eHealth Strategy 2015-2018 - North York General...

eHealth Strategy 2015-2018 North York General Hospital

Table of contents 1.0 What is eHealth? ................................................................................ 3

2.0 Executive summary ............................................................................ 3

3.0 Building on our strengths .................................................................... 4

4.0 2015-2018 eHealth Strategy ............................................................... 5

4.1 Integrated care ................................................................................... 6

4.2 Evidence-based decisions .................................................................. 8

4.3 System leadership ............................................................................ 10

4.4 Operational excellence ..................................................................... 11

5.0 Resources and capacity ................................................................... 12

6.0 Measuring our success ..................................................................... 13

7.0 Risks and mitigation ......................................................................... 15

Appendix A: Organizational profile ............................................................ 16

Appendix B: Stakeholder engagement and environmental scan ............... 19

2015-2018 eHealth Strategy Pg. 3 of 25

1.0 What is eHealth?

eHealth is defined as health care practice supported by electronic processes and communication. At North York General Hospital (NYGH) we use the term eHealth to describe the fusion of technologies with clinical care and operations. It encompasses the hospital’s information technology infrastructure, information systems, integrated medical devices, and all of the electronic information we use to deliver patient care, support clinical and management decisions, plan and manage operations, as well as carry out research and innovation. NYGH’s eHealth strategy supports our entire community, including patients and families, professional teams, staff and administration. eHealth also extends beyond the hospital’s walls to community, regional, and provincial partner programs, enabling the seamless delivery of informed patient care.

2.0 Executive summary

Over the last few years, NYGH has made eHealth an organizational priority and critical enabler of our corporate strategic plan. Strategic investments in health information technologies and meaningful clinician adoption of these technologies, has improved the quality and safety of care delivered at NYGH.

North York General is recognized as one of Canada’s leaders in the adoption of electronic medical records (EMR) because of the successful multi-year, transformational rollout of our eCare project. We continue to lead the nation in the adoption of evidence-based, electronic order sets and the hospital is promoting the continued development and adoption of order sets by hospitals across Canada through an online toolkit developed in collaboration with Canada Health Infoway. True to North York General’s core value of our patients come first in everything we do, eCare is helping us reduce the risk of errors and ensure the right care is provided for every patient, by every provider.

As part of our eHealth efforts, we introduced a business intelligence framework and technology platform to support organizational performance measurement and decision-making. This has enabled more timely, on-demand access to financial reports and balanced scorecards for hospital leadership, and enhanced analytical capability to support our planning and management needs.

Our eHealth journey is not over. We will continue the important work we have started to fully leverage the benefits of eHealth technologies for our patients, clinicians and leaders. At the same time, we need to begin shifting our focus to connecting information beyond our walls, with our health care partners and patients.

The 2015-2018 eHealth Strategy outlines our journey and priorities over the next three years, and aligns with North York General’s 2015-2018 Strategy. Supporting our hospital on its journey to achieve excellence in integrated patient-centred care through learning, innovation and partnerships is the guiding driver for NYGH’s Clinical Informatics and Information Services team. The various projects that constitute our eHealth Strategy are organized into four key initiatives: Integrated Care, Evidence-based Decisions, System Leadership, and Operational Excellence.


3.0 Building on our strengths

Key strengths of North York General Hospital’s eHealth team include: a depth of knowledge in clinical and eHealth best practices; a rapidly maturing Decision Support team; and a passion to pursue excellence.

NYGH’s 2007-2014 Information Management and Information Technology Plan achieved remarkable progress in the implementation of clinical and business management technologies. Today, our electronic medical record (EMR) works as a partner to improve patient safety and help clinicians make the most informed care decisions. From a management perspective, near real time reporting of key performance indicators is now possible through our Business Intelligence System.

The table below lists our major eHealth accomplishments and achievements since the launch of eCare in 2008.

Theme Accomplishments

Patient Safety Won six national awards for quality, safety and innovation. Reduced medication administration errors by 40%. Improved medication reconciliation by 72%.

Electronic Medical Record Achieved HIMSS Stage 6 – the first community teaching hospital in Canada to do so.

The first Canadian hospital to roll out closed-loop barcode medication administration in all medical, surgical, and critical care units.

The first Canadian deployment of computerized provider order entry (CPOE) with regularly-updated evidence integrated into the physician decision-making workflow.

Integrated personal health records in NYGH’s EMR by scanning paper documents into electronic form.

