eHealth takes giant step forward in northwest

BY NORM TOLLINSKY

The introduction of a Physician Office Integration (POI) eHealth initiative in northwestern Ontario is speeding up the delivery of hospital reports to primary care providers, saving paper and freeing clerical staff from the monotonous task of printing, faxing and mailing approximately 22,000 reports every month.

POI in northwestern Ontario started off as a physician-driven initiative linking the Port Arthur Health Centre with Thunder Bay Regional Health Sciences Centre. It expanded a year or so later when clinics in Atikokan and Red Lake lobbied for it, and went region-wide in the fall of 2010.

Currently, the system links 12 of the region’s 13 hospitals with 168 primary care providers in 22 clinics from Marathon to Ear Falls.

POI electronically distributes discharge summaries, diagnostic imaging reports, lab reports, admission notes and operative reports from the hospitals’ shared Meditech information system to a patient’s electronic medical record. All together, the hospitals in the northwest process and distribute approximately one million reports a year.

“I started at the North West LHIN in early 2009 and one of the most highly demanded services was to expand the work of these three early adopter physician groups,” said Brian Ktytor, the LHIN’s chief information officer and eHealth lead. “Thunder Bay Regional had also been hearing the same thing, so the LHIN, in partnership with Thunder Bay Regional and St. Joseph’s Care Group, made a case to access some funding.”

eHealth Ontario allocated $376,000 to expand the system and information technology staff at Thunder Bay Regional went to work in the spring of 2010.

150,000 patients

“With the expansion, we’re providing this enhanced medical record service to more than 150,000 patients,” said Ktytor. “When you look at the overall investment of $376,000, we’re just a little over $2 per patient, so there’s a really big return on investment for the expansion of this service. There’s a lot of value for $2 a patient.”

The way the system worked at first, Port Arthur Health Centre was only able to get reports from Thunder Bay Regional, while primary care providers at clinics in Atikokan and Red Lake could only get reports from their local hospitals.

“Now,” said Jody Schmidt, co-ordinator, information systems for the two Thunder Bay hospitals, “the clinics can get reports from any of the participating hospitals.”

Preliminary discussions are being held with Lake of the Woods District Hospital in Kenora, the only holdout. Plans are also under way to expand the system to clinics in Sioux Lookout and Nipigon.

“The only thing holding them back is the implementation of their EMR, and that’s in the works now,” said Schmidt.

In fact, POI “has made them even more anxious to get their EMRs because it has increased the value of having an EMR now that it’s not just a standalone system,” added Ktytor.

Until recently, the system worked with two EMR vendor products. Now, it supports seven EMR products. With most of the leg work done, a new clinic can be up and running within days.

The reports show up in a physician’s work queue and are integrated with patient records after they are reviewed.

A faxed report could also be added to a patient’s EMR, “but when you get something faxed to you, it’s not data, it’s just a picture of the report,” said Ktytor. “With POI, it’s actually data, so you can use the power of the EMR to mine the data, look at trending and graph the numbers.”

The shared Meditech hospital information system facilitated the expansion of the system. Thunder Bay Regional and St. Joseph’s Care Group adopted Meditech in 1999 and all of the other hospitals in the region came on board between 2004 and 2007, said Ktytor.

Northeast

The North East LHIN is also working to implement a region-wide physician office integration system, “but is a bit later out of the gate than the northwest,” said Tamara Shewciw, chief information officer and eHealth lead for the North East LHIN.

The staged implementation of POI in the northeast will see some primary care providers connected as early as this summer. POI in the northeast will tie together 22 of the northeast’s 26 hospitals using Meditech hospital information systems and any clinic or primary care provider with an electronic medical record system.

“As for the non-Meditech sites, we will continue to work at how to bring them into this regional solution,” said Shewciw.

“The savings will be great and it’s a green solution, but the greatest benefit is that that the data will be flowing that much quicker into physician offices,” she said. “If you go to Sudbury for cancer treatment, your notes will come back to your primary care provider quickly, so it’s the timeliness of the information that will be so great for patient care. The physicians are thrilled. It’s something they’ve been asking for since I started in this job.”

In the northwest, a little over 50 per cent of primary care providers have adopted EMRs, while in the northeast, the adoption rate is just under 50 per cent. The provincial goal is 65 per cent adoption by March 2012.