alberta wellnet: How Will it Influence Clinicians

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alberta wellnet How Will it Influence Clinicians?
Calgary Regional Health Authority Workshop on
Health Informatics July 22, 1999, Calgary,
Alberta Dr Tom Noseworthy
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Outline

• Vision
• Wellnet Basics
• Results to Date
• Priority Setting
• Go-Forward Plan
• Implications for RHAs and Physicians

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The Vision of an Evidence-Based Health System

• In an evidence-based health system, sufficient,
  useful evidence is available for all health and
  health care decisions. Information systems and
  technology are state of the art. Decision makers
  at all levels of the health system are able to
  get access to relevant and timely information on
  population health strategies and both medical and
  non-medical health determinants. Information is
  integrated and readily accessible from all health
  sectors and from other sectors which affect
  health.

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• Incentives and tools are in place to ensure that
  the best evidence is used. Decision making is
  accountable and transparent. An efficient and
  effective health system exists which contributes
  to improved health status and quality of life.
• National Forum on Health (1997)

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alberta wellnetVision/Mission

• Vision
• Better information for better health.
• Mission
• To enable better decisions, using integrated
  system-wide health information, to improve the
  health of Albertans and the management of the
  health system.

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alberta wellnetValues

• We value the privacy of individual health
  information.
• We believe that relevant information about health
  and health care must be accessible to all health
  stakeholders and decision makers
• Albertans, policy makers, administrators,
  researchers, physicians, pharmacists, nurses and
  other health professionals.
• We believe in maximizing accountability within
  the health system.

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Why alberta wellnet?

• Too little information to guide decisions.
• Under-investment in information technology.
• High cost of each health authority going it
  alone.
• Shared benefits of common systems.
• Increasing emphasis on accountability.
• Better information for better health.

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Key features of alberta wellnet

• Partnership
• Province-wide approach
• Information stored where it is now but with
  common standards.
• Gateways link existing systems.

• Privacy protected.
• RHAs can develop their own systems but link to
  provincial network.

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alberta wellnet scope
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wellnet Domains
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Health Authorities
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• System-wide applicationsincluding Gateways
• Common applicationsfacilitated by wellnet
• Unique applications withina stakeholder
  organization
• may need interfacesto a wellnet Gateway
• should attempt to followwellnet standards
  (enablefuture integration).

Physician Offices
1
3
G
G
2
1
3
3
G
G
3
Pharmacies
Alberta Health
2
G
Others
3
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Results to date

• Strategic Blueprint endorsed.
• Y2K issues coordinated additional funding
  leveraged.
• Basic architecture done.
• Gateway design done.
• Pharmacy Information Network (PIN) design done.

• Common Opportunities underway
• Tri-Region financials
• MediSolutions.
• Telehealth underway.
• Newborn metabolic screening in pilot stage.
• SPHINX in development.
• Drug Profile in pilot stage.

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Drug Profile design and implementation
Claim adjudication
Explicit written consent
Emergency physicians, nurses and admitting/ unit
clerks will access valuable medication
information on patients aged 65 and over who give
their consent.
Pharmacy
Dispensing event data
History of unlocked records
Application
Database
User interface
Hospital
Alberta Blue Cross
alberta wellnet

• Healthcare professional
• obtain patient consent
• access drug information
• print for medical record
• verify information with patient

• audit of all drug profile accesses
• provide security

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Potential projects

• Breast cancer screening
• Cervical cancer screening
• Newborn metabolic
• screening
• Drug Profile
• Telehealth
• Eligibility determination
• SPHINX
• Immunization
• Pharmaceutical
• Information Network
• Gateway
• Infrastructure

• Common Opps - Health authorities
• Common Opps - Continuing Care
• Public Health
• Common Opps - Physician Office
• Systems
• Demographic registry/ provider
• and site registries
• Integrated Cancer Care Network
• Lab and diagnostic imaging
• Website
• Call centre

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Decision-making process
Three filters
Projects for consideration Preliminary investment
cases 49 MM
Investment portfolio 30 MM
Return to health and the health system
Strategic priorities Tactical Infrastructure
Strategic
Prioritization framework
Tactical Infrastructure Strategic
Stakeholder Commitment Feasibility
Requirements
Design
Buy/Build
Pilot/Rollout
Go/No go
Go/No go
Go/No go
Go/No go
Business case
Business case
Business case
Business case
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Prioritization criteria
High 2
Medium 1
Low 0
Weight
5 5 5 5 5 3 3 3 1
Net financial benefits Intangible
benefits Probability of benefit
realization Timing of deliverables Stakeholder
support Dependencies Ability to deliver Capacity
to absorb Solution availability
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Go-forward projects

• Allocate priorities against budget available.
• Go forward with

• Breast cancer
• screening
• Newborn metabolic
• screening
• Drug Profile
• Telehealth
• SPHINX
• Integrated Cancer
• Care Network

• Pharmaceutical
• Information Network
• Common Opportunities -
• continuing care/public
• health
• Common Opportunities -
• Health authorities
• Gateway

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Key challenges

• Strike the balance long-term v. quick wins.
• Show benefits to regions and individual
  Albertans.
• Maintain support over the long-term.
• Protect privacy.
• Satisfy demands and meet expectations with
  limited funds.
• Align projects with stakeholder needs, priorities
  and readiness.

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What does this mean for your region?

• Long-term plans not quick fixes.
• Not all regions will see benefits immediately.
• Need to balance plans against dollars and ability
  to implement.
• Early benefits to regions
• Common Opportunities, Telehealth, Drug Profile
  
• and Metabolic Screening.
• Access to basic network services AGNpac.

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Physician and Infostructure Framework

• Empower the public
• Strengthen and integrate health care services
• Create information resources
• Improve privacy protection