Information Technology Association of Canada itac Welcome Ontario’s eHealth Strategy Breakfast Sarah Kramer President &a

Information Technology Association of Canada www.itac.ca Welcome Ontario’s eHealth Strategy Breakfast Sarah Kramer President & CEO eHealth Ontario

Overview of eHealth Ontario Sarah Kramer, President and CEO ITAC Breakfast Event March 31, 2009

Why eHealth Ontario? Deliver the government’s eHealth agenda to the province Restore credibility to the organization that must deliver that agenda Instill greater transparency, accountability for results Enhance capacity for broad stakeholder engagement Expedite effective project delivery

eHealth in Ontario – A Shift No dedicated provincial eHealth Strategy Funded, Cabinet approved Strategy Government responsible for Strategy eHealth Government as stewards; eHealth Ontario responsible for eHealth Strategy Diffuse/competing/confusing accountability Single point of accountability at eHealth Ontario Duplication, fragmentation and Proliferation of eHealth efforts Provincial strategy delivered through local, regional and province-wide solutions Technology plan Health System Transformation Strategy

What’s Changed? New, experienced leadership New Board that is active and engaged 3 year Strategic Plan developed, released to stakeholders and public, approved Former SSHA service issues are being addressed Stakeholder engagement Stakeholder engagement process has been implemented. Over 400 individuals/groups provided input to the strategic plan

Dr. Alan Hudson, Board ChairOC, FRCS C, MBChB, LMCC, FRCS Ed, FRCS C, DD Hon, FCS SA Hon Matt AndersonCEO, Toronto Central LHIN Matthew Barrett*Former Chairman, Barclays Bank Khalil BarsoumFormer Chair and CEO, IBM Canada and IBM UK Ken DeaneAssistant Deputy Minister of the Health System Accountability and Performance Division, MOHLTC Michael DecterPresident and CEO, Lawrence Decter Investment Council Sarah KramerPresident and CEO, eHealth Ontario Lisa LifshitzPartner, Gowling Lafleur Henderson LLP J. David LivingstonPresident and CEO, Infrastructure Ontario Heather SherrardVP, Clinical Services, University of Ottawa Heart Institute Geoff SmithPresident and CEO, EllisDon Corporation Carol Stephenson*Dean, Richard Ivey School of Business eHealth Ontario’s Board of Directors * Appointment process underway

eHealth Ontario’s Mandate • Play a leading role in harnessing IT and innovation to improve patient care, safety and access in support of the government’s health strategy • Provide a single, harmonized and coherent eHealth Strategy for Ontario that supports the government’s health agenda • Align all publicly-funded eHealth initiatives through a single point of accountability • Encompass all provincially funded healthcare system information initiatives that support clinicians and patient care delivery, and are actually or potentially province-wide in scope

Values Vision Achieving excellence in healthcare by harnessing the power of information Mission Deliver a comprehensive, patient-focused, secure and private electronic system that will improve the way patients receive care. • eHealth Ontario: • Relentless Pursuit of Results • Provider and Patient Focused • Fostering Openness and Transparency • Exhibiting Leadership in eHealth • Displaying an Emphasis on Value • Accountable to Shareholders and Stakeholders • Fostering Partnership and Collaboration

1. eHealth Ontario will focus on enabling clinical outcomes (value) for better patient care, not technology for its own sake 2. Early clinical benefits are the key to building and sustaining support for the eHealth Strategy 3. The eHealth Strategy will be transparent 4. Advice from experts with a track record of success will be sought 5. Performance metrics and success indicators will be measured and reported publicly Guiding Principles of eHealth Ontario’s Strategy

6. Partnerships will be established to deliver eHealth solutions 7. Deployment models will vary by project 8. Wherever possible, legacy systems will be leveraged to achieve provincial goals 9. Clinical content of solutions must be relevant and complete 10. Clinicians will be engaged early and often to ensure project success Guiding Principles of eHealth Ontario’s Strategy (cont.)

