Effective Exchange and Integration of Cancer Control Information with Community Partners

1. Effective Exchange and Integration of Cancer Control Information with Community Partners • Brian Schmidt • Don Henkelman • Carol Rother • Theresa Volk

2. The Vision • Cancer care information is fully integrated with community care • Bi-directional information exchange or sharing is transparent and automated • The processes to support the above are more cost effective than the current processes

3. The Challenges • The de-facto standard for information exchange still measures 8½ by 11 inches • Data standards are in the early stages of development • Cancer care information is managed by a provincial system, while community-care information is managed by Regional or local systems • The Regional and local systems are very heterogeneous

4. The Challenges (cont.) • The confidentiality of patient information & patient’s right to privacy must be maintained • The information highway is frequently a dirt road filled with potholes leading no-where • No one has any money – solutions must have very short development cycles and be cost effective

5. BCCA Strategy – Focus on Internal Systems • Build an Information Technology infrastructure that is state-of-the-art • Deploy across the entire enterprise • Establish corporate-wide electronic communications • Build a ‘killer-app’ that supports your core business of patient care • Build strategic partnerships with best-of-breed vendors for operational support systems

6. BCCA Strategy – Focus on Change Management • Experience a re-engineering project • Become a process-focused organization • Have the courage to change • Develop a culture of change • evolution not revolution • Evolve to an integrated Electronic Health Record

7. BCCA Strategy – Focus on Industry Standards • Personal Health Number • HL7 • DICOM • Lab Test Standard • Provider Registry • H.320 & H.323 videoconferencing • ISO 17799 Security Standard

8. BCCA Strategy – Focus on Existing Data Linkages • Automate the capturing of external reports • Automate linkages to the client registry • Automate the capturing of external images • Attach external documentation to the electronic record immediately upon receipt • Support multiple patient identifiers

9. BCCA Strategy – Facilitate External Communications • Develop a web site directed to the health care professional • Guidelines, protocols, manuals, generic support information • Support ‘community of interest’ groups • Membership lists • Group-specific documents • Links to related information • Information on conferences, lectures, etc. • Access to CME • Leverage video, voice and data convergence

10. BCCA Strategy – Provide External Access to our EHR • Initially use ‘Windows’ clients over VPN • From home or office • Extend to electronic document exchange over the Internet • Extend to full access to our existing EHR over the Internet • Ensure patient confidentiality by leveraging established patient-physician relationships

11. BCCA Strategy – Web Services • Use Internet technologies to provide ‘cancer services’ • Services can be integrated into desktops or applications by users or vendors • Services can be accessed via a Cancer Agency portal from any web application • Requires standards, especially security & authentication standards

12. The Ultimate Vision – The Fully Integrated Virtual EHR • Integration & management of clinical information from a variety of sources • Care providers role defines the view on integrated clinical information • User is unaware how the information arrives at the care-giver station

13. 1st Step in the Vision – The BCCA Extranet Project • Goal of the project: • Design and development of extranet application • Provide health care professionals with secure, authorized access to BCCA applications • Primary purpose • develop communities of interest • improve bi-directional exchange of information

14. Develop the technical infrastructure Provide access to e-Chart Develop “communities of interest” Develop the Surgical Oncology Network website Provide electronic distribution of reports Create applications to support on-line requisitioning, referral and ordering Enhance our website to provide easy access to info for health care professionals Extranet Project Priorities

15. Technical Infrastructure • The goal is to develop a robust infrastructure to support the secure exchange of information with external stakeholders • Working with Ministry of Health Security Working Group to develop standards

16. Access to E-chart • Phase One: giving Agency physicians access to Agency applications from external locations using VPN technology • Phase Two: extending this access to community physicians • Long term: provide authorized physicians with immediate, online access to clinical information wherever secure Internet access is available (home, office, hospital)

17. Communities of Interest • Identify various communities with similar needs (e.g. Surgical Oncology Network, Tumour Groups) • Enhance 2-way communication, access to information between members • Create a template to standardize information management for communities

18. Surgical Oncology Network • Develop website for communication & information exchange for surgical oncology community • Facilitate Continuing Medical Education (CME) • Develop model for authorized access to information

19. Electronic Report Distribution • Distribution of electronic reports and clinical information to physician offices • Physician offices will no longer have to re-key information into their office systems

20. On-line Requisitioning, Referral and Ordering • Develop applications to allow physician offices to requisition tests or refer patients on-line • Result in decreased duplication of tasks & tests

21. Management of Information on our Website • Implementation of a Content Management System to support web site development • Develop one point of access to timely and accurate Cancer Agency information for health care professionals

22. Decreased duplication of tasks, tests and information Timely access to clinical documentation from community hospitals Ability to view clinical information on-line and discuss a case with a BCCA oncologist Potential for direct access to Agency services/applications Extranet Project Benefits

23. How can we work together? • Identify institutions and individuals who are interested in pursuing these opportunities with us • Visit the BCCA booth in the lobby and fill out a postcard with your contact information