Northeast rolls out Physician Office Integration

Tamara Shewciw, eHealth lead, North East LHIN.

Hospital discharge reports being sent electronically to physician EMRs

Family physicians across northeastern Ontario who are used to waiting weeks for hard copy hospital discharge reports and spending hours scanning them and entering data into their electronic medical record (EMR) systems are in store for a pleasant surprise.

Twenty-five hospitals in the North East LHIN are in the midst of rolling out a Physician Office Integration (POI) capability, which will allow for the transmission of discharge summaries, lab and diagnostic imaging reports directly into a physician’s electronic medical record system.

Spearheaded by the North East LHIN and Health Sciences North in Sudbury, Physician Office Integration will ensure speedy delivery of hospital reports and does away with the labour intensive photocopying, faxing, scanning and re-keying of data by hospital staff and primary care providers.

“This is something that physicians really, really want,” said Tamara Shewciw, chief information officer and eHealth lead for the North East LHIN.

EMR vendors are at various stages of developing and rolling out interfaces into the POI system.

“We have quite a few up and running and we’re rolling out more,” said Shewciw. “All 25 hospitals are plugged in. Some are totally done. Others are in the queue.”

McMaster University’s open source OSCAR EMR has been upgraded for POI, X-WAVE is rolling out, P&P is testing and Practice Solutions has completed a pilot at a family health team on Manitoulin Island, said Shewciw.

Brian Ktytor, senior director, health system performance.

The reports are automatically transmitted into the physician’s EMR, but each vendor does it a little differently.

“They can populate the EMR once a day, twice a day, or go into an inbox where the physician can review the reports.”

Next step is to use the POI to automatically notify primary care providers when one of their patients shows up in a hospital emergency department.

“We don’t have that now, but we’re working on it,” said Shewciw. A similar capability piloted by Health Sciences North automatically notifies the North East Community Care Access Centre when clients present in the emergency department. Once it’s fully tested, it will be rolled out to the rest of the region.

The North West Local Health Integration Network was one of the first LHINs in the province to go live with POI in early 2011 and has close to 100 per cent of EMR-equipped primary care providers in the region registered with the system, said Brian Ktytor, senior director, health system performance.

“It’s a very popular service and it’s just one step along the way to a completely interoperable electronic health record that we’re building.

With POI and the Ontario Laboratory Information System (OLIS) up and running, eHealth is really starting to gel, said Shewciw.

Still to come but in development is “a system integration hub” that will link the two northern LHINs with the Champlain and South East LHINs to give “health service providers access to personal health information from across the continuum of care and at any point of care throughout the cluster.”

cNEO

Called cNEO, short for Connecting Northern and Eastern Ontario, the project will ultimately roll up to a province-wide system in concert with parallel initiatives being undertaken by two other LHIN clusters.

cNEO, explained Ktytor, is the “cornerstone infrastructure,” or “highway” that will deliver health-related information from any source to wherever it needs to go.

The Integrated Assessment Record (IAR), another important eHealth initiative, has been embraced by most agencies providing mental health services across Northern Ontario.

According to Shewciw, the IAR allows authorized users to view a consenting client’s assessment information electronically, “so when a patient goes from one health service provider to another, they don’t have to redo all that information.”

ePrescribing, she noted, is a little further down the road, but here, too, “there are pockets of great things happening,” including a successful pilot at the Group Health Centre in Sault Ste. Marie. (See Northern Ontario Medical Journal, June 2010.)

There’s also the Ontario Drug Profile Viewer that allows hospital emergency staff to access a list of prescriptions for seniors covered by the Ontario Drug Benefit Plan. Recently, community health centre staff in the northeast have also been given access to the viewer, “so it’s spreading out,” said Shewciw.

“People often ask me, ‘When are you going to be done?’ I have a hard time answering that because it’s akin to the iPhone. How do I know I bought my last one?

“When I started in this position (in 2008), 22 per cent of GPs in the North East LHIN were electronic. Now, we’re at 70 per cent,” said Shewciw.

eHealth may never be done, but it’s quickly achieving critical mass and revolutionizing the health-care system.

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