Decision Support / Business Intelligence

Implemented a business intelligence system which has enabled clear accountability and transparency in operational and strategic performance.

Automated operational and corporate reporting. Created a culture where information drives decision making at all levels of the

organization. Near real time reporting of patient flow indicators enables action which has

helped reduce wait times in the Emergency Department by over 40%.

Patient Outcomes Achieved an 83% decrease in the time to first dose administration for urgent antibiotics in patients with sepsis.

45% reduction in risk of death from pneumonia and chronic obstructive pulmonary disease (COPD) through the use of CPOE and closed-loop medication administration with clinical decision support.

Produced a 56% reduction in inpatient mortality from pneumonia and COPD when patients were admitted using CPOE and a correctly matched evidence-based order set.

Classified as the top performer in the GTA and second best in Canada for the reduction of preventable in-hospital deaths in 2012

Recognized by Cancer Care Ontario for being the best performing hospital for cancer surgery wait times (time from decision to treatment) in 2013/14.


4.0 2015-2018 eHealth Strategy

North York General Hospital’s 2015-2018 eHealth Strategy is deliberately aligned with the hospital’s mission, vision, values and strategic pillars. The various projects that constitute our eHealth Strategy are organized under four key initiatives, namely: Integrated Care, Evidence-based Decisions, System Leadership, and Operational Excellence. Each of these initiatives support North York General’s strategic pillars to Deliver, Connect, Transform and Advance care.

Figure 1 eHealth initiatives supporting NYGH's strategic pillars


4.1 Integrated care

We will enable a patient experience that is interactive, collaborative, and supports care coordination through the seamless and secure exchange of information among health care providers and our patients, wherever they may be.

As of spring/summer 2015, eCare has not yet been deployed in the Emergency Department or Neonatal Intensive Care Unit. These areas require eCare in order to achieve a complete integrated solution across all of NYGH’s acute care areas. We must also roll out additional automation in certain areas already live on eCare, and enhance our electronic documentation to meet the requirements for full EMR adoption.

In parallel, we need to begin shifting some of our attention and resources to exchanging health information beyond our walls and with our patients. A number of regional and provincial eHealth assets have been in development for several years, and are now coming to fruition. We have an opportunity to leverage these assets in order to securely access and share information with others in the circle of care, and replace many of our inefficient, paper-based processes.

Areas of focus:

Full electronic medical record (EMR): Complete our eCare EMR journey across all inpatient areas and the Emergency Department so that all our care providers have electronic access to patient information and advanced care tools, wherever the clinician may be. We will strive to be the first acute care hospital in Canada to achieve the highest level of EMR adoption – HIMSS EMRAM Stage 7.

Integration with others: Lead the adoption of provincial eHealth assets and other solutions which enable electronic healthcare information exchange with other hospitals, community providers and patients to support continuity of care and engagement of patients with their care providers.


Major work streams:

Full Electronic Medical Record (EMR) 2015-2018 Work effort intensity

eCare – NICU

eCare – Emergency Department

Blood Transfusion Barcoding

Pathology Order Entry

Pacemaker integration

Expanding eCare functionality to deployed units

Integration with others

eCare – Ambulatory

Connecting GTA (CGTA)

Hospital Report Manager (HRM)

HDIRS - Shared Medical Imaging Pictures and Reports

Wait Times Information System (WTIS)

RM&R & CHRIS – Shared Community Health Information

Future Integration


4.2 Evidence-based decisions

We will continue to enable our clinicians to make better, safer and faster decisions, which will reduce unwanted variability, improve clinical outcomes, and enhance our models of care in a cost-effective way. We will also support our leaders in planning and managing their operations with better information and analysis.

As our funders continue to shift toward quality and performance-based funding models, clinical and financial information must be translated into evidence and insight. We need to build on our eCare and business intelligence foundations to provide clinical decision support for all our clinicians, business decision support for our leaders, and big data for applied research and innovation. Now more than ever, access to large internal and external sources of data coupled with the ability to analyze this data effectively, are critical to transforming the way we deliver care in partnership with others.

Areas of focus:

Order sets and clinical decision support: Enhance and expand the adoption of evidence-based electronic order sets and clinical decision support to assist all clinicians across the hospital in providing consistent, high-quality care to every patient.

Big data and predictive analysis: – Invest in tools to link and analyze electronic information in our hospital with key data from community providers and other external sources, to enable better management and care delivery decisions, research and innovation.


