E-health centre to test patient records systems

Following the completion of its initial pilot phase earlier this spring, Canada Health Infoway and the Centre for Global eHealth Innovation on Monday officially launched the e-Health Collaboratory at the Centre’s site at Toronto General Hospital.

The Collaboratory, which is a non-profit initiative between Infoway and the Centre, was designed to help vendors comply with Infoway’s standards for electronic health records called the Standards Collaboration Process (SCP). Standards include, diagnostic imaging interoperability with registries, the HL7 v3 electronic drug messaging standard (CeRx), the HL7 v2.4 and v3 client registry messaging standards and the HL7 v3 provider registry messaging standards.

“What we’re looking to do with the collaboratory is provide objective third party analysis that the applications have implemented these standards correctly,” said Dennis Giokas, chief technology officer at Infoway. “(The Collaboratory) gives buyers and sellers the level of confidence that the application is functioning correctly at some level and should accelerate the process of getting these systems integrated and deployed.”

One of the Collaboratory’s three areas of service, called conformance testing, gives vendors the opportunity to test their EHR products against Infoway’s standards. The Collaboratory also provides useability testing of the products to users and physical space for vendors to demonstrate their product to potential users such as clinicians and physicians. The Centre includes multi-media technologies, testing rooms with observation space, props, and theatre staging sets that simulate health care settings such as clinics, hospital wards and operating theatres.

Infoway is a federal government initiative that is working with vendors, health care workers and provincial and territorial CIOs to further the adoption of EHR systems at health care facilities across Canada. Infoway has provided $1.3 million for the next phase of the project. The initiative also relies on vendor contribution to pay for its services.

For the pilot phase, the Collaboratory selected six vendors to deploy their EHR solutions in the “Physician’s Office of the Future,” set up at the Centre.

“In the scenario a person comes into office, they’re on vacation in a remote part of the country and they don’t have their proper ID,” said Joanne Hohenadel, the Collaboratory’s project manager. “The (receptionist) can look the patient up against provincial client registry. They’re able to update the client registry, local EMR and go to a centralized EMR viewer.”

There were 10 vendors in total who participated in this phase, including Dinmar, which tested its Oacis Clinical Viewer and Data Repository applications as part of the project. In one scenario, for example, a physician looks up allergies from Dinmar’s clinical repository, which houses types of allergies from all systems as opposed to one lab’s system. Interoperability across systems is key to physicians being able to do their job correctly and efficiently but it’s not always a priority for some vendors, said Manny Abraham, senior manager, Dinmar.

“The biggest challenge in IT is collaboration between vendors,” said Abraham. “This was something that was lacking and somebody brought it to the forefront.”

Likewise Tony Iantorno, partner, B Sharp, said it gives the health care provider the opportunity to test out the products before buying them. B Sharp provided its B Care application for the pilot that helps clinicians assess the patient’s condition.

“(The Collaboratory) is unique because it provides an unbiased setting where you can engage with other vendors and work together to build a cohesive solution,” said Iantorno. “It’s also unbiased from a purchaser perspective with the assumption if a vendor claims they are compliant to the latest standards, it can be validated in this environment.”

Infoway’s Giokas said the problem is that many EHR systems don’t interoperate today because many health-care organizations don’t use common standards.

“Not only do you need to move data between these two systems logically but you need to understand what that data is so that it can be used by the system,” said Giokas. “If you’re testing for drug interactions, for example, you need to be able to code drugs in a way that the algorithm can understand what the coding is and execute it.” Giokas added it’s also important that the clinician understands what information is being presented to them on the screen.

Going into the next phase, the Centre’s Hohenadel said the Collaboratory will focus on testing to ensure solutions comply with standards.

“We found the need is for ‘conformance’ testing,” she said. “That is the long-term vision and where we’re moving forward with the Collaboratory.”

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