eHealth and PITO Update

1
eHealth and PITO Update

• Practice Support Program Presentation
• April 2007

2
eHealth Introduction
3
eHealth Alphabet Soup
eHealth
Information technology supporting health care
Surgical Registry
Telehealth
Electronic Health Record
Shareable patient data
Lab
Other
Drug
Public Hlth
DI
iEHR
CIS
EMR
EMR
EMR
CIS
CIS
EMR
EMR
CIS
EMR
EMR
CIS
EMR
EMR
CIS
EMR
EMR
Health Authority Clinical Information Systems
Generic EHR Viewer
Electronic Medical Records in Physician Offices
4
Brief Domain Project Descriptions

• PLIS Provincial Lab Information System
• Will make lab reports from public and private lab
  services available to authorized clinicians
  across the province
• CDI Connecting DI
• Will link together the PACS (Picture Archiving
  and Communication Systems) from across the health
  authorities to enable exchange of lab images and
  reports
• eDrug (PharmaNet 2)
• Expand the capabilities of PharmaNet to include
  ePrescribing and other features, integrated to
  EMRs
• Public Health / Health Surveillance
• A shared system for health surveillance,
  communicable disease, and other aspects of public
  health. Includes integration of immunization
  management with EMRs.

5
iEHR The plumbing

• The iEHR project is responsible for three major
  items
• The Health Information Access Layer (HIAL)
  the plumbing
• The iEHR Viewer to provide access to data for
  clinicians who are not accessing it via a an EMR
  or HA clinical information system
• The Shared Health Record to enable exchange of
  data not already covered by lab/drug/DI/PH/etc.
• The iEHR provides a key mechanism to consistently
  manage privacy and security across all domains of
  the EHR by controlling access, monitoring
  access, logging access, etc.

6
What does it all mean to me as a doctor?

• EMR I can replace paper records in my office
  and the paper that comes in from outside the
  office, streamline how the office functions, and
  access my patients records from my home and the
  hospital
• HA Clinical Information systems If I visit a
  patient in the hospital, I will have easy access
  to all data related to the patients stay
• EHR (iEHR lab/drug/DI/etc domain projects) I
  can access information from other parts of the
  health system faster and more reliably (lab
  results, discharge reports, etc) directly from my
  EMR
• Surgical Registry My patients and I will be
  able to make more informed decisions regarding
  referrals and services to access
• Telehealth My patients will be able to access
  specialized services, even if they are in a
  remote area

7
eHealth Availability Staged expansion
2009
2008

• PITO EMR Implementations
• Pilots starting in 2007 followed by rollout in
  2008

• Initial Wave of eHealth Components
• e.g. eDrug (Pharmanet 2)
• e.g. Access to consolidated lab reports

• Second Wave of eHealth Components
• e.g. Diagnostic Imaging (images reports)
• e.g. Public Health Surveillance

• Subsequent Waves of eHealth Components
• TBA
• TBA

New eHealth services will be implemented in
phases each year
8
PITO Introduction Update
9
PITO Goals

• Support optimal quality of care (access to info
  CDS)
• Support physician office efficiency
• Primary health care (shared care, CDM, etc.)
• Support specialist workflow referrals,
  waitlists
• De-identified data to support population health
  (core data set)
• Enable physician EHR adoption (integration to
  iEHR) to support domains and Infoway targets

10
PITO Offering

• What will be available to physicians?
• High-speed private network between their office,
  their EMR vendor, their local HA, and eHealth
  (consistent high-speed bandwidth)
• Virtual Private Network (VPN) access from home or
  away
• Secure email
• Funding for purchase of hardware that meets their
  EMR vendors specifications
• ASP-hosted EMR, including implementation
• Transition support services

