Ontario seeks standard approach to data management

The Ontario government is augmenting its plan to establish regionalized health authorities by creating councils to standardize the way data is collected, managed and stored at hospitals and community care access centres.

Called local data partnerships, the idea is to gather physicians, technical experts and other stakeholders into councils to discuss issues around clinical, financial and eventually primary care information. The first council, devoted to problems in physician documentation, has already been set up. The Ministry of Health and Long-Term Care is planning to hire four data management coordinators that will support these councils, which will represent the 14 new local health integration networks (LHINs) Ontario is creating. The province introduced legislation late last week that, if passed, will see management of local services devolved to the LHINs.

Adalsteinn Brown, an assistant professor in the Department of Health Policy Management and Evaluation at the University of Toronto, is leading the government’s data partnerships initiative. He said the partnerships are intended to streamline and bring consistency to an area that has suffered from lack of standards. Unlike most other provinces where one or two abstracting software systems are the norm, for example, Ontario hospitals and health-care centres use 10 different software systems for abstracting, and a total of 48 systems across all health records functions, according to a recent survey the province conducted.

“To a lot of people, this is the least sexy area of our health system,” he said, adding that the support from LHIN physicians and other health-care professionals has been surprisingly strong. “We had 200 people (at an initial meeting) here without any pay. It’s not just a day of cookies and milk. They were there to work.” 

Although health-care CIOs and health-record strategists may be represented on the panels and councils, Brown said he hopes the local data partnerships will become a vehicle to bring a variety of care professionals together. 

“In some sense this could be independent of IT,” he said. “This will create a much better opportunity for technology and people processes to interact.”

While the local data partnerships may be used to facilitate best practices and collaboration among professions in the LHINs, front-line staff are speaking out about the regionalization plan itself. On Friday the Ontario Nurses Association (ONA), the Service Employees International Union Local1.on (SEIULocal1.on), the Canadian Union of Public Employees (CUPE) and the Ontario Public Service Employees Union (OPSEU) all announced plans to picket local MPPs over concerns there hasn’t been enough consultation about creating LHINs. 

CUPE spokesperson Stella Yeadon said the unions fear integration of health-care services in a geographic area will mean slashed wages, imposed contracts, and the privatization of the provincial health care sector. The legislation behind LHINs has already passed through second reading, she pointed out, even though many patients and staff don’t understand what regionalization means for them.

“You can have all the Oracle technology programs or whatever you want, but if you haven’t effectively thought out how the direct patient care side is going to be implemented, it’s not going to mean much,” she said. “If people can’t find services in their own community, it doesn’t matter what technology you use.

Brown said it was up to the Ministry to respond to the unions, though he said the point of the local data partnerships is to increase transparency and accountability in the system.

“If you want to create system integration, you don’t buy the technology and integrate the people,” he said. “We want to work through all the cultural issues that are important.”

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