GHPP

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• ConnectingGTAGTAs HIAL Provider Portal
  Project
• Project Overview
• April 3, 2009
• Jim Forbes, Chief Technology Officer, UHN
• Jackie Kwong Leung, Project Director, UHN

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Agenda
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The Greater Toronto Areas Needs What are the
challenges? What is the vision?
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The GTA serves a diverse population and
encompasses a large and set of healthcare
providers and services
Organizations in the 5 GTA LHINs

• 5 CCACs
• 203 Community Support Services
• 46 Hospitals
• 177 Long-Term Care Facilities
• 86 Community Support Services
• 149 Mental Health and Addiction Services

of Family Health Teams by LHIN
The five GTA LHINs LHIN 5 - Central West LHIN 6
- Mississauga Halton LHIN 7 - Toronto
Central LHIN 8 - Central LHIN 9 - Central East

• 4 Central West
• 6 Mississauga Halton
• 10 Toronto Central
• 6 Central
• 7 Central East

GTA LHINs Total Population 5,829,150 (over 45
of popn of Ontario) of Physicians in Ontario
22,141 (1,400 FHT physicians) of Ontario
discharges by GTA LHINs 43.8
Provider Portal Implementations in the GTA LHINs

• IBM
• McKesson (3)
• Medseek (5)
• Valco Sys. Data-Glider (1)
• MyChartTM (1)
• SharePoint (1)

http//www.icis.ca/cihiweb/dispPage.jsp?cw_pageAR
_1070_Ecw_topic1070
http//www.health.gov.on.ca/transformation/lhin/lh
inmap_mn.html
http//www.statcan.ca/Daily/English/071219/d071219
b.htm
Medseek 4 implemented, 1 planned
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Patient care and referrals cross LHIN boundaries
these rely on many applications and often
paper-based processes
Legend

• Engaged in the CSA
• ? Not engaged in the CSA

Note LHINs are not to scale
Source GTA HIAL and Provider Portal Current
State Assessment Survey Responses
Based on 33 organizations that were able to
provide referral data in their survey response
(details vary)
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GTAs need for a robust and agile technology
framework to deliver clinical value to healthcare
providers

• Current Challenges
• Need to improve exchange of clinical information
  amongst providers, supporting provision of
  quality care across care continuum
• Several diverse legacy clinical information
  systems, lack of shared systems
• Existing capabilities do not meet needs for
  connecting diverse groups
• e.g. Integration, process orchestration, identity
  management and governance
• Detailed plans and timelines for provincial
  eHealth solutions are still under development
• Organizations are limited in capacity to
  participate in much-needed eHealth initiatives

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Electronic information exchange will support a
broad range of providers across the care continuum

• Future Benefits
• Increase ability to access complete, accurate,
  relevant, and reliable clinical data from
  multiple sources across the continuum of care
• Support achievement of clinical goals in
  Ontarios eHealth Strategy
• Reduce incidence of missing or lost clinical
  information
• Enabling better, safer and more timely clinical
  decision-making
• Increasing patient satisfaction
• Improved inter-professional care and
  collaboration through efficient information
  exchange between providers
• Reduced complexity of interconnected systems

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The End State Vision for ConnectingGTA
Delivers Clinical Value
Access to Clinical Data
Specialized Clinical Views
Populate Provincial Repositories
Access To Clinical Functions
Targeted data and users for specific agendas
Tools and protocols for clinical care
Write and update data stores
All data All users
GTA HIAL and Provider Portal
Improve exchange of clinical information amongst
health care providers in the GTA, supporting
provision of quality care across care continuum
Establishes a Foundation
Shared Integration
Shared Services
Portal Framework
Aggregate information and access to external
services
Consolidate and share interfaces and integration
capabilities
Core initial enabling services Identity,
Consent, Audit and Logging
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A three-year approach will build the program to
the end state vision
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The ConnectingGTA Project How we are doing it
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The project governance structure developed for
the planning phase will evolve as implementation
begins
GTA LHIN eHealth Leads LHIN CEOs
Business (Clinical) Advisory Committee
Steering Committee
Technical Advisory Committee
Privacy Security Committee
Lead Org Project Sponsor
eHealth Ontario
Project Team
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Clinical priorities were selected to align with
provincial, LHIN and local level priorities and
initiatives
LHIN Priorities and Initiatives
Related eHealth Initiatives

• Diabetes Registry
• Ontario Lab Information System
• Diagnostic Imaging
• All Drugs All People
• Panorama
• e-Referral
• Telemedicine
• Telehomecare
• Electronic Medical Records

• Integration with Primary Care
• Seamless senior care
• Mental Health and Addictions
• CDPM
• Wait Times

GTA HIAL and Provider Portal
Linking Providers across the Care Continuum
GTA Priorities
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Approach for Detailed Planning Phase
Oct
Nov
Feb 2009
Mar
Apr
May 2008
Sep
Clinical Priorities
Current State Assessment

• Established Project Governance
• Surveyed 46 organizations, 5 jurisdictions,
  related provincial/regional initiatives

• Prioritized data categories
• Developed business requirements
• Convened clinical focus groups
• Developed technical requirements

Requirements Definition

• High level 3-year release plan
• Operational information governance (privacy)
• Business Case for Release 1 Implementation

Solution Strategy Business Case
Early Starts (Implementation)

• Lab data population
• Foundational layer and common services
• Viewer adoption

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Solution Components What is GTAs definition of
a portal and HIAL?
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Solution Components Provider Portal

• Web-based user interface built on a portal
  framework, supports assembly and display of
  clinical information from diverse sources
• Facilitates access to external services in a
  structured, personalized, transparent and
  standards based way
• Enhances user experience through personalization
  options

• Includes session or context management capability
• Can consume external services for privacy and
  security and does not mandate the use of internal
  custom databases for operation

Security Privacy Layer
Portal Platform Capabilities e.g.
personalization, context sensitive presentation,
search, collaboration, etc.
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Solution Components GTA HIAL
GTA Provider Portal
Other GTA Portals and POS Applications (e.g.
HIS/EMR)


GTA HIAL
Business and Technology Governance and Ops
Processes
Standards
Registries
Clinical repositories
GTA data stores
GTA shared health record
The HIAL is a logical and physical layer that
provides access to clinical function providers
and data providers for service consumers or users
(portal, EMR, hospital information systems and
others)
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The GTA solution will integrate with other
standards-based portals and HIAL services
(existing and future)
Illustration only
Client Registry
Diabetes Registry
OLIS
Provider Registry

Provincial HIAL
GTA HIAL
Other Regional or Institutional HIALs
GTA Provider Portal
GTA Health Care Providers
GTA Data Sources
GTA Organizations may use a Provincial Portal
or take view/data services into their
portal/other systems
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Questions

• For more information, contact ConnectingGTA_at_uhn.on
  .ca

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