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Electronic Medical Records(EMR) and Integration
Program Update
14 April 2011
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Electronic Medical Records (EMR) & IntegrationTodays agenda
Br ing ing i t
a l l t oge t he r
I n t e g r a t i o n
cha l lenges
EMR &
I n t e g r a t i o nProgram
EMR Use
Today
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Cl in ical and
A d m i n i s t r a t i v efunc t i ona l i t y
Source: BC Ministry of Health, EMR Project, RFP, 2007.
Practice Management
Patient registration
Appointment scheduling
Eligibility checking
Claims submission and billing
Accounts receivable
Health card scanning
Chart tracking
Patient tracking
Referral management
Elect r on i c Med ica l Record s
Patient triage, assessment, management
Care planning
Order/receive diagnostic imaging tests
Order/receive laboratory tests
Order medications
Receive medication profile
Manage medication renewal requests
Manage immunizations
Online dictation
Clinical workflow
Clinical decision support
Clinical messaging alerts
Patient communications
Electronic Medical RecordsTwo components
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Source: 1) 2009 Commonwealth Fund International Health Policy Survey of Primacy Care Physicians; 2) Mirror, Mirror on the Wall:How the performance of the U.S. Health Care System compares intenerationally; 2010 update; Commonwealth Fund
* Must include 9 of14 of the following functions: electronic medical record; electronic prescribing and ordering of tests;electronic access test results, Rx alerts, clinical notes; computerized system for tracking lab tests, guidelines, alerts toprovide patients with test results, preventive/follow-up care reminders; and computerized list of patients by diagnosis,medications, due for tests or preventive care.
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Automation of Physician OfficesEMR use in Canada
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Qualitative BenefitsEMR use by physicians in community settings
AccessAccess
QualityQuality
ProductivityProductivity
Improved referrals and patient self-
care
Decreased patient waiting time
Increased patient safety
Improved management of chronic diseases
Improved clinical outcomes
Improved care coordination
Cost avoidance through increased efficiency
Monetary savings in drugs, radiology and lab
domains 4
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Goals of the EMR and Integration program
Focus investment at the points of care where the benefits of health
IT can deliver immediate value to patients and clinicians
Significantly increase the number of EMR systems in
community-based practices and out-patient settings
Target is 12,000+ additional clinicians using an EMR
Upgrade and connect EMRs so they are interoperable with the core
health information systems being developed across the country
Achieve increased clinical value for clinicians through the
advanced use of EMRs, e.g. accessing more complete medication
profiles, lab results, immunizations and hospital discharge
summaries
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Electronic Medical Records and IntegrationIn summary: the investment focus of ~ $340 million
Upgradeexisting clinical solutions
Electronic medicalrecords
Community pharmacysystems (e-prescribe)
Connect hospitalinformation systemswith ambulatory EMR
Deploymore clinical solutions
Implement upgraded
electronic medical
records incommunity and
out-patient settings
Achieveincreased clinical value
Derive clinical value
from the use of
electronic medicalrecords in
community care
settings
~35% ~65%
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Clinician does e-prescribing and receives a complete
medication history and automated medication alerts
into the EMR
Level 2
Enter encounter notes
Enter problem lists, allergies, immunizations
and vitals
Enter new prescriptions/renewals into the EMR,
which can be printed
Generate automated alerts and reminders
from within the EMR
Receive laboratory results into the EMR
Level 1
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Electronic Medical RecordsAchieving Clinical Value
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Building Community
National EMR Forum (jurisdictions)
Peer-to-Peer Networks (clinicians)
Medical Education Program (future clinicians)
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Addressing the Challenges
1. Highlighting and harmonizing regional variations in
implementation standards
2. Decreasing the development effort required for developers
to connect EMRs, EHRs and other systems
3. Simplifying the process of rolling out solutions across
multiple jurisdictions
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Addressing the Challenges
Design challengesWhere can all of the specifications and their variations
be found?
How can we reduce the variation amongst jurisdictions?
Development challengesHow can we simplify complex message structures?
Where can we find best-practice solutions?
How can we quickly test implementations across
multiple jurisdictions?
Implementation challengesHow can we create recognition for compliance with
jurisdiction and national standards?
HarmonizedDocumentation
HarmonizedDocumentation
Developer toolsDeveloper tools
National CertificationNational Certification
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One-stop shop
Easy to search
Highlightsjurisdictional
differences
Has led to
jurisdictional
harmonization
Addressing the ChallengesHarmonized documentation
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Messages used to connect these systems are extremely complex
Messages (and message sets) vary across jurisdictions
Developers need to test their solutions in each jurisdiction
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Addressing the ChallengesDeveloper tools
Canadianstandards
Localizedstandards
Code
Infoway DevelopersJurisdictions Developers
Message
Bui lder
Message
ReMixer
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A Single Pan-Canadian Program
One certification program for EMR products that allows both national andjurisdiction classes of certification as required
Integrated Assessment
A single set of EMR criteria, test cases and test data
Seamless Process
A simple, integrated process provided by Infowayand/or the jurisdictions for
product vendors to certify their EMRs
Integrated with EMR Funding Programs A certification approach that supports EMR funding programs within jurisdictions
Evolves over Time
A certification approach based on recognized industry standards that will continue
to evolve as EMR products mature 13
Addressing the ChallengesApproach to EMR Certification Services
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By Summer 2011
1. Access to the EMR & Integration wiki for documentation
2. Launch of Message Builder developer tools
3. Launch of InfowayEMR Certification
4. Opportunities for Infoway funding in conjunction with jurisdiction
EMR upgrade requirements
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In the next few years
More EMR Adoption
60% of community based physicians using an EMR
Enhanced EMR interoperability capability
Lab results and queries
Medication profiles and e-prescribing
Clinical Reports (diagnostic imaging, hospital)
e-Referral
Improved alignment
More similarities between provincial programs and implementations National EMR certification
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Learn more about the Developer Tools
Join us at eHealth, May 29June 1 in Toronto
presentations
hands-on demonstrations
Email [email protected] receive information on upcoming Message Builder launch
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Questions?
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Email for information aboutMessage Builder as
it becomes available.
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