OntarioMD: Advancing digital health in Ontario

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Front-line health care providers, quality improvement organizations, digital health delivery leaders and government recognize that digital health delivery has become an indispensable support to keep up with increasing health system demands. It is no longer imaginable that health care could be delivered without digital information technology to manage the array of information processed and recorded for patients every minute in Ontario physician practices, hospitals, home care, long-term care homes, public health units and health care provider practices across the continuum of care. All have adopted digital health tools, in varying degrees, to manage and support patient care.

There is a lot of discussion about what digital health doesn’t do yet – the promise not yet fulfilled, and definitely the glass half empty analogy. What about the glass half full? It is truly important to understand what digital health is doing every day in the health care system.

I’m going to focus on digital health in primary care because that is the area in which we spend our time as an organization. OntarioMD has been at the forefront to rollout digital tools and services across the province to support and enable efficient and effective practice and underpinning the delivery of excellent care to patients. We are known for our success in getting electronic medical records (EMRs) into the hands of community-based family physicians and specialists. From a province with one of the lowest adoption rates when our work began, to now one of the highest. How valuable are EMRs to the health care system? They’re more valuable than people may realize. More than 15,000 physicians and more than 1,100 nurse practitioners are using them to care for about 11 million Ontarians.

EMRs in primary care enable clinicians to manage your personal health information in a secure manner. EMRs require login credentials to access information, and no charts will be misplaced or lost. Protecting personal health information is critical to all of us. EMRs are the secure virtual filing cabinet to protect your information and make it accessible only to those to whom you give consent. We take privacy and security obligations very seriously and we offer a comprehensive program to enable physicians to stay up-to-date on their obligations and how to protect your information in their EMR systems.

Let’s say you were in the hospital emergency department last week and experiencing severe abdominal pain. If your physician used an EMR, they would be getting your discharge summary about your visit from the hospital directly to the EMR through OntarioMD’s Health Report Manager (HRM). They see your discharge summary in their EMR inbox, with a summary of your visit and it is increasingly likely that they may have called you for a follow-up appointment before you call the office.

Whether you are a patient with a single lab test or you require regular laboratory tests to be performed. Physicians are sent your results electronically by the laboratory, and they can also query OLIS (Ontario Laboratory Information System) to see your results. EMRs enable the physician to display results graphically, and this makes a lot easier to review trends in your results, supporting discussions about what might be working well or where attention needs to be focused.

Prescriptions generated and managed in EMRs provide extraordinary value. With an EMR, your physician can alert about drug indications or potential conflicts with current medications. Thousands of Ontarians experience adverse events due to drug interactions every year. EMRs have helped to reduce adverse drug events. It is one of the most valuable things digital health delivers for patients and the health care system.

If your physician wants to ask a specialist about something, he or she can make a request through an online portal and get an answer often in hours. This means you don’t have to wait for months and then take time away from family or work to go to a specialist for something that could have been dealt with by your family physician. OntarioMD is working with our partners in the Ontario eConsult Program to make it even easier for physicians to request an eConsult through their EMRs. This is just one of the ways we’re connecting the health care system to benefit patients.  

Back to the glass half empty – can everyone in the health care system seamlessly exchange data electronically to care for patients? No, but we’re getting there. Ontario physicians understand that the way forward is digital. They see its value and potential by using their EMRs and connecting to OntarioMD products and services and those of our partners that augment the value of digital health to realize better patient outcomes and healthier Ontarians.  

What about the physicians who use digital health and their needs? It’s great that they’re using digital health in increasing numbers to care for patients. We care about their workflows and ensuring that they get the training and ongoing support they need.  We know that it is important to create capacity in a physician’s office to support their adoption and best use of digital health tools and services, all while they are getting on with their most important work – delivering excellent care to their patients.   

Let’s keep working together to fill that glass and realize even more value for our health care system!

Shared Experiences in Digital Health: Visit by the Norwegian Minister of Health and Care Services and Delegation to OntarioMD

Contributed by Sarah Hutchison

On January 24, OntarioMD had the honour of welcoming Norway’s Ambassador to Canada, Her Excellency, Mrs. Anne Kari Hansen Ovind, and the Minister of Health and Care Services, Mr. Bent Høie and his delegation, to our office. The purpose of the visit was to discuss common themes in digital health faced by Norway and Ontario, and how lessons learned in both jurisdictions can impact how we enable system priorities, leadership, and innovation looking forward.