Major work streams:

Order sets 2015-2018 Work effort intensity

Clinical Reporting Tools

Physician Reporting

Discharge Summaries

Safety

Antimicrobial Stewardship Solution

Patient Portal

Pharmacy Perpetual Inventory

Medical Imaging

Laboratory Medicine

Automation tools

Patient/Community Wi-Fi

Registration Kiosks

Automation/Access including CareCompass

Dictation/Transcription Automation

Big Data and predictive analysis

Analytics Strategy

Data Warehouse Upgrade

Data Lake/ETL Tools

Visualization Tools

Modeling Tools

Joint Data Warehouse


4.3 System leadership

We will continue to demonstrate system leadership and advance system transformation by sharing what we have learned, and by collaborating with key organizations to develop and adopt emerging eHealth solutions.

Areas of focus:

Teach others: Share our expertise in design and implementation of advanced EMR systems and evidence-based clinical decision support, to enable other organizations to build high-quality systems that enhance patient care, at lower cost.

Lead and innovate: Collaborate with government agencies and other external organizations as a trusted advisor, innovator and early adopter of emerging health information technology solutions.

Major work streams:

Teach others 2015-2018 Work effort intensity

eHealth and Ministry activities

Canada Health Infoway

Canadian CPOE Toolkit

Central Local Integration Network

Lead and innovate

Smart Rooms

Asset Tracking (RTLS/RFID)

Clinical Mobility (Medication)

Innovation


4.4 Operational excellence

This initiative is foundational to the success of the three previous initiatives outlined above.

eHealth initiatives are not projects that start and finish. These complex projects require ongoing operational support structures to continuously monitor systems, as well as having the capacity to support ongoing improvements to ensure systems are closely aligned to updated evidence-based best practices.

We must build and sustain our eHealth initiatives on a solid footing, and work in partnership with our customers to be successful and meet their needs.

Our increasing reliance on mission critical information systems to deliver care and manage our organization requires us to ensure our systems are secure, high performing and always available. We will invest in protecting, refreshing and growing our infrastructure to support the systems we depend upon.

At the same time, we will strive for excellence in service delivery. This includes implementing lean processes and tools, following leading industry standards, training and developing our staff, and working in partnership with our peers and stakeholders to design, implement and support solutions.

Areas of focus:

Infrastructure: Enable infrastructure technologies that users find seamless with the goal/mantra of “Always vigilant, always available.” Important investments are needed to address the hospital’s aging infrastructure and to ensure long term scalability and sustainability. Continually improving service quality and efficiency by adopting leading industry standards, tools, and lean processes.

Compliance: Enhance processes for regular review and assessment for compliance with applicable legislation, standards, regulations, and reporting as core responsibilities and requirements for excellence in eHealth.

Major Work Streams:

Infrastructure 2015-2018 Work effort intensity

Integration

Upgrades

End User Computing

Network Infrastructure

System Stewardship

Compliance

Compliance with Legislation, Standards, Regulations and Reporting


5.0 Resources and capacity

Successful implementation of the various projects across our eHealth initiatives will require a considerable commitment and investment of hospital resources over the next few years. We estimate a total capital investment of $6.4 million and incremental operating expenses of $637,000, plus amortization of capital investments, to achieve our eHealth Strategy 2015-2018:

People and Culture

NYGH has been successful at attracting, developing and retaining very highly skilled staff with deep systems and process knowledge. However, at the time of writing this strategy, at least 17 hospitals in Ontario are going out to market for new advanced clinical systems and implementation resources. Additionally, there is little redundancy within the Clinical Informatics and Information Services team’s deep skills, which creates the need to balance professional development, job satisfaction, work/life balance, flexibility, and resourcing, while maintaining momentum.

Collaboration

The active participation of key stakeholders is critical to successful implementation and adoption of eHealth solutions. Well defined expectations, requirements, and standardization will foster collaboration among care providers and patients to find solutions, and eliminate current barriers in the capture and sharing of information.

Change Management

eHealth is a key facilitator in the organization’s evidence-based improvement objectives – whether it is rolling out a new electronic system or participating in Lean, Six Sigma or Kaizen initiatives. Our leaders, clinicians and staff are well accustomed to continually reviewing and making changes in the way we deliver care to reduce risk, improve quality, and become more efficient. Preparing and supporting our clinicians, patients and families to embrace and benefit from the many changes in processes and tools we integrate into our environment will be key to our continued success in leveraging our eHealth investments.


