Simcoe Muskoka gets upgraded network infrastructure to improve patient care

TORONTO - March 31, 2008 - Smart Systems for Health Agency (SSHA) today announced that more than 20 of the largest health care organizations in the North Simcoe Muskoka Local Health Integration Network (LHIN) have received increased network bandwidth enabling them to improve health services to residents. The upgrade enhances care by enabling health care providers to transmit electronic digital images of patient x-rays, scans and ultrasounds over a private and secure network.

The enhancements come from Smart Systems for Health Agency (SSHA), an agency of the Ontario Ministry of Health and Long-Term Care responsible for electronically connecting health care professionals to each other and to patient information.

The ability to electronically transmit digital images helps reduce patient wait times for treatment and enables doctors to more quickly collaborate on a diagnosis. With the upgrade, physicians can now also streamline care by integrating their clinical and chronic disease management systems with hospitals and data from Community Care Access Centres.

According to Jean Trimnell, North Simcoe Muskoka LHIN's Chief Executive Officer, this will allow the region to dramatically increase the scale, reliability and speed of network-based connections and applications to services local residents.

The increased capacity has broadened the North Simcoe Muskoka region’s use of the Ontario Telemedicine Network and extended video conferencing services, eliminating the need for residents to travel to larger centres for care. Physicians can also utilize the technology to speak with experts across the province on a diagnosis.

This is the first LHIN to complete the upgrade of SSHA’s network to its largest health care partners and hospitals.

Depending on location and connection method, participating organizations are now experiencing bandwidth speeds of up to 200 Mbps, representing an increase of between three to 40 times previous speeds.

Organizations benefiting from the upgrade are:
Collingwood General and Marine Hospital, Collingwood · Huronia Medical Centre, Midland · Mental Health Centre Penetanguishene, Penetanguishene · Muskoka Algonquin Healthcare - Burk’s Falls & District Health Centre, Burk’s Falls · Muskoka Algonquin Healthcare - Huntsville District Memorial Hospital site, Huntsville · Muskoka Algonquin Healthcare - South Muskoka Memorial Hospital site, Huntsville · Ontario Telemedicine Network - Regional Office, Barrie · North Simcoe Hospital Alliance - Huronia District Hospital, Midland · North Simcoe Hospital Alliance - Penetanguishene General Hospital, Penetanguishene · North Simcoe Muskoka Community Care Access Centre - Main Office, Barrie · North Simcoe Muskoka Community Care Access Centre - Bracebridge · North Simcoe Muskoka Community Care Access Centre - Collingwood · North Simcoe Muskoka Community Care Access Centre - Midland · North Simcoe Muskoka Community Care Access Centre - Placement Coordination Service - Huntsville · North Simcoe Muskoka Local Health Integration Network, Orillia · Orillia Family Health Network, Orillia · Orillia Soldiers' Memorial Hospital, Orillia · Royal Victoria Hospital, Barrie · Simcoe - Muskoka District Health Unit - Head Office, Barrie · Simcoe - Muskoka District Health Unit, Huntsville · The Villa Care Centre, Jarlette Health Services, Barrie

Background
The North Simcoe Muskoka LHIN, with a total population of 435,000 people, is one of 14 LHINs across Ontario mandated to plan, integrate and fund local health services, including hospitals, community care access centres, community health centres, long-term care homes, mental health and addiction programs and a variety of community support services agencies. The LHINs oversee nearly two-thirds of the $37.9 billion health care budget in Ontario. For further information on the North Simcoe Muskoka LHIN, visit the LHIN here.

Smart Systems for Health Agency (SSHA) is an agency of the Ontario Ministry of Health and Long-Term Care, responsible for electronically connecting health care professionals to each other and to patient information. SSHA provides a common IT platform that helps health care providers access vital patient and health information they need to deliver better care. For more information, visit www.ssha.on.ca.

US Regional Health Information Organizations and the Nationwide Health Information Network: Any Lessons for Canadians?

Denis Protti Professor, School of Health Information Science, University of Victoria, British Columbia, and visiting professor, City University London, England.

The creation of regional clinical data exchanges (usually referred to as RHIOs) is a centrepiece of the US national healthcare information technology strategy. How well are they doing and what lessons can we learn that might be applied here in Canada?

