Collective Will: Health care CIOs call for a new way of thinking

When officials at Ontario’s Trillium Health Centre recently unveiled a seven-year, $100-million initiative aimed at creating a “”network of medical knowledge”” at a recent press conference in Toronto, the air was thick with hype.

And those on hand went to great lengths to demonstrate some new

thinking had finally come to those in charge of the province’s aging health care system.

After all, in the words of Ken White, Trillium CEO, today’s health care model is much the same as it was a century ago, with the hospital or the doctor’s office at the centre. With this new network, however, Trillium will help create “”a new model”” that enables the health care system to “”turn the hospital inside out and put the patient at the centre.””

And so Trillium Health Centre announced Transforming Health Care into Integrated Networks of Knowledge, or THINK, in partnership with eight vendors. More than just some new thinking, the new model seems to embrace something that’s gone missing from any discussion of health care reform — a commitment to the dramatically increased role that IT can play in such system.

The announcement follows a recent report by the Health Council of Canada which calls for all hospitals to broaden their use of IT to make patient records immediately available to health-care professionals by 2010. Trillium expects to meet the report’s proposals two years before the deadline.

“”Our goal is to design and implement systems that put information in the right hands, in the right way and at the right time,”” says Wayne Mills, who started as Trillium’s vice-president and chief information officer when the bidding process began three years ago.

This includes, for example, the integration of multiple health-care records, from lab tests to pharmacology, into a single electronic patient record, and anytime-anywhere availability of patient records to patients, doctors and nurses via electronic devices such as PDAs and tablet PCs, White added.

Transition strategies

Other benefits include reduced wait times for diagnoses and treatment, the ability for patients to schedule procedures online and less time spent on paperwork and more time with patients for health-care workers.

These examples follow recommendations set out by the Ontario Ministry of Health, which has directed hospitals to invest in transition strategies to become more efficient.

Led by Trillium, which has sites in Etobicoke and Mississauga, Ont., THINK is funded in part by reallocating internal resources, reprioritizing its capital investments and reinvesting savings from operational efficiencies in clinical and non-clinical areas. This includes annual investments in acquiring or replacing hardware and systems. Overall, Trillium spends almost five per cent of its overall operating budget on IT, said White.

Under the terms of the agreement, all parties are working together to develop integrated systems in data management, distribution, storage and security for Trillium.

As the lead organization in the partnership, IBM Canada will provide industry consulting expertise and project management to ensure all sub-contractor products and services are delivered and implemented.

“”(THINK) requires all levels of collaboration, integration and co-operation,”” said Rik Ganderton, partner and national leader, health-care industry, at IBM Canada, which will also provide WebSphere Portal software to integrate heterogeneous systems and points of access to systems for health care professionals.

As part of the first phase of the implementation, expected to take about two years, Trillium is standardizing its corporate performance management cycle on Cognos products, providing dashboards to gather information on patient wait times, for example.

While it’s hoped this new thinking will be emulated elsewhere, the co-ordinated approach to IT is also happening elsewhere in the province. Late last year, a quintet of Ontario health-care organizations set a precedent when it put one man in charge of its IT strategy.

Lewis Hooper was named CIO for a group of five organizations that include Scarborough Hospital, Durham Access to Care, Lakeridge Health, Rouge Valley Health System and Scarborough Community Care Access Centre, the first such appointment in Ontario.

Hooper, a consultant who worked on the Ontario Health Services Restructuring Commission and the Ontario Third Party Review, says he is aware that dividing his time among the various organizations will be difficult, but he says he is ready for the challenge. More importantly, his appointment will put him in an excellent position to rectify one of the biggest problems noted in health care IT, the lack of connectivity between health-care institutions.

Knowledge transfer

“”What I’ve picked up is that in the health-care business, we don’t always understand the importance of knowledge transfer. It’s really part of the whole business of health-care. Think about what we do: We acquire knowledge from the patient — their history, diagnostic tests — we transfer it to somebody who can apply it with their own set of skills, whether it’s a nurse or a physician. They add to that knowledge trail, and they move it on to the next person in the chain. The part that I’m seeing here is that the partners that I’ve got — the three hospitals and two CCACs — see that as an important piece. They see that as a real opportunity to tweak the health-care paradigm a little bit, to move the information better in a way that meets the patient confidentiality.

“”I’ve been fortunate enough to do some research on information technology in health care, and what you’ll find is those folks that have got good information systems tend to have lower costs than other hospitals,”” he said.

“”When they fund hospitals, and the hospital’s funding a new building project, they don’t fund the IT portion. They’ll fund the other stuff, but if you want to put a network in, that’s not part of the budget.

“”You know, other parts of the country are in a very different situation. What’s happened in most of their health-care systems is they’ve regionalized. Our network would be comparable to one of the regions in B.C. — Fraser Valley, or something even smaller than one of those things, although we’re the biggest LIHN in Ontario. What I see is really for us to go to them and see what they’ve done in overcoming these issues. I anticipate learning from them.””

— with files from Shane Schick

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