6.0 Measuring our success

While we will measure success on individual projects in relation to project-specific objectives, we have identified the following eHealth Strategy key measures of success: Integrated Care eCare deployments with 100% clinician adoption in NICU and Emergency Departments

Achieve highest level of adoption in Electronic Medical Records internally and enhanced sharing of patient information with community providers as measured by:

o HIMSS Electronic Medical Record Adoption Model (EMRAM) Stage 7 by March 31, 2017 o HIMSS Continuity of Care Maturity Model (CCMM) Stage 4 by March 31, 2017 o Stage 5 by March 31, 2018

Connect eCare to o Connecting GTA (CGTA) – hospital deployment by March 31, 2016 o Hospital Report Manager (HRM) – hospital deployment by March 31, 2016 o Other key provincial eHealth assets as they become available for use

Evidenced-based Decisions Full alignment with quality, safety and evidence-based decision benchmarks, such as:

o Provincial: Health Quality Ontario’s Quality Based Procedures (QBP’s) o National: Choosing Wisely Canada o International: Leapfrog CPOE Standard

Increase NYGH evidence-based CPOE library to over 700 order sets. All existing order sets in production regularly updated and maintained with the latest evidence

2016: Joint research data warehouse with the North York Family Health Team (NYFHT) established and Phase 1 scope research completed by March 31, 2016

On the Healthcare Analytics Adoption Model, achieve: o 100% of level 3 and 90% of level 4 by March 31, 2017 o Level 5 by March 31, 2018

Operational Excellence Information Services (IS) operations aligned to industry best practice structure (Control

Objectives for Information and Related Technology (COBIT) or Information Technology Infrastructure Library (ITIL) frameworks)

Define a technology service catalogue with established rejuvenation targets, disaster recovery documentation for critical systems. Creation of technology design standards guide to assist with the technology infrastructure deployment (re)development of NYGH facilities

Governance and stewardship programs in place for data and critical systems Annual improvement in customer satisfaction of 5% or more, as measured by annual surveys of

hospital clinicians and staff.


System Leadership Canadian CPOE Toolkit organic growth: membership to over 100 hospitals, grow order set

library to over 2,000 order sets by March 31, 2018 Canadian CPOE Implementation Guide published Completed deliverables for Canada Health Infoway and Central Local Health Integration

Network (LHIN) Generate revenue and attract funding through Health Information Systems /CPOE advisory and

applied research services for system partners, agencies, government and private industry Publications: Industry and academic journal articles highlight North York General technology

deployment successes and results


7.0 Risks and mitigation

As we execute North York General’s 2015-2018 eHealth Strategy and strive to fully realize opportunities, we will also face a number of risks. The key risks and associated mitigation strategies are summarized below.

Management risks Cross-team integration/communication | Ownership of work streams | Data governance Further develop governance committees through education and active participation from

stakeholders Establish data governance and system stewardship subcommittees

Technical Risk Technology vendor viability |Technology solution limitations Further develop strategic partnership with critical vendors to partner for success Keep technology current with vendor supported platforms and roadmaps Ensure proper diligence and documentation as solutions are commissioned

Integration/Delivery Risk System or Partner priorities | Initiatives | Ability to deliver Active program and portfolio management in collaboration with NYGH’s eHealth Steering

Committee Robust project governance, project and change management Active leadership and participation on engagements with the Ministry, LHIN and partner

committees Collaboration with peers and partners

Business/Financial Risk Market demand changes | Budget constraints | Regulatory changes Reduce costs by consolidating hardware/software as well as limiting IT contracting and

outsourcing Stay ahead of compliance risks, such as data privacy, through continued vigilance and

education Project stage-gate initiatives and continual review of business cases to ensure sustainability and

viability Partner with the North York General Foundation and external funding bodies to secure

alternative funding options Explore revenue generation through eHealth consultancy and research services

Resource/Skill Risk Knowledge and skill management | Resource retention | Operational vs. Strategic focus Reduce operational risks to IT and business by improving IT resilience; streamline and

standardize infrastructure technology components and related operating processes (e.g., asset management, change management, and problem management)

Prioritize projects and resource allocation based on strategic alignment Employee engagement surveys and programs


Appendix A: Organizational profile

North York General Hospital's mission, vision and values reflect our commitment to providing the best and safest care to our diverse communities and pursuing excellence through learning, innovation and partnerships.

