1. Electronic Access to Information Benefits Patient Care in Saskatchewan Kevin Kidney, Project Director EHR, eHealth Saskatchewan Michael Craig, Vice President, Orion Health

2. Presenter Disclosure Faculty: Kevin Kidney - eHealth Saskatchewan Michael Craig - Orion Health Relationships with commercial interests: – Kevin Kidney - Project Management Consultant, Solvera Solutions – Michael Craig – Vice President, Orion Health

3. Agenda What is the “eHR Viewer” eHR Viewer Background EHRs in Saskatchewan Initial eHR Assets Goals Evolution of eHR Viewer Clinical Data in the eHR Viewer Benefits Lessons Learned

4. A secure website developed for Saskatchewan health care providers that provides access to patient profiles regardless of where they present for care or where they live in the province. What is the “eHR Viewer”

5. eHR Viewer: Background eHealth Saskatchewan/Orion Health Collaboration Project aligns with the province’s overall interoperable EHR strategy - integrates Orion Health’s Clinical Portal Saskatchewan applications. Integration - multi-vendor, cross-collaborative team of Project Managers, Healthcare SME’s, Technical Leads and Implementation Consultants. Canada Health Infoway as a funding partner

6. Orion Health’s Role Orion Health worked in conjunction with eHealth Saskatchewan to provide: Subject matter expertise; requirements validation; product installation; Integration services; Product configuration; testing; and deployment services Today, eHealth Saskatchewan and Orion Health continue to work together in delivering new clinical features and functionality

7. Initial eHR assets Patient data in Saskatchewan is created/stored in various systems. For example: Laboratory Information Systems Pharmacy Information System Saskatchewan Immunization Management System (SIMS) Radiology Information System (RIS) and Picture Archiving and Communications System (PACS) Hospital Systems (Sunrise Clinical Manager) Physician Electronic Medical Record (EMR) systems Transcription Systems

8. Goals in building the eHR Viewer The SK EHR vision is “Simply stated… getting the right information, to the right individual, at the right time, in the right place!” to: Improve quality of patient care through informed decision making, Improve the patient experience through the coordination of service delivery, Improve overall efficiency and sustainability of the health sector, Inform management decision-making and provide the necessary information base, Support planning, outcome measurement, accountability and research.

9. Goals of the Project Team Provide value to the patients, clinicians/health care providers Align with health system priorities Continue to leverage the supporting infrastructure for the EHR Continue to evolve the EHR infostructure Continue to Add Value – make it “do-able ”

10. − Diagnostic images − Clinical encounters − Integration with hospital systems in context − Patient Portal − Remaining Health Regions & Canadian Blood Services Labs Evolution of eHR Viewer Future Future 2013 2013 2012 2012 2011 2011 2010 2010 2009 2009 -Provincial Standard Lab message -SDCL & Sunrise Labs − Pharmaceutical profile (PIP) − Drug Allergies & Contraindications (PIP) − Sun Country, Mamawetan, Saskatoon BloodBank Labs − Immunization information − Discharge Summaries − Clinical Document Repository − Chronic Disease Management Data − Clinical Observation Repository − Prince Albert Parkland & Prairie North Labs -Direct Lab Distribution to EMR’s -Regina Qu’Appelle & Saskatoon Labs − eHR Viewer (IDM, patient demographics & Lab Results, Privacy services) − Integration w/ Shared Client Index − Saskatchewan Lab Results Repository(SLRR) − Five Hills & Kelsey Trail Labs

11. eHR - Architecture

12. Clinical Data in the eHR Viewer

13. Demographic information to uniquely identify a patient

14. Clinical Data in the eHR Viewer Laboratory Test Results

15. Clinical Data in the eHR Viewer Dispensed Medications

16. Clinical Data in the eHR Viewer Known Medication Allergies and Intolerances

17. Clinical Data in the eHR Viewer Immunizations

18. Clinical Data in the eHR Viewer Transcribed Clinical Reports – Discharge Summaries

19. Clinical Data in the eHR Viewer Chronic Disease Management indicators

20. Who uses the eHR Viewer The eHR Viewer is currently in many health care settings: Community Pharmacies Walk-in Clinics Specialist Clinics Family Practice Clinics Saskatchewan Cancer Agency Saskatchewan Institute of Applied Science and Technology (SIAST) Campus Health Center Wascana Rehabilitation Center Regional Health Authority Laboratory Medicine Medical Staff (Pathologists, Hematopathologists, Medical Biochemists and Medical Microbiologists)

21. eHR Viewer Users

22. Benefits Fewer duplicate tests and quicker access to information Access to over 90% of all lab results. Lab Results Repository has more than 30 million lab test results, (60,000/day). History of previous testing Integration to Pharmacy Information Program repository provides access to over 105 million prescriptions (43,000/day). Ease of use and implementation - Intuitive user interface Highly scalable and able to integrate with other health systems and data domains. As eHR Viewer is rolled out across the province, clinical data will be available anywhere a patient seeks medical care in province

23. Facilitates the sharing of patient centric information across the continuum of care

24. A more accurate & timely picture of the patient Faster diagnosis Better treatment decisions Less time waiting for information

25. Reduced duplicate laboratory testing Reduced duplicate medication treatment Supporting patient confidentiality Actively involve patients

27. Lessons Learned Rigorous project planning and execution Strong project governance structure (agile decision-making) Steering Committee Clinical Consultation Privacy and data governance Build the right team – “One Team” approach Never under estimate the time for each project phase Do-able value added releases

28. Lessons Learned Ensure supporting business process readiness Streamline the on boarding process: Online User Self Registration Online Acceptance of User Agreements Online training and self-directed tools and supports Online User account management (Password resets) Document, Document, Document Test, Test, Test Keep an eye on performance Pilot with providers – “limited production roll-out”

29. A few more testimonials… “The eHR Viewer is the best lab information source I have seen…the interface is intuitive. I can quickly log on from anywhere; it is easy to find patients; and best of all, even if a patient's tests were done in another health region, the results are still immediately available.“ Dr. Milo Fink – Saskatchewan Physician “Since I began using the eHR Viewer I have been able to impact patient care in a positive way each and every day.” Kimberly Sentes – Saskatchewan Pharmacist

30. Questions For more information: Kevin Kidney Mike Craig Project Director, EHR Vice President eHealth Saskatchewan Orion Health Office: 306.337.5510 Office: Mobile: 306.591.2654 Mobile: E-mail: kevin.kidney@eHealthsask.ca E-mail: michael.craig@orionhealth.com