Background and Definitions There seems to be general agreement in the United States that a Regional Health Information Organization (RHIO) is a neutral, non-governmental, multi-stakeholder organization that adheres to a defined governance structure to oversee the business and legal issues involved in facilitating the secure exchange of health information to advance the effective and efficient delivery of healthcare for individuals and communities. The geographic footprint of an RHIO can range from a local community to a large multi-state region. As regional networks of stakeholders mature, they often find the need for a formal independent organizational and governance structure (i.e., an RHIO) with systems to ensure accountability and sustainability for the benefit of all stakeholders. Experts maintain that RHIOs will help reduce administrative costs associated with paper-based patient records, provide quick access to automated test results and offer a consolidated view of a patient's history. The terms RHIO and Health Information Exchange (HIE) are often used interchangeably though most would see HIE as a "concept" relating to the mobilization of healthcare information electronically across organizations within a region or community as opposed to an "organization." Typically, an HIE is a project or initiative focused around electronic data exchange between two or more organizations or stakeholders. This exchange may include clinical, administrative and financial data across a medical and or business trading area. HIEs may or may not be represented through a legal business entity or a formal business agreement between the participating parties. Local Health Information Infrastructure (LHII) is a term occasionally used synonymously with RHIO. LHII was originally termed by the Office of the National Coordinator of Health Information Technology (ONCHIT) to describe the regional or local initiatives that are anticipated to be linked together to form an envisioned National Health Information Network (NHIN). The NHIN describes the technologies, standards, laws, policies, programs and practices that enable health information to be electronically shared among multiple stakeholders and decision makers to promote healthcare delivery. When completed, the NHIN will provide the foundation for an interoperable, standards- based network for the secure exchange of healthcare information in the United States. The development of the vision of the NHIN began originally with the National Health Information Infrastructure (NHII) described more than a decade ago in the Institute of Medicine report The Computer-Based Patient Record. The original idea behind the NHII was that it would be an initiative set forth to improve the effectiveness, efficiency and overall quality of health and healthcare in the United States. This would be accomplished through a comprehensive knowledge-based network consisting of interoperable systems of clinical, public health and personal health information that would improve decision-making by making health information available when and where it is needed. These interoperable systems would use a set of technologies, standards, applications, systems, values and laws that support all facets of individual health, healthcare and public health. The path toward reaching a NHIN is anticipated to be through the successful establishment of RHIOs. When completed, the envisioned NHIN will provide universal access to electronic health records. In 2004 - not surprisingly following a visit from British Prime Minister Tony Blair - President George Bush called for electronic health records to be widely available in the United States by 2014. The federal government has launched initiatives to establish interoperability standards, examine variations in state privacy laws, conduct demonstrations of the NHIN and fund studies of areas such as strategies for state governments. Organizations such as the eHealth Initiative and the Markle Foundation have brought together the diversity of healthcare stakeholders and communities to share experiences, create tools and identify policies and steps that will facilitate the achievements to date. RHIO Models and . . . . [to continue please click here]

Why RHIOs Aren't Working: Views from an American Who Can See White Rock, British Columbia, from His Backyard

David E. Garets FHIMSS, President & CEO, HIMSS Analytics

Misaligned Incentives

[This article responds to: US Regional Health Information Organizations and the Nationwide Health Information Network: Any Lessons . . . ?]

Our "system" is "distinguished" by an incredible lack of aligned incentives.

• Insurance companies want to keep their insured consumers from engaging in expensive procedures or showing up in expensive venues (emergency departments) and have a reputation for looking for creative ways to not pay for medical services.


• Hospitals think they're the centre of the medical universe and make their money getting most of the sick people and providing as many services for them as are reimbursable by the tight-fisted insurers.


• Most American physicians are independent business people trying to maximize their incomes and attempting to gain leverage from hospital competition in their communities.


• Pharmaceutical companies, for the most part publicly held manufacturing firms, are intent on maximizing their profits and have figured out how to be successful - spend billions of dollars lobbying the US Congress to keep price controls and imported drugs out of the country while marketing directly to consumers.


• US residents, 47 million of whom are uninsured (approximately 16% of the population), are left to fend for themselves with competing doctors, hospitals, pharmaceutical companies eager to have them "ask your doctor whether whatever drug we're pushing today is right for you." In the United States, the costs for this madness are escalating far faster than inflation and presently comprise at least 15% of the US gross domestic product, a far higher percentage than in any other developed country, with poorer outcomes.


• And finally, employers, who fund a large percentage of the healthcare costs for employed Americans and their families, are furious at the increasingly large bite employee and retiree healthcare costs are taking out of their profits, making it increasingly difficult for many of them to be globally competitive. They're trying to get a handle on containing those costs. In large part, they attempt to manage this by shifting more of the costs to their employees.

I don't mean to be cynical, but RHIOs are the least of our worries!

Let Me Count the Hurdles [ . . . to continue click here.]