

ReMixer


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A Single Pan-Canadian Program

One certification program for EMR products that allows both national andjurisdiction classes of certification as required

Integrated Assessment

A single set of EMR criteria, test cases and test data

Seamless Process

A simple, integrated process provided by Infowayand/or the jurisdictions for

product vendors to certify their EMRs

Integrated with EMR Funding Programs A certification approach that supports EMR funding programs within jurisdictions

Evolves over Time

A certification approach based on recognized industry standards that will continue

to evolve as EMR products mature 13

Addressing the ChallengesApproach to EMR Certification Services


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By Summer 2011

1. Access to the EMR & Integration wiki for documentation

2. Launch of Message Builder developer tools

3. Launch of InfowayEMR Certification

4. Opportunities for Infoway funding in conjunction with jurisdiction

EMR upgrade requirements

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In the next few years

More EMR Adoption

60% of community based physicians using an EMR

Enhanced EMR interoperability capability

Lab results and queries

Medication profiles and e-prescribing

Clinical Reports (diagnostic imaging, hospital)

e-Referral

Improved alignment

More similarities between provincial programs and implementations National EMR certification

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Learn more about the Developer Tools

Join us at eHealth, May 29June 1 in Toronto

presentations

hands-on demonstrations

Email [email protected] receive information on upcoming Message Builder launch

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Questions?


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[email protected]

Email for information aboutMessage Builder as

it becomes available.

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EMR and Integration April2011 Lynne Zucker En

Documents

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