Clinical Priorities Clinical Strategy Diabetes Management Medication Management Wait Times Supports Ontario government health priorities • Fast clinician adoption of eHealth systems Have had proven success in other jurisdictions • Benefits are known and achievable • Profoundly improve patient care and clinical outcomes Offer a large clinical value proposition • Future eHealth initiatives have a strong foundation to build on (EHR 2015) Provide return on investment (ROI) for eHealth infrastructure investments 11

Diabetes Management Medication Management Wait Times • Monitor patient compliance with evidence-based interventions • Alert physicians when best practicesnot being followed • Report on care gaps • Enable online prescriptions and • medication History • Provide decision support for physicians • ordering drugs • Alert of potential adverse drug events • Enable public reporting and • performance management • Expedite patient referrals out • of acute care where appropriate • Divert ER visits to more appropriate • community care settings • Blindness • Heart attacks • Amputations • Renal failure • Deaths • Focus of ERs on urgent patients • Access to community services • Adverse drug events • Physician office visits • Hospitalizations • Deaths To Reduce To Reduce To Increase • % prescriptions ordered online • % reduction in adverse drug events • ER length of stay • Wait for post acute care • % patients receiving best practice care Measure Measure Measure Clinical Priorities ER length of stay Wait times To Reduce

Ontario eHealth Strategy, Priorities and Solutions • Diabetes Management • Baseline Dataset • Diabetes Registry • EMR interoperability with Diabetes Registry • OLIS interoperability with Diabetes Registry • Medication Management • ePrescribing Demonstration Project • Drug Information System (DIS) • Drug Profile Viewer (DPV) • Systemic Treatment Computerized Physician Order Entry (CPOE) • Wait Times • eReferral and Resource Matching • Emergency Department Reporting System (EDRS) • Wait Time Information System (WTIS)

Systems best managed as single instance, province-wide applications Data required across the province Solution is well defined and can interoperate easily with a wide variety of clinical system vendors System supports province-wide programs or strategies Systems best managed at a regional level Handle clinical information that supports or follows referral patterns Require tight integration with legacy systems Systems best managed locally A wide variety of legacy application vendors are already installed Few standards exist resulting in incompatible data models and user interfaces Strong influence on local clinical workflows Cost of moving to standard platforms is very high Application Delivery Model Characteristics

WTIS EDRS Telemedicine eCHN Chronic Disease Management and Prevention / ColonCancerCheck CCIS SETP CCIM DI/PACS HIAL eReferral Systems Physician EMRs CCAC Systems Hospital Information Systems Diabetes Registry Drug Information System Drug Profile Viewer Client Registry Provider Registry User Registry Consent Registry OLIS Province-wide DI Exchange Panorama HIAL Each group will be delivered using most appropriate model 1 Province-wide application; provincial standards; managed/hosted by eHealth Ontario* 2 Provide-wide application; provincial standards; not managed/hosted by eHealth Ontario 3 Regional applications (more than 1 LHIN); provincial standards 4 LHIN, hospital or physician office applications; provincial standards 5 LHIN, hospital or physician office applications; no provincial standards Provide-wide application; provincial standards; not managed/hosted by eHealth Ontario LHIN, hospital or physician office applications; provincial standards Regional applications (more than 1 LHIN); provincial standards Province-wide application; provincial standards; managed/hosted by eHealth Ontario* LHIN, hospital or physician office applications; no provincial standards Portal * Depending on procurement approach