11
PITO Update

• RFP Process in progress
• CAG and eHealth groups reviewed the EMR RFP
  requirements
• EMR RFP closed April 2 with 33 responses (very
  high interest)
• Initial evaluation and short listing is underway
  and will proceed through April/May
• User Demonstrations with practicing physicians in
  June
• Selection and negotiation with final six in July
• PITO Pilot Projects beginning in August/September
• Will test and evaluate the full PITO offering and
  implementation
• Pilots will start with hardware/network and then
  move to EMR
• Request for expressions of interest by physician
  to be issued in May

12
PITO Update (continued)

• PITO Funding levels announced
• 70 of up to 10,000 for Y1 one-time
  implementation costs
• 70 of up to 4,080 for Y1 recurring costs
  (helpdesk, hosting)
• 70 of up to 6,420 for ongoing recurring costs
  (Y2 and after)
• Funding levels for hardware and implementation
  support will be released shortly
• PITO Program Director selection nearing
  completing
• Short list prepared
• Interviews occurring this week
• Successful candidate should be selected by the
  end of April

13
EMR RFP/MSA Unique points

• Maximum of 6 vendors
• Validation, user demonstration, and conformance
  tests
• Current vs. future interoperability
• Hardware out of scope (addressed in MSA Schedule
  11)
• Level 1 helpdesk for PITO offerings in scope
• Foreign disclosure and other privacy provisions
• Pricing on a per-physician unit basis
• Termination services
• Continuity and Step-In Rights
• EMR-2-EMR Conversion Specification
• Service Level Requirements

14
Privacy and security measures

• The bar has been significantly raised compared
  to past EMR procurements and what most individual
  physicians would typically have today
• RFP requirements
• Privacy
• Security
• MSA
• Disclosure to third parties
• Disclosure to the Province
• Foreign disclosure
• Technical Obligations and Privacy/Security
  Obligations

15
Physician most frequently asked questions

• What if I have an EMR and my vendor isnt
  selected by the EMR RFP?
• PITO funding will be contingent on transition to
  a PITO-approved EMR. The PITO SC is addressing
  how to best support physicians who need to make
  this transition.
• If my EMR vendor is selected for the
  PITO-Approved list, what do I do?
• Physicians who already have an EMR, that is one
  of the 6 on the PITO-approved list, will sign up
  for PITO and transition to the PITO-approved ASP
  version of the EMR in order to receive PITO
  funding.
• Will I be eligible?
• Most BC physicians will be eligible. PITO is
  establishing some base criteria to ensure maximum
  use of EMRs. Most physicians will be eligible as
  long as they are funded through MSP and adopt one
  of the 6 approved EMRs. Specific criteria will be
  released before the pilots. PITO funding is
  available to both GPs and specialists.
• I need to replace my old computers, can I buy
  them now?
• PITO SC will be releasing an announcement on this
  subject in the next few weeks.
• How do I sign up to be a pilot site?
• PITO will be releasing a request for expressions
  of interest in May for groups of physicians
  interested in being pilot sites.
• Will the PITO ASP EMRs be reliable, particularly
  in remote areas?
• PITO has carefully addressed the two major areas
  of potential failure network reliability
  through the design of the secure network, and EMR
  reliability and local office redundancy through
  the EMR RFP

16
PITO / PSP Alignment
17
PSP/PITO Coordination

• The PITO and MOH PSP teams have been working on a
  coordinated implementation process
• The local PSP Teams and PITO representatives
  (Relationship Managers) will provide
  coordinated support for physicians
• A set of minimum transition support services
  have been identified (e.g. readiness needs
  assessment)
• Additional optional transition support services
  will be defined subsequently (e.g. process
  optimization)
• The step-by-step implementation process and
  transition support services will be tested during
  the PITO pilot implementations in the summer/fall

18
What will be available for Practice Support Teams?

• May
• Overview materials on PITO and eHealth solutions
• July
• Identification of PITO pilot sites
• Identification of the 6 PITO-approved EMRs
• PITO EMR/IM-IT implementation process and contact
  points
• September
• Details on eHealth solutions and timing
• PITO registration materials