Sto:Lo Health Conference

Transcription

1 Sto:Lo Health Conference Mark Sommerfeld First Nations Health Council Jeffrey Yu First Nations and Inuit Health Jeff Aitken - Ministry i of Health Services February 12, 2009

2 Presentation Objectives Provide an overview and status update regarding: 1. Provincial ehealth & Telehealth project activities in BC 2. Ti Tripartite Commitment t to First Nti Nations ehealth & Telehealth Tlh lth 3. Tripartite First Nations ehealth and Telehealth project activities

3 ehealth Projects Jeff Aitken Director First Nations ehealth, EMR, Provincial Telehealth Office Ministry of Health Services 3

4 Investing in ehealth and Innovation to Ensure Sustainability ehealth Vision An integrated, interoperable ehealth system in which health care information is accessible, when and where it is needed, to support personal health, health care decision making and health system sustainability. 4

5 ehealth Will Support Access to clinical information about individuals At the point of care Demographic information Drug information Lab test result information Diagnostic imaging results information Public health information (immunization data) By health professionals who have the need, ability and appropriate security to access this information Across the province As and when health professionals are ready to use it 5

6 Benefits Health care providers will be able to make more timely clinical decisions concerning patient care and public health protection Patients will benefit from better quality care and reduced treatment delays Patients will enjoy better access to specialized services and care Patients will not be subjected to duplicate, sometimes risky medical test procedures 6

7 ehealth Project Environment AUTHORIZED ehealth USERS Health Health Information Information Access Access Layer Layer (HIAL) (HIAL) Authorization & Authentication Standards-based Electronic Health Record Integration Disclosure Directives & Audit Trail Viewer Provider Information Patient Demographic Information Drug Information Lab Test Results Information Diagnostic Imaging Public Health Information 7 CITIZEN ACCESS Future State

8 BC ehealth Project Overviews The goal is to implement world class excellence in the protection of privacy and the assurance of security in patient-centred, providersupported ehealth systems in British Columbia iehr Project iehr will deliver a private and secure Electronic Health Record service for BC that will enable sharing of electronic health record data across the continuum of care Provincial Laboratory Information Solution (PLIS) Project PLIS will provide a province-wide repository of all patient lab test results, from public and private labs, accessible at any authorized point of care 8

9 BC ehealth Project Overviews - continued BC Yukon Public Health Information Project Support public health service delivery by improving public health information management and public health surveillance technology in British Columbia and the Yukon. edrug Project Building on the success of BC s existing PharmaNet system, the edrug project will introduce the next generation system (PharmaNet erx) improving medication profile content from both community and acute care settings, special authority processing, and eventually yproviding electronic prescribing 9

10 BC ehealth Project Overviews - continued Connecting Diagnostic Imaging Project CDI will provide better access to digital (filmless) diagnostic images and reports produced by both public and private radiology labs Physician i Information Technology Office (PITO) Program The PITO Program will provide electronic medical record (EMR) and practice management systems for physicians offices, replacing today s largely paper-based health records and enabling staff to access BC s electronic health record 10

11 EHR Activity beyond June 09 (tentative) Jan Mar 2009 Apr Jun 2009 Jul Sept 2009 Oct Dec 2009 Jan Mar 2010 Release Production Prototype Schedules to be confirmed Release Full Production Ele ectronic Health Record Rele eases 5 EMR vendors conformance tested 1,000 physicians registered PPN implemented PharmaNet1 Integration PHIP Integration PLIS Deployment Continued PITO Physician Registration & EMR Installation (not integrated with EHR) Philips DI Viewer across VHC & FHA (not integrated with HIAL) Extend DI Viewer to IHA & NHA, then VIHA & PHSA 11

12 Telehealth in BC Mi i t f H lth S i Ministry of Health Services Provincial Telehealth Office February 2009

13 Telehealth lth in BC - Highlights ht Telehealth services are currently available in approximately 20 clinical program areas, including oncology, mental health/psychiatry, pharmacy, thoracic surgery, homecare, renal, rheumatology and wound care, as well as special services for children. The capacity for two-way, way live videoconferencing, clinical, administrative and health related educational encounters exist in more than 100 communities throughout the province. There are approximately 200 Telehealth facilities providing access to approximately 500 videoconferencing end points. Telehealth facilities supported approximately 18,000 Telehealth consults through videoconferencing in 2007 with anticipated annual growth of 25% per annum. Health education and training are being provided to approximately 30 First Nations communities via videoconferencing technologies in BC. 13