Our Mission:

Providing exceptional health care to our diverse communities.

Our Vision:

Excellence in integrated patient-centred care through learning, innovation and partnerships.

Our Values:

Our patients come first in everything we do

Excellence We strive to achieve better outcomes in everything we do, collaborating with patients, families and partners.

Respect We embrace the strength in our diversity and treat everyone with respect and dignity.

Integrity Every day, we act in a professional and ethical manner.

Compassion We provide an exceptional care experience to our patients and their families with empathy, sensitivity and understanding.

North York General Hospital is one of Canada's leading community academic hospitals. We provide an exceptional care experience for our patients and their families, and have proudly served our diverse communities in north Toronto, and beyond, since 1968.

NYGH offers a wide range of acute care, ambulatory and long-term care services at three sites: the General Site (4001 Leslie Street); the Branson Ambulatory Care Centre (555 Finch Avenue West); and Seniors' Health Centre (2 Buchan Court). Our regional programs serve all of south central Ontario.

The hospital partners with 36 different academic institutions, including the University of Toronto, to prepare future physicians, nurses and other health care professionals to work in interprofessional teams, providing essential care in a community hospital setting. NYGH programs are the training site for four core clerkship programs and we provide a site for core rotations to 22 different University of Toronto residency programs. In addition, 247 physicians at NYGH have faculty appointments in the Faculty of Medicine at the University of Toronto. Almost 70% of all our hospital-based physicians have a faculty appointment.

Our staff, physicians and volunteers have a history of transforming health care to better serve our patients. We are leaders who adopt the most innovative health information technology, strategists who carefully chart patient flow and find ways to reduce wait times, and visionaries who dream of, and work towards, the ideal patient experience. From boardroom to bedside, we go above and beyond to offer the best and safest care. We put our patients first in everything we do.


Team structure

eHealth services are delivered through two core teams:

1) Health Information Management (HIM), Privacy, and Decision Support led through a Director reporting to the Chief Financial Officer (CFO), and

2) Information Services (IS/IT) consisting of: Clinical Informatics, Client Server and Host Systems, and Corporate Systems and Services, all led by the Chief Information Officer reporting to the CFO / Vice President.

Both teams collaboratively deliver on the hospital’s eHealth priorities informed by a multi-disciplinary eHealth Steering Committee. This advisory committee supports the development of the eHealth Strategy, prioritization of projects and allocation of eHealth funds for the annual tactical plan, ongoing monitoring of strategy execution, and collaborative problem solving.

Below is the current membership of the eHealth Steering Committee: Member Title

Sumon Acharjee (Chair) Chief Information Officer

John Aldis Vice President of Corporate and Information Services, CFO

Nghi Luu Patient and Family Advisor

Mary Lynne MacMaster Director, Patient Experience and Quality

Dawne Barbieri Director, Professional Practice, Research and Education

Elizabeth McCarthy Senior Communications Specialist, Corporate Communications and Public Affairs

Kathy Chun Director, Cytogenetics and Molecular Genetics

Sonia Pagliaroli Manager, Clinical Informatics

Chi-Cheng Chu Manager, Information Services

Rita Reynolds Chief Information Privacy Officer

Corey Clarke Manager, Health Records

Edith Rolko Director, Pharmacy and Infection Prevention and Control

Alshad Damji Manager, Infrastructure Services and Integration

Dr. Jeremy Theal Chief Medical Information Officer

Mark Fam Director, Strategy and Diagnostics

Deepak Sharma Director, Health Information Management, & Decision Support

Linda Jussaume Program Director, Surgery

Susan Woollard Program Director, Medical

Bessy Leung Director, Financial Services

Kitty Tsang (Ex-Officio) CFO-Foundation


Patient- and Family-Centred Care: is a big focus in the care and service delivery culture of NYGH. Patient Advisors partner with the organization and are available to eHealth project teams directly as part of the design and deployment of eHealth solutions. As part of the eHealth Steering Committee, the Patient Advisor representative is an active and equal partner honouring the four pillars of patient- and family-centred care: Respect and Dignity; Information Sharing; Participation; and Collaboration.


Appendix B: Stakeholder engagement and environmental scan

As a community, provincial and national leader in eHealth, North York General Hospital is committed to information management as a strategic enabler, and the development of electronic health records that can be securely and privately shared among all appropriate care providers for each and every patient. This is foundational to patient-centred care.

