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Canada Health Infoway Transforming Practice & Improving Care Across
Canada
Presentation to the Clinical Leaders Summit Ireland’s Future Health Summit, May 26, 2016
Maureen M. Charlebois Chief Nursing Executive & Group Director Clinical Adoption – Canada Health Infoway
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CANADIAN CONTEXT• Federal government sets
and administers national health care principles
• 13 provincial/territorial governments plan, finance, manage, evaluate their health services
• 700 + hospitals and 2,500+ long-term-care homes
• 400,000 + GP’s, specialists, nurses, pharmacists and allied health professionals
VisionHealthier Canadians through
innovative digital health solutions
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Approach – strategic investment model$2.098 billion in approved projects to date; 387 active or completed projects
Solution deployment projects in each jurisdiction
CommonBlueprint & Standards
Twelveinvestmentprograms
Programcriteria
Programeligiblecosts
Projectsizing andestimation
Approved projects for investment
1. Registries2. Diagnostic Imaging Systems3. Drug Information Systems4. Laboratory Information Systems5. Interoperable EHR6. Telehealth7. Public Health Surveillance8. Patient Access to Quality Care9. Innovation and Adoption10. Infostructure11. EMR and Integration12. Consumer Health Solutions
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THREE WAVES OF DIGITAL HEALTH INNOVATION
• Building blocks
• Digital tools for clinicians
• Empowering patients
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Knowing the Plan for Canada
CE_Plan_Small.wmv
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THE FIRST WAVE
LABORATORYINFORMATION
SYSTEMS85%
DIAGNOSTICIMAGING IN HOSPITSLS
100%
DISPENSED DRUGS62%
CLINICALDOCUMENTATION
100%
PATIENT &PROVIDER
REGISTRIES100%
• Foundational infrastructure for digital health: investments in six core components of an electronic health record
• Leadership in architecture, standards, privacy
• Pan-Canadian strategy
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THE SECOND WAVE: DIGITAL TOOLS FOR CLINICIANS• Electronic medical
records
• Expansion of telehealth
• Public health surveillance
Source: 2015 Commonwealth Fund International Survey of Primary Care Physicians
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THE THIRD WAVE: EMPOWERING PATIENTS• Improving the
patient experience
• Enhancing patient safety
What Patients say they want access to: Online Appointment Booking
E-consultations/visits Online lab results/views
Online prescription renewal
Access to results drives value for patients
10Source: Impacts of direct patient access to laboratory results – Final Report 2015
Change Management Framework
Benefits Evaluation Framework
Clinical Engagement Strategy
Clinical Adoption: Accelerate Adoption & Benefits Realization
Pan-Canadian Benefits Realization
Overall impact on Quality of Care – Clinicians Perspective
Sources: 2014 Infoway-CNA National Nurses Survey, 2014 Infoway National Survey of Community Pharmacists and National Physician Survey (2014) * % Not sure or No Reponses not reported
Transformative Leadership • Change leadership is the strategic, systematic approach that supports
people and their organizations in the successful transition and adoption of electronic health solutions.
• The outcomes of ‘change leadership’ results in adoption and the full realization of benefits and clinical transformation.
A Focused Approach to change management that incorporates these six elements noted in the CM Framework helps to ensure alignment of activities, solution adoption and realization of benefits.
Change Management Framework
Clinical Adoption Framework
Q1. What has helped the most to lead change in your organization?
Q2. What are the barriers to successful change in your organization?
Top 3 Change BarriersTop 3 Change Enablers
Leadership is the top Change Enabler
• Visible/engaged senior leadership
• Stakeholder engagement• Clinical/change champions
• Competing priorities• Lack of visible/engaged
senior leadership• Lack of effective
communications
Transforming Clinical Practice
‘‘Current Current State’State’Where are we now?Where are we now?
‘‘Desired Desired State’State’Where do we want to be?Where do we want to be?
Visible Clinical & IT Leadership Budget for Change Management Selected Change Approach/Methodology Engaged Clinicians & Informatics Specialists Communication Plan & Key Messages Workflow Analysis & Practice Process Redesign Role Specific Training & Education Ongoing Technical, Operational & Clinical Support Pre & Post Change Indicators & Evaluation
GAP Analysis:What type of support is required to get there?
Why is change so hard?
17Amygdala – ‘Flight or Fight’
Stuck_on_an_escalator.wmv
Clinical Engagement Strategy
Beliefs, Attitudes, Behaviors, Benefits ?
Transforming Practice, Improving Care Collaboration & Communication
Improves Efficiencies &
Avoids Duplication
Decision Support & Workflow
Information Management & Education
Timely Access to Information
Pan-Canadian Clinical Peer Leader Networks Clinical Peer Leaders working with their colleagues providing clinical leadership, support, mentoring and coaching to facilitate learning and use of technology in practice.
Transforming health care –clinical leadership• 96% of Peer Leaders ‘agree/strongly agree’ they are positively influencing their colleagues understanding and adoption of EMR/other technology systems in their practice settings• 89% of Peer Leaders ‘agree/strongly agree’ that the Peer Network is beneficial to clinicians
• To ensure that clinicians in training are ready to practice in, and gain value from, an technology enabled environment when they graduate
• To develop and integrate competencies related to the use of technology into the curricula design/ educational processes of the Faculties of Medicine, Nursing and Pharmacy
• To establish Faculty Peer Leader Networks to provide mentorship, engagement and influence culture change related to the effective use of technology in clinical practice and Consumer Health solutions through innovative teaching strategies
Infoway’s Next Generation Strategy
These successes positioned Infoway as a strategic investor in eHealth within Canada
The Next Generation - Impact
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TWO AMBITIOUS GOALS FOR 2016-2017
• Establish a multi-jurisdiction e-prescribing solution
• Expand telehomecare and patient online services
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OUR SOLUTION• Will enable prescribers to
electronically transmit a prescription to a patient’s pharmacy of choice
• This will:• Reduce use of paper
prescriptions• Optimize existing
drug system investments
• Enhance patient safety
• Improve continuity of care
• Improve health outcomes for patients
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TELEHOMECARE AND PATIENT ONLINE SERVICES• Telehomecare is ready
to be immediately scaled
• Improves quality of life for patients with chronic conditions
• Fewer emergency room visits and hospital stays
• Continue to invest in:• e-visits• e-renewals• e-booking• e-views
ePractice
Connecting the TeamCommunication& Collaboration
Connecting to Evidence Based Information Knowledge Based Practice
Connecting to Quality Measures Data Analytics
Connecting the Patient Self –Management
Clinical Leadership – Transforming Practice
We need to build capacity and
integrate the required digital health
competencies into Professional
Practice Frameworks
and Models of Care
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Technologies are not simply inventions which people employ but are the means by which
people are reinvented.
We shape our tools and thereafter We shape our tools and thereafter our tools shape us. our tools shape us.