14 BC Telehealth Benefits The Provincial Telehealth initiatives will improve access to health care for all BC citizens, especially for those in rural, remote and First Nation communities, by increasing the use of videoconferencing technology for clinical and professional encounters. Telehealth will: Deliver faster, more efficient health care by using technology to remove the distance barrier; Reduce patient travel burden, particularly benefiting elderly people and those with young children who currently have to travel long distances to access health care services; Provide access to wider range of specialist advice and services, by increasing the range of clinical services available through Telehealth; Improve health professional retention and productivity in isolated communities by mitigating distance barriers, resulting in less isolation, and provide more opportunities for professional development, leading to greater job satisfaction; 14

15 TeleHomeCare - Overview Objective: To improve care and reduce hospital readmissions of patients with CHF (Congestive Heart Failure) through early detection and self monitoring of patients. Partners: VIHA (Lead), IHA Monitor in patient s home - uses text & voice prompts Patient guided through taking vital signs (weight, blood pressure, heart rate, oxygen saturation levels) Vital signs and answers to subjective questions are encrypted and transmitted to Health Authority server Software on server triages patient data, recommends actions such as home visits, physician referral Nurse monitors alerts through dedicated workstation (VIHA = Vancouver Island Health Authority) (IHA = Interior Health Authority) 15

16 TeleOncology - Overview Objective: To improve access for patients and their families in remote and rural areas of the province to specialized oncology services provided by regional cancer centres Partners: PHSA (Lead), VIHA, IHA, NHA, FHA Building on existing services Five Cancer Centres (Vancouver, Victoria, Surrey, Kelowna, Abbotsford ) providing services to all of province New centre Prince George (2010) Oncology specialists provide initial and/or follow up consults to patient remotely through VC technology 16 (PHSA = Provincial Health Services Authority) (NHA = Northern Health Authority) (FHA = Fraser Health Authority)

17 TlW TeleWoundCare - Overview Objective: To implement community-based wound care services throughout NHA with primary focus to support Home Care Nurses and staff in FN communities providing wound care Partners: NHA 2004 pilot in Quesnel and FN Community Tache to support improved woundcare in northern & aboriginal communities Home Care Nurses and health care staff in First Nations communities to use digital cameras and specialized clinical i l application to document & track wounds in the home care setting Woundcare specialist to review and provide consultative advice Ongoing education to nurses regarding difficult or special cases Implement in 21 communities plus 3 or more FN communities 17

18 TeleThoracic - Overview Objective: To provide access to quality thoracic surgical care to residents of BC and the Yukon through videoconferencing technology. Partners: PHSA (Lead), VIHA, VCH (NHA, FHA, IHA, Yukon) Thoracic surgeons provide comprehensive care to patients with non-cardiac thoracic conditions (e.g. lung and esophageal cancer) Thoracic services provided through four Centres of Excellence Vancouver, Victoria, Surrey, Kelowna Dec 2003 Kelowna began providing TeleThoracic services (initial assessment and post-operative follow-up) to communities in interior and north Same model to be implement in 21 additional communities to receive services through Telehealth technology gy( (ex. Gold River, Abbotsford, Fort St John, Sechelt) (VCH = Vancouver Coastal Health Authority) 18

19 TeleOphthalmology - Overview Objective: To improve retinal screening service access for populations at high risk of retinopathies (i.e. diabetics) living in rural and remote communities including First Nations Partners: ITHA (Lead), VIHA Retinal screening clinics 3 Fixed-site locations plus mobile clinics across Vancouver Island Screening by trained Nurse photographer Retinal Image Packages downloaded to Inter Tribal Health Authority Server Retinal specialist will review online and prepare assessment report 19

20 Provincial Telehealth Project Timeline Jan Mar 2009 Apr Jun 2009 Jul Sept 2009 Oct Dec 2009 Jan Mar 2010 Apr Jun 2010 TeleHomeCare Phase 1 Rollout Completed IHA Phase 2 Rollout Completed VIHA TeleThoracic Phase 1 Rollout Phase 2 Completed Rollout VIHA,VCH, Completed FHA,NHA PHSA TeleOncology Phase 1 Rollout Completed VIHA,PHSA, FHA,NHA Phase 2 Rollout Completed VIHA,PHSA, IHA,NHA Phase 3 Rollout Completed NHA, VIHA TeleWoundCare Phase 1 Rollout Completed NHA Phase 2 Rollout Completed NHA TeleOphthalmology Rollout Completed VIHA, ITHA 20

21 First Nations ehealth & Telehealth Mark Sommerfeld, ehealth Consultant, FNHC Jeffrey Yu, Manager esolutions Unit, FNIH, Health Canada 21

22 ehealth H E A L T HE L IE NH FE distance. t (Mitchell, OA 2000) RL MT A H T HEALTH I INFORMATICS C The combined use of electronic communication & information technology in health sector. The use in the health sector of digital data transmitted, stored and retrieved electronically for clinical, educational, and administrative purposes, both at the local site and at a S E HEALTH TELEHEALTH

23 ehealth eat ehealth, by its very nature, requires a high degree of collaboration (First Nation-Federal-Provincial) i i l) In a First Nations context, ehealth is an early innovator and integrator in reshaping relationships between (and amongst) First Nations and provincial and federal governments Firmly establishing these relationships at all levels is a y g p critical success factor for the ultimate success and sustainability of First Nations ehealth at all levels.