Medication Management Medication Management 35% of physicians sending prescribing events to DIS Wait Time Management Public Health Units begin utilizing Panorama Surveillance Analytics 65% of primary care physician offices enrolled in provincial program; with 2/3 patient charts online First 100 primary care physicians receive invitations for patient screening from the ColonCancerCheck program 100% of wait time funded hospitals meeting reduced ER reporting deadlines through EDRS 5% of physicians sending prescribing events to DIS 50% of physicians accessing remote lab data online Consumer eHealth strategy developed Public Health Units begin utilizing Panorama Immunization & Vaccine Ordering and Delivery All wait time funded acute hospitals and 20 post-acute hospitals publicly reporting ALC data through WTIS-ALC 75% of chemotherapy orders OTN Diabetes Telehomecare ordered electronically OTN Diabetes Telehomecare ordered electronically pilot projects complete 100% of diagnostic images shared across LHINs 3 (Waterloo Wellington) and 4 (Hamilton Niagara Haldimand Brant) and across LHINs within Pan Northern Ontario PACS project and Champlain project Clinicians within Greater Toronto Area begin accessing OLIS data 100% wait times funded hospitals submitting ALC data and meeting reduced ER reporting turnaround time 65% community pharmacies submitting dispensing events & 35% of physicians sending ordering events to DIS eReferral business process and data standards defined; Begin funding LHIN initiatives that adhere to standards Drug Information System limited roll-out pilot complete EDRS enhancement requirements developed WTIS-ALC deployed to beta sites 100% of wait time funded hospitals publicly reporting wait time data on all surgeries as defined by Access to Care Program eReferral (ED-CCAC) available to 40% of ER visits in Ontario Baseline and targets established for % of patients with diabetes receiving best practice care 75% of primary care physicians receiving quarterly quality reports (HbA1c, LDL, retinal exam) & 25% of primary care physicians accessing Diabetes Registry functionality online 25% of people with diabetes with confirmed primary care physician 5% of physicians sending prescribing events to DIS All community lab tests in OLIS Diabetes Registry procured and limited release working prototype in use 100% of relevant lab tests fed into Diabetes Registry from OLIS Begin Diabetes Registry deployment in 14 LHINs 80% of people with diabetes with retinal exam data Drug Information System procured 2 local ePrescribing pilots complete Oct ‘09 Apr ‘10 Oct ‘10 Apr ‘11 Oct ‘11 Apr ‘12 Apr ‘09 July ‘09 Jan ‘10 July ‘10 Jan ‘11 July ‘11 Jan ‘12 80% of people with diabetes identified 100% of people with diabetes with lab service history (HbA1c and LDL) 100% of diagnostic images shared across LHINs within the TEN project Begin Drug Information System full deployment 100% of diagnostic images shared across LHINs within Greater Toronto Area West project Diabetes Registry live Lab results from OLIS begin feeding Diabetes Registry Begin Provincial DI exchange deployment 100% of primary care physicians receive first quality report (HbA1c, LDL,retinal exam) Diabetes Management Physician eHealth Diabetes Management eReferral (ED-CCAC) available to 70% of ER visits in Ontario Public Health Units begin utilizing Panorama Communicable Disease and Outbreak functions Legend Diabetes Management Wait Times Systems that Support Clinical Strategy orClinical Operations MedicationManagement ~40% people with diabetes receiving best practice care in April 2009 >50% people with diabetes receiving best practice care 65% of PCP offices will have 2/3 patient charts online by April 2012 eHealth Ontario’s Strategy Roadmap 2009 - 2012

Ensure a transparent and open dialogue Create a level playing field for the industry Work together with ITAC to communicate and share information with industry Seek advice and input from industry experts Listen Principles of Working Together

Quarterly eHealth Consultation Breakfasts – Facilitated by ITAC and aimed at information exchange Expert Roundtables – On an as needed basis, leveraging the experience and expertise of ITAC members Conferences – HIMSS09, HealthAchieve2009 (OHA), e-Health 2009: Leadership in Action (COACH) Annual Speech to ITAC members Identified point of contact at eHealth Ontario Practice of Working Together

Fair, transparent and efficient eHealth Ontario will be regularly posting vendor contracts eHealth Ontario has a new Procurement Policy, approved by government The new policy is consistent with the Ontario Government’s and conforms to what is generally required by Management Board Infrastructure Ontario’s expertise in procuring large scale projects is being leveraged Treasury Board/Management Board Cabinet will approve projects exceeding $10M Approach to Procurement

Critical Success Factors • Government of Ontario political will and investment capital • Relentless drive to achieve clear, measurable goals • Single point of accountability • Focus on a discrete set of initiatives • Participation of clinicians and other stakeholders • Positive working relationship with the vendor community

Cornerstone Information Systems • Client, Provider, User, Consent Registries • Portal • Health Information Access Layer (HIAL) • Physician eHealth • Ontario Lab Information System (OLIS) • Telemedicine • Consumer eHealth

Diagnostic Imaging/PACS Panorama Chronic Disease Prevention and Management/Colon Cancer Check Hospital Information Systems eChild Health Network (eCHN) Performance Management Systems Critical Care Information System (CCIS) Surgical Efficiency Target Program (SETP) Community Care Information Management (CCIM) Community Care Access Centres Systems Clinical Activity Information Systems

Technology Services • Data Centre • Network • E-mail • User Support • Authentication/Registration • Application Maintenance

Enabling Practices and Talent Management • Procurement and Contract Management • Program Management Office • Architecture and Standards development and Maintenance • Privacy • Metrics and Benefits Measurement Program • Data Quality Improvement Program • eHealth Human Resources Expansion Program

Information Technology Association of Canada www.itac.ca Thank you for joining us today Ontario’s eHealth Strategy Breakfast

Information Technology Association of Canada itac Welcome Ontario’s eHealth Strategy Breakfast Sarah Kramer President &a