Tag: emr

Ontario EMR Specification v4.0 FINAL version released


Ontario  EMR version 4.0 specification(final) was released couple of days ago by Ontario MD for EMR vendors to apply for funding offering and comply with version 4.0 requirements.

 

Here is the link to the schedule and version 4.0 requirements.

https://www.ontariomd.ca/portal/server.pt?space=CommunityPage&cached=true&parentname=CommunityPage&parentid=4&in_hi_userid=2&control=SetCommunity&CommunityID=553&PageID=1763

Version 4.0 has some key requirements from a jurisdictional EHR or document exchange between healthcare provider point of view.  One of the key requirement is the requirement for EMR vendors to implement Hospital Report Manager specification to enable transfer of clinical documents like discharge summaries, transcribed reports (radiology, lab and others) from healthcare providers (mainly acute care hospitals) to primary care physicians(PCP) using an EMR.

This is great first step forward to enable the family doc to receive discharge summary from the hospital before the patient shows at the doc’s office and EHR.  Though at a provincial level this standard (Hospital Report Manager) doesn’t seem to align with the Ontario Clinical Document Specification, which is currently under public review as well.

Friends at eHealth, kindly take a note of this.  I am reviewing the CDS and will be submitting my comments through the public review forum as well.

Saravana Rajan

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Microsoft quits EMR/HIS market in US


Here is the latest from Microsoft, the horizontal heavyweight, who entered the healthcare vertical with the acquisition of Global2000’s HIS product.

Microsoft is to stop selling its Amalga HIS and John’s @ Chilmark analysis and why its the right move for Microsoft.   I agree that EMR / HIS  is a mature market with healthcare vertical heavyweights like Cerner, McKesson , Meditech and industry darling Epic.

EMR / HIS market entry through acquisition from a foreign player looked never feasible given how healthcare delivery is unique to each country with the regulations,  structure ( public versus private), clinical workflows and business processes associated with it.  Even between US and Canada there is quite a difference though Meditech has significant presence in both countries due to various reasons.

Saravana Rajan

healthcare…once upon a time!


“Once upon a time, going to your doctor was simple. You knew his first name, or perhaps just called him “Doc.” He lived just down the street and made house calls. And if you were sick, you would see him that day, because, well, you were sick” … that’s how the story starts for Hello Health! (founded by an American and Canadian in NY)

Hello Health attempts to make healthcare simple and accessible to patients and promises  to taking medicine to its basics.  With Hello Health, you can interact with your doc in your favourite means of technology.  If you have query and you would like to just e-mail, you just e-mail and its Free!  You make your appointments online and access your records as well.

At the primary care level, as the first point of contact for the patients, accessibility and responsive care is crucial for patients and especially for patients with chronic diseases like diabetes, cancer, heart disease and COPD.

So is Hello Health disruptive ? Absolutely in private healthcare market like US, its bringing the medicine back to basics and attacks the complex payer/physician centric model.  In market economics, as the value propositions of the consumers change, new players emerge to provide the missing value and this is often called as invisible hand and works in most cases. It remains to be seen whether it will work in healthcare.

Can a service like Hello Health, work in a single payer system like Canada ? Of course, it can, provided it meets the regulatory requirements of the government and the docs adopt the government certified EMR

Hello Health!
Hello Health!

(Electronic Medical Record), of course with lots of incentives.

Accessing a primary case physician is  relatively easy (caveat: if you have a family physician) in the Canadian Healthcare system and every one is aware of the improvement needed in terms of technology adoption.

In US, the question remains whether the proposed mandatory legislation by Obama administration can hinder a service like this. Boston Globe has a good coverage on this. http://bit.ly/WE67p

Also this type of pay for use service only serves the basic healthcare needs and Can it fix the completely ailing US healthcare system, where complex care consumes most of the resources in the system ?

It remains to be seen and the quest for solving the healthcare puzzle continues.

EMR (eletronic medical record): does it exist in Ontario ?