24 Current Tripartite te Collaboration at o First Nations Provincial i Health Services Tripartite First Nations Health Plan* Federal Health Services Communities *Tripartite First Nations Health Plan is Tripartite First Nations Health Plan is implemented by First Nations Health Council on behalf of BC First Nations

25 Health Transformation Transformative Change Accord: First Nations Health lthplan Ten year Plan includes twenty nine key action items in four areas of: Governance, Relationships &Accountability, Health Promotion/ Disease & Injury Prevention, Health Services, Performance Tracking Action Item # 23 Create a fully integrated clinical telehealth network

26 First Nations ehealth Governance Structure and Engagement Tripartite Strategy Council for First Nations ehealth will establish the strategic direction for BC First Nations ehealth, and will contribute to the alignment with the BC Ministry of Health s ehealth Strategy Council, First Nations, and federal ehealth strategic planning Tripartite Technical Working Group for First Nations ehealth analysis and planning of non strategic issues for First Nations ehealth operates as extension of Tripartite Strategy Council for First Nations ehealth provides support to the Tripartite Strategy Council for First Nations ehealth First Nations ehealth Centre of Excellence Society Key First Nations ehealth operational entity Key First Nations ehealth operational entity effectively manage the First Nations Telehealth Network and apply information technology to facilitate the creation and use of health related data, information, and knowledge for purposes of improving health outcomes

27 Relationship Diagram BC Leadership Council BC ehealth Strategy Council Ministry, Health Authorities, Ophysician & Pharmmacist Community Medical Integration Working Group ehealth Deployment Task Group Health CIO Council PLIS (Lab)- edrug EMR-PITO Registries Telehealth iehr(hial) Steering Steering Steering Steering Steering Committee Committee Committee Committee Committee Public Health Information Steering Committee Connecting Diagnostic Imaging Steering Committee Clinical Advisory Groups

28 BC First Nations Telehealth Expansion Objective: To build and expand Telehealth capacity within First Nations communities; to ultimately integrate a First Nations Telehealth Network with the provincial Telehealth and ehealth networks. s

29 First Nations TeleHealth e ea Expansion Project Lead Organization: First Nations ehealth Centre of Excellence (CoE) Society Project Timeline: October September 2011 Scope: Integration of First Nations Telehealth Network with ehealth Network Gateway Enabling 57 endpoint sites (51 FN Communities 6 HA endpoints) Each site outfitted standard equipment to enable inclusion in emerging network Building community capacity (including engagement, education, training) Expansion of existing wellness & education services through videoconferencing Development of clinical programs (initial focus: Maternal Health, Mental Health, Diabetes/CDM) and services in alignment with First Nations Health Plan Establishment of First Nations Telehealth Shared Service Operations Development of Telehealth-specific capacity within the COE and its resources

30 First Nations Telehealth Benefits to Community New training opportunities for community members and health workers - made accessible from within the community Enable easy and cost-efficient way for health workers and administrators to meet and collaborate with other health centres and health organizations Reduce patient travel burden, particularly benefiting elderly people and those with young children who currently have to travel long distances to access health care services Reducing health professional isolation through enhanced opportunities for peer support and professional development. Improved retention of professional staff in remote work settings Establishment of a First Nations health network infrastructure that will enable other ehealth and communications solutions for First Nations Health Centres

31 Connectivity update, including federal funding support First Nations/Federal/Provincial stakeholders have partnered to bridge the digital divide Investment of $35 M over the next 3 years Health Canada First Nation Inuit Health (FNIH) $17.5 M BC Ministry of Labour & Citizen Services (LCS) $17.5 M All 203 FN Communities will have access to Consumer Grade connectivity Approximately 20 FN communities will have access to Industrial Grade connectivity Planning FN Health Network to integrate with the province

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33 ehealth eat / Telehealth e eat Next tstepsa and Plans Continue to support efforts of First Nations ehealth Centre of Excellence Society and First Nations ehealth Strategy t Council Support First Nations Telehealth Expansion project team as they begin to execute their project plan Continue to support planning and design efforts for the Health Authority Network initiative and First Nations Network initiative Continue to build First Nation ehealth capacity to help advance Continue to build First Nation ehealth capacity to help advance 29 Tripartite Health Plan action items

34 Thank you