The Norwegian delegation was very interested in learning about OntarioMD’s success in implementing electronic medical records (EMRs) in community-based family physician and specialist practices and how successes with EMR integrated products and services align with Ontario’s Patient’s First Digital Health strategy and priorities. While there will always be more to do, these products and services are already leading to a more connected digital health system in Ontario given the strong and connected foundation that they now represent.

We talked about the critical success factors and methodologies used to deploy products and services to physician practices. OntarioMD’s engaged EMR vendor community and our EMR Certification Program are key enablers for digital health and have created a very valuable mechanism to translate health system priorities using EMR Specifications, into EMR functionality that drives EMR use by physicians. Other   partnerships have also led to the success of our work. There are many organizations that want to deploy their products to physicians but reaching the diversity and range of physician practices across the province is a challenge.  There is increasing recognition that to be more effective as a system we must make it easier for physicians to adopt technology, being very attentive to minimizing the administrative burden for physicians and minimizing disruption at the practice level which means a responsibility to create alignment with our partners.  We also need to provide the opportunity for innovative vendors with great solutions in health care to have a delivery channel that makes sense for all.

For the adoption and sustained use of digital health products and services, robust change management support is a core ingredient.  This support is available to  physician practices anywhere in Ontario and  provided by Practice Advisors with in-depth knowledge of EMRs and other digital health products and services; a network of over 50 Peer Leaders (physicians, nurse practitioners and clinic managers) mentor and educate physicians and their staff on how to make improvements to their EMR use; and the EMR Practice Enhancement Program that provides intensive coaching for physician practices to standardize data, improve the quality and integrity of data, improve preventive care, improve internal workflow processes to enhance the patient experience and much more.  We agreed that digital health is often NOT about the availability of technology, but about creating capacity and support for the clinicians who are end users.

The delegation and OntarioMD had a lot of shared themes to discuss – from population health priorities, the impact of privacy and security, access to data, quality improvement, and patient engagement and how innovation and new technology will continue to present great opportunities and challenges alike. Norway has tackled many of these themes and has also developed methodologies and best practices that have been effective in its digital health eco-system. With increased globalization, we increasingly recognize that forums, such as the one we were privileged to participate in, will continue to advance our paradigms and challenge our thinking about the future of digital health.

EMR: Every Step Session Profile Minding Your MEQs: Optimizing your EMR for Safer Opioid Management

This post was contributed by Dr. Kevin Samson. 

OntarioMD’s EMR: Every Step Conference in Toronto on September 28, 2017 will feature 25 seminars designed to inspire and educate clinicians on how to get more benefits from their EMR.

In the coming weeks, we’ll highlight some of the sessions, which have been certified by the College of Family Physicians of Canada’s Ontario Chapter for up to 7.5 Mainpro+ credits. To register for the EMR: Every Step Conference and attend sessions, please register at https://www.ontariomd.ca/about-us/events/every-step-conference-toronto.

In Minding Your MEQs: Optimizing your EMR for Safer Opioid Management, Dr. Kevin Samson will look at how new and innovative EMR tools can help promote the safer and effective prescribing of opioids to patients with chronic non-cancer pain.

Each year more than 650,000 Ontario Drug Benefit (ODB) eligible Ontarians are prescribed opioids. Today, prescription opioids are more likely to be found on the street than heroin, and opioids have become the drug of choice for teens. Opioids are responsible for more than 3,000 ER visits and more than 600 deaths each year.

Finding the time and expertise required to meet recommended prescribing requirements and provide optimal, individualized opioid treatment for patients with chronic non-cancer pain is a real challenge for physicians. But clinicians can tap into new tools to use their EMRs to optimize their opioid prescribing, and improve clinical outcomes for these patients.

These tools are presented in a toolbar which appears in the EMR, within the charts of patients who require opioid therapy. One important feature of the toolbar is that it displays the calculated morphine equivalents (MEQs) that the patient is on, and the display turns color to attract attention when the levels are above certain ranges. The toolbar also includes buttons representing each of the recommended requirements (pain condition diagnosis, risk screening, goal setting, informed consent, appropriateness of opioid(s) selected and dose, opioid effectiveness, and drug testing). If any of the requirements are missing or out of date for a particular patient, the corresponding buttons will change colour to provide clinicians with a user-friendly ‘at a glance’ view of the patient’s opioid management status. Clicking the buttons brings up standardized, evidence based tools used to manage the patient’s care. Additional buttons in the toolbar provide links to other related tools, references, handouts and patient report cards.