To this end, a strategic planning process was completed that included extensive stakeholder engagement of over 235 staff, front -line caregivers and patients. The process examined the needs of the organization, the current state of technology, information, and solutions, and the future directions of eHealth solutions and the hospital. From this gap analysis, a number of strategic themes, initiatives and objectives emerged.

A key component of North York General’s governance model includes an eHealth Steering Committee with multi-disciplinary membership from across the hospital, including representation from a patient and family advisor. In addition, NYGH’s Patient Advisory Committee was able to review and provide feedback into the future plans and priorities of this strategic plan.

Much of our 2015-2018 eHealth Strategy is influenced by and in some cases dependent on external organizations. Some of the policy and strategic directions of these organizations with eHealth implications are summarized in the table below.


Key trends and external influences on NYGH’s 2015-2018 eHealth Strategy

Organization Influences


Five opportunities for action: a) care closer to home; b) easier access; c) support new models of care; d) improve patient safety; and e) enabling high performance health. Any new investments will target remote patient monitoring and consumer health.

Ministry of Health and Long-Term Care

MOHLTC is taking steps to ensure that investments in eHealth advance the objectives of Patients First. The starting point is eHealth Governance 2.0. As this is formalized, hospitals are being asked to pause Health Information System procurements to allow a panel to look at options going forward. This could create opportunity for NYGH to be a leader for future directions. Health Links is the top priority. Health System Funding Reform is the biggest financial impact on hospitals in

some considerable time. Maximum funding opportunity = focus on clinical transformation and outcomes

improvements. Demonstrable, proven, and repeatable. Priorities:

o Putting Patients at the Centre — the Right Care, Right Place, Right Time o Moving Forward on Accountability and Transparency

Collaborating on shared responsibilities across Government

Health Quality Ontario Monitors and supports quality improvement using available evidence. Developing a new strategy for measuring and reporting performance and will

have significant information and data needs.

eHealth Ontario Continues to make progress on its 2015 eHealth Blueprint. Focus is on Cluster work (e.g. Connecting GTA). Hospital Report Manager (HRM), Ontario Laboratory Information System

(OLIS), physician eHealth, regional integration and standards work continues.

Central LHIN Health Links is a top priority. Cluster strategic plan has been sent to the Ministry for approval, not released

yet. LHIN wide decision support tool is currently being considered. Resource Matching & Referral (RM&R) integration and discussions underway

on a central intake model.

Cancer Care Ontario Focus is on cancer risk reduction, early detection, quality of and access to care, improving the patient experience, innovative models of care delivery, and expanding efforts in personalized medicine.

Community Care Access Centres

Advancing Client Health Record Information System (CHRIS) to better enable information exchange with partners (including NYGH).

Ontario Telemedicine Network / OntarioMD

eConsult program for secure clinical collaboration.

Local community Ongoing EMR adoption and deployment

http://www.ehealthblueprint.com/en/


In addition to the generally available information, we consulted the leaders of key external organizations, specifically with:

Cancer Care Ontario

eHealth Ontario

Ministry of Health and Long-Term Care

Ontario Hospital Association


The interview package and findings from these consultations is summarized below.

eHealth External Stakeholder Consultation Package Introduction

Building on our Strategic Plan 2012-2015 and the successes of our organization over the last several years, NYGH is undergoing a strategic plan refresh to refine and shape the direction for our organization over the next three years.

NYGH is also developing a three year eHealth Strategy. We see eHealth as a key enabler of our corporate strategy.

We see close collaboration and partnerships with external stakeholders as vital to achieving our organizational strategies and maximizing our collective value to the health care system and the patients we serve. As a key external stakeholder, we would like to get your thoughts and perspectives on the questions outlined below to challenge and validate our current thinking and better inform our future corporate and eHealth strategic directions.

1) In general, what role should NYGH serve over the next 2-3 years as a(n): • Community academic hospital • Clinical care provider • Research organization • Educational organization • Engaged partner across the continuum of care • Innovation oriented organization

2) In thinking about the future direction of the organization, are there any words or descriptors you feel NYGH should strive to become as an organization?

3) From an eHealth perspective, what strategic directions and opportunities do you think NYGH should focus on to be successful in its role and to benefit the health system as a whole?

4) Are there any opportunities you feel that we can pursue together?


