Moving Forward with eHealth in theWaterloo Wellington LHIN

The HEALTHeCONNECTIONS Project

9th Annual eHealth SummitJune 10-12, 2009

Dr. Glenn HolderCIO, WWLHIN

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Waterloo Wellington LHIN• Population: 750,000 (rural and urban centres)• Geography: 4800 sq km (Waterloo Region, Wellington County,

South Grey)

• 10 hospital sites (8 hospital corporations)• 1 community care access centre• 30 community support services• 21 community mental health and addictions services• 35 long term care homes• 4 community health centres (with 3 satellites)

• 9 family health teams • 3 public health units• 956 physicians• Numerous other non-transfer-payment local providers

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Introduction• HEALTHeCONNECTIONS Project

• a demonstration project supported through Canada Health Infoway’s Patient Access to Quality Care (PAQC) Program and by eHealth Ontario

• using individual-empowering eHealth elements to create new and innovative care delivery models

• an initial focus on chronic disease prevention and management (diabetes)

• is currently in implementation phase

• Presentation Overview• Challenge• Unique attributes of WWLHIN • Guiding principles• Approach and anticipated outcomes

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Challenge

• Healthcare has tended to be provider- and organization-focused• Minimal integration of information or services

• Healthcare must become individual-centered and consumer-driven. • Enabling eHealth services are prerequisite

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WWLHIN provides a unique opportunity for addressing this challenge

• Moderate size and complexity

• Community-based alternative health service delivery models

• Implementation and standardization of clinical systems

• Demonstrated commitment

• High-tech communities with very high IT literacy

• World class academic institutions

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HEALTHeCONNECTIONS Guiding Principles

• eHealth solutions/services + individual-centered healthcare delivery models

• Flexibility to respond to local and regional priorities

• Communities must collaborate• Focus on cultural and clinical change• Build on the relationship between primary care

providers and individuals • Manageable scope

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HEALTHeCONNECTIONS Approach

• Care networks• eHealth enabled, individual-centred diabetes

care model• Personal Health Record/Portal (PHRP) with

CDM tools• Clinical portal• Benefits Evaluation (BE) program

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Project Scope

• 1,600 diabetes patients using the PHRP/CDM

• Up to 37,500 patients using the PHRP

• 9 family health teams – 150 physicians + 100 allied providers

• 5 diabetes education centres

• 25 diabetes related specialists

• 6 acute care hospitals/emergs.

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Solution Overview

Primary CareEMRs

Monitoring Device(e.g. , )

FHTCare Network

Individuals &Informal Care Providers

PHRP/CDM tools

Primary CareEMRs

Clinical Portal

Community CareCase Mngmt

Acute CareEMRs

mydoctor.ca

PracticeSolutions

ClinicalConnect(MedSeek)

Red=HEALTHeCONNECTIONSDeliverable

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mydoctor.ca

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Self-Management Resources

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Clinical Transformation – Roles of stakeholders

• Care networks

• Primary care

• Diabetes education centres

• Specialists

• Individuals

• Others

*All of the above will participate in the benefits evaluation

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Partner Funding Program

• Offset the one-time costs of healthcare provider participation • Clinical transformation • Patient education and enrolment, • Establishing electronic information sharing

mechanisms and processes• Benefits evaluation program

• Outcome based• Enrolment targets• Retention targets

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Benefits Evaluation

• Expected benefits• Quality• Access• Productivity

• Indicators and metrics

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Benefits Evaluation

Provincial targets for diabetes managementMeasure Pop. Target

Most recent HbA1C test in last year <= 7 > 60%

HbA1C test in last six months > 90%

Documented self-management goals updated in last 12 months > 70%

BP <= 130/80 > 55%

Current use of ACE Inhibitor or ARB medication > 60%

LDL <= 2.0 nmol/l > 65%

Retinopathy screening in last 730 days > 90%

Foot exam in last 12 months > 90%

Microalbuminuria (ARB) screening in past 12 months > 65%

Source: QIIP

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Timing

• Implementation of eHealth-enabled, individual-centered care delivery model for diabetes management by Fall 2009

• Benefits evaluation through to Summer 2010

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Strategic Alignment

• Ontario and WWLHIN strategic healthcare priorities

• Ontario and WWLHIN e-Health strategy, architecture, standards and implementation

• CHI Patient Access to Quality Care (PAQC) Program

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Looking Forward

• Applying the model beyond diabetes management

• New classes of eHealth services

• Options for an open, standards-based PHRP platform

• An ecosystem for innovation in consumer eHealth services with WWLHIN as a living laboratory

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Acknowledgements

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