Electronic Medical Record as defined by HIMSS Analytics is an application environment composed of the

  • clinical data repository
  • clinical decision support
  • controlled medical vocabulary
  • computerized order entry
  • provider order entry
  • pharmacy and
  • clinical documentation applications

This environment supports the patient s electronic medical record across inpatient and outpatient environments, and
is used by healthcare practitioners to document, monitor, and manage health care delivery within
a care delivery organization (CDO) like a hospital / clinic / doctor’s office and imaging centers.

The data in the EMR is the legal record of what happened to the patient during their encounter at the CDO and is owned by the CDO.

If you still have confusion between EHR and EMR, please refer to this document published by HIMSS Analytics which explains the difference and does a good job.

So where is Ontario in terms of EMR implementation compared to the United States. slide_0026_full

Proceedings from Ontario HIMSS meeting


Switching gears to information technology in healthcare, I attended the annual general meeting of Ontario chapter of HIMSS. It was great to meet friends and see some familiar faces in the industry and listen to interesting education sessions from the status of Electronic Medical Record(EMR) adoption in healthcare provider settings to a pilot chronic disease management project in Barrie, Ontario

The meeting was held in the lovely Sunnybrook Estates, which always enthralls me as I am a big fan of historic places and buildings.

Sunnybrook Estates
Sunnybrook Estates

Coming back to the sessions, most of the session was webcast and archived and you can find the webcast in the links below.

  • John Hoyt, Vice President Healthcare Organizational Services, HIMSS, who gave us the FIRST view of HIMSS Analytic results specific to Ontario

http://alex2.sunnybrook.ca/Mediasite/Viewer/?peid=804b861b7ecf43b2b143ae50217fab82

  • Trina Noonan, North Simcoe Muskoka Community Care Access Centre, who presented on an exciting project CHRIS-Procura Integration Project, she hopes to present a first year update at our AGM 2010

http://alex2.sunnybrook.ca/Mediasite/Viewer/?peid=590034bd85624cf4836e66a04ff024a4

  • Lee Miller, Director IT North Simcoe Muskoka CCAC and Florann Shaw, We Care, gave us a glimpse of the technology used to monitor patients’ health status remotely

http://alex2.sunnybrook.ca/Mediasite/Viewer/?peid=f5880304fe2f447a84edc8d69e7bf969

  • Shelley Cameron, Barrie and Community Family Health Team who presented on a very successful Telehomecare chronic disease management pilot project with great potential.

I am going to elaborate on two specific sessions, especially the following sessions.

  1. John Hoyt, VP at HIMSS, who showed, for the first time, the status of EMR adoption in Ontario hospitals
  2. Shelley Cameron on telehomecare chronic disease management pilot project, which had very successful outcomes and has huge implications for chronic disease management in Ontario

Next time, I hope to see you at the Sunnybrook Estates and stay tuned for further posts on the two above.

Healthcare a brewing crisis for a long time!


In most parts of the world one thing that’s common across the board for every country is that they always have a health care crisis.

My definition of crisis comes from Wikipedia’s definition of crisis and tend to take the meaning of “testing time”.

From the view, East or west, first world or third world,  almost all the countries are facing some sort of health care crisis and governments, businesses,  Not-for-profit organizations, individuals are all involved in working on a solution.

For example, to name a few crisis’ in brewing in coutries, here is a breif list.

  • In America – 46 million(about 1/6th) of the population is uninsured, with the highest spending in health-care as % of GDP(see image) and poor adoption of IT in health care.

Healthcare Spending as % of economy, Source:The Economist

  • In Canada (where I live), where its public health care, though most of the population thinks that we have the best health care the crisis is in supply of capacity and demand, efficiency of patient care, which results in a some unacceptable level of wait times for care
  • In India, where I grew up, the crisis is totally different as Health Insurance is not prevalent, affordable health care for Indian population is an oxymoron, big gap in health care infrastructure and the list goes on
  • In UK and other European nations, I would presume they are dealing with capacity and efficiency issues and its a learning curve that I have to take to understand more in detail on the health care crisis in Europe

In this blog I attempt to look at various solutions that are being proposed or worked at either by government, not-for-profit organizations or private enterprises towards continuous improvement in health care delivery across the world.

Stay tuned for more!

Thanks,