NYGH Strategy and eHealth Strategy Consultations

Conducted by: John Aldis, Dr. Jeremy Theal, Sonia Pagliaroli

Cancer Care Ontario

eHealth Ontario

Ministry of Health & Long Term Care

Ontario Hospital Association


Participants Michael Sherar, President & CEO

Wei Qiu, Chief Medical Informatics Officer

Lorelle Taylor, ADM, Health System Information Management and Investment, CIO

Greg Hein, eHealth Liaison Director

Christine Chen, Program Consultant

Evan Mills Sr., Program Consultant

Anthony Jonker, Director, Hospital Business Initiatives

Emitis Moshirzadeh, eHealth Consultant

Lou Reidel, Director Health Finance and Research

Terry Moore, Executive Regional Director, Ontario Region

Brent McGaw, Project Director, Ontario Region

Lucia DiPasquale, Project Manager

What role should NYGH serve?

Continue to be great partner on CCO contract, wait times performance etc.

Network partner

Culture of performance improvement

Community academic hospital first

Leader on innovation in eHealth, Ontario hospital HIS/CPOE advancement

Engaged partner across continuum of care (e.g., Health Links)

Innovation oriented organization (e.g., eHealth, balanced scorecard, robust models for performance measurement & evaluation)

Community academic hospital

Innovation oriented organization

“beacon to others” in modeling leading practices”

Innovation oriented

“innovation done well”


What should NYGH strive to become?

More patient centred, integrated care, patient navigators e.g. colonoscopy, mammography

Measuring & improving continuum of care, quality

Integration w/ palliative care

Keep focusing on wait times

Shift care out of hospital and integrate with partners

Stay the course

Stay the course and align with provincial mandate, ensure initiatives scalable and leverage provincial assets

Get better at promoting eHealth strengths outside traditional eHealth spheres e.g., media, corporate and foundation communications, corporate strategy

Leader in evidence-based eHealth

Improve promoting eHealth strengths outside traditional spheres e.g., media, corporate & foundation comms, corporate strategy

Communicate better patient outcomes tied to NYGH’s eCare

“invest in this story” vs. other poor examples

What eHealth directions and opportunities should NYGH focus on?

Continue focus on being data/evidence driven, analytics etc.

Integrate data across providers to measure and drive QI

Partner with external organizations on sharing and analyzing clinical data across care continuum to support health care delivery and research

Actively participate in regional/provincial eHealth initiatives

Leverage existing and/or emerging provincial assets

Potential to develop NYGH eHealth expertise as a provincial asset

Leverage HIMSS maturity leadership

Leverage Big Data & analytics e.g., joint DW, & readmission reduction pilot project, potential bundled payments initiative

eHealth initiatives enabling patient and family engagement

Potential to engage with private sector on eHealth innovation e.g., Toronto Board of Trade Human Health Sciences Cluster

Align to standardized nomenclature for clinical information e.g., SNOMED


Opportunities we could pursue together?

Partner to leverage CCO software (InScreen) to support patient reminders for colonoscopy screening intervals based on discrete data available in NYGH system

Potential to partner on potential CCO-funded QBP procedure bundled payments

Potential to pursue small scale innovation projects funded out of eHO discretionary funding, aligned with eHO mandate

Potential to partner on centralized HIS implementation/consultation team

Potential to partner on consolidation/certification of HIS to reduce number of HIS vendors across Ontario

Explore to work with MOHLTC to innovate on i) standardization of practices e.g., CPOE Toolkit; and ii. leveraging for better outcomes e.g., HSMR, pilot Big Data project

Potential joint education initiative to support implementation best practices provincially for HIMSS maturity including workshops and webinars for CPOE Toolkit

Potential to access funding for Infoway priorities like Ambulatory and Primary Care EMR and Consumer Health

Potential to collaborate on development on Med Rec Toolkit and leverage provincial “All Drugs, All People” initiative

Potential to work with Infoway and MOHLTC to develop Centre of Excellence eHealth, including centralized implementation resources/expertise i.e., SWAT Team, toolkits, measurement & outcome methodologies

Potential for provincial and/or pan-Canadian joint procurement of eHealth technologies and services


Brief consultation feedback from Health Quality Ontario (HQO) (Lee Fairclough, Vice-President, Quality Improvement & Mark Robson, Project Manager): Potential for NYGH to collaborate with HQO on development of standardized materials aligned with QBPs published through Canadian CPOE Toolkit (e.g., order sets, policies and procedures, medical directives, workflows)

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