In this EMR: Every Step Conference session, Dr. Samson will share data and feedback from patients and physicians in the practices that have deployed the toolbar, he will explore the toolbar’s impact on the quality and completeness of opioid-related data in the users’ EMRs, and its impact on prescribing patterns.

EMR: EVERY STEP CONFERENCE

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Written by Revin Samuel, OntarioMD Staff

OntarioMD’s EMR: Every Step Conference returns to Toronto on September 28, 2017. This year we’re offering more than 25 new educational sessions, a series of EMR training workshops, the vendor showcase area, opportunities to meet with OntarioMD Peer Leaders, networking opportunities and keynote addresses from Ontario’s Deputy Minister of Health, Dr. Bob Bell, as well as patient advocate and former VP of Public Affairs for SickKids and Mount Sinai Hospitals, Judith John. And the conference has been certified by the College of Family Physicians of Canada and the Ontario Chapter for up to 7.5 Mainpro+ credits, which are transferrable for specialists!

Click to register for the Toronto EMR: Every Step Conference!

But what is now Canada’s largest EMR conference series has humble roots. OntarioMD first launched nearly a decade ago as a series of small EMR seminars and vendor showcases in small towns across Ontario. In the early days of EMR adoption, these events gave Ontario community-based physicians and their staff an important opportunity to gather with like-minded clinicians and get the information and education they needed to make use of the new technology. They could meet with OntarioMD staff and vendors of OntarioMD-certified EMRs under one roof, gathering tips and best practices.

Interest in those initial events grew as EMRs gained acceptance and popularity. The first EMR: Every Step Conference took place in Ottawa in 2012. By then, the focus had expanded as more physicians moved from selecting and implementing an EMR to wanting to understand how to optimize its use in their practices. Popular sessions focused on privacy and security and using EMRs to improve chronic disease management. And the vendor showcase was bigger and better than ever.

I found the conference to be inspiring; what I got out of it was a completely new way of looking at how I practice medicine.” – Dr. Ron Ireland

In the years since, the agenda has incorporated even more content on advanced EMR use to improve practice workflows and patient outcomes. OntarioMD Peer Leaders – practicing physicians, clinic managers and nurses in the field who are considered EMR experts – began to deliver presentations educating their colleagues on EMR best practices. And the conference has become a platform for OntarioMD’s digital health partners to present some of the latest innovations in health care technology. Organizations such as the Ontario Telemedicine Network (OTN), Health Quality Ontario (HQO), Cancer Care Ontario (CCO), eHealth Ontario, and the Ontario Medical Association, have all established a firm presence at the EMR: Every Step Conference.

The conference has grown grew from a regional EMR seminar series to the largest event of its kind in the country. Attendance grew from about 50 physicians per event to more several hundred in smaller cities to about 1,000 in Toronto.  The conferences have also expanded from two streams of content to four streams. The vendor showcase has expanded from 10 EMR vendors demonstrating the features of their certified EMR products, to more than 25 vendors and health care and related technology organizations exhibiting at the conference. And in 2015, we began to call for abstracts, giving the Ontario clinicians who had become EMR power users the opportunity to present their own innovative ideas on how EMRs are changing health care.

“The conference was really helpful. It has broadened my perspective and filled in the gaps so I can better use my EMR to serve my patients” – Dr. Amy Wong

The EMR: Every Step Conference now attracts almost 1,000 attendees each year. We’ve introduced a conference app to give attendees a chance to read speaker bios, create their own personalized conference agenda, complete and submit event evaluations, and even see which of their colleagues are attending. We’ve expanded opportunities for attendees to meet one-on-one with Peer Leaders, and complete an EMR Progress Assessment with OntarioMD Practice Advisors.

Clinicians across Ontario have come to anticipate the EMR: Every Step Conference each year. As your trusted advisor for EMR optimization, we will continue to find new ways to grow and add valuable, leading-edge content to Canada’s largest EMR conference series in the years to come.

Register Now!