TORONTO — A Western province initiative to build a shared health-care provider registry has one project manager singing the praises of collaboration, while another cautions that one size doesn’t always fit all.

The four Western provinces formed the Western

Health Information Collaborative (WHIC) in 1999. The group recently completed their provider registry service (PRS), which was designed to help share costs between the provinces and prevent the replication of work.

“”We figured, ‘Hmm, we’d better figure out what collaboration is all about,”” said project director Chris Schrader, who works in B.C.’s Ministry of Health Services. Schrader shared the details of the project Tuesday at the E-Health 2003 conference.

B.C., which took the lead role on the project, set out to build the software two years ago as the foundation for a business-to-business portal for licensed and unlicensed individual providers, licensed and unlicensed healthcare operators, and related suppliers.

The broader goals of the project, according to Schrader, included improved operations systems, authenticated access to electronic health records and improved data analysis. These goals were realized by a collaborative effort between the provinces (B.C., Saskatchewan, Alberta and Manitoba) and agreement on essential elements like standards, he said.

It became obvious to Schrader that a project of this magnitude was necessary just by looking at some of the data practices in B.C. hospitals. He said that in some cases hospitals were using 13 different databases just to track information. “”There’s got to be some room for efficiencies there,”” he said.

Sierra Systems Group, based in Victoria, B.C., responded to WHIC’s request for proposal (RFP). Sierra’s initial estimate for the project was $1.8 million, said a partner with the company, Trevor Hodge. To bring that done to WHIC’s $1 million budget, Sierra outsourced much of the work, including the development, to India. That process was aided by the fact that a second-generation Indian-Canadian living in Victoria worked as a project manager for the company. “”He was able to bridge that cultural gap for us,”” said Hodge.

Sierra and the B.C. government worked out a deal where the company could resell the platform to other jurisdictions and nations. Hodge said that the U.S. may prove a lucrative market, since states will require a similar registry to comply with Health Information Portability and Accountability Act (HIPAA) regulations.

The first stage of the PRS was completed in March and has gone live in B.C. and Manitoba, with Alberta and Saskatchewan to follow. There are another two stages to come, said Schrader, which will involve collaboration with Canada Health Infoway, a government-wide body dedicated to accelerate the delivery of electronic health records.

Enhancements to PRS will include capturing data from human resource and payroll sources. Identity management will be an issue there, said Schrader, since multiple data on the same person will be coming from different streams.

Schrader said that he kept a ‘lessons learned’ database as the first stage of the project unfolded. One of those lessons is that collaboration worked. “”It is possible to collaborate and have a successful product,”” he said. “”We’re still friends. We still get together to have cocktails after a meeting.””

Linda Miller, director of information management for Alberta Health and Wellness, based in Edmonton, echoed Schrader’s sentiments, but with a caveat: collaboration comes with a price. Not every agency involved in a project can contribute equally, nor should they be made to. Each jurisdiction has its own timeline and pressures, she said. Infrastructure needs may vary from province to province.

She pointed out that WHIC started out in 1999 as an undertaking supported by the four Western provincial premiers. That support waned over time. “”I have to tell you that political memory is short,”” she said, adding that it is necessary to find local support to push a project through to its conclusion.

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