1.
Canada Health Infoway
Transforming Practice &
Improving Care Across
Canada
Presentation to the Directors of Nursing and Midwifery Summit
Ireland’s Future Health Summit, May 26, 2016
Maureen M. Charlebois Chief Nursing Executive & Group Director
Clinical Adoption – Canada Health Infoway

2.
2
CANADIAN CONTEXT
• Federal
government
sets and
administers
national health
care principles
• 13
provincial/terri
torial
governments
plan, finance,
manage,
evaluate their
health services
• 700 + hospitals

3.
Vision
Healthier Canadians through
innovative digital health solutions
3

4.
Approach – strategic investment model
$2.098 billion in approved projects to date; 387
active or completed projects
Solution
deployment
projects in each
jurisdiction
Common
Blueprint &
Standards
Twelve
investment
programs
Program
criteria
Program
eligible
costs
Project
sizing and
estimation
Approved
projects for
investment
1. Registries
2. Diagnostic Imaging Systems
3. Drug Information Systems
4. Laboratory Information Systems
5. Interoperable EHR
6. Telehealth
7. Public Health Surveillance
8. Patient Access to Quality Care
9. Innovation and Adoption
10. Infostructure
11. EMR and Integration
12. Consumer Health Solutions

5.
5
THREE WAVES OF DIGITAL HEALTH
INNOVATION
• Building blocks
• Digital tools
for clinicians
• Empowering
patients

6.
6
Knowing the Plan for Canada
CE_Plan_Small.wmv

7.
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THE FIRST WAVE
LABORATORY
INFORMATION
SYSTEMS
85%
DIAGNOSTIC
IMAGING IN
HOSPITSLS
100%
DISPENSED
DRUGS
62%
CLINICAL
DOCUMENTATION
100%
PATIENT &
PROVIDER
REGISTRIES
100%
• Foundational infrastructure
for digital health:
investments in six core
components of an electronic
health record
• Leadership in architecture,
standards, privacy
• Pan-Canadian strategy

8.
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THE SECOND WAVE: DIGITAL
TOOLS FOR CLINICIANS
• Electronic
medical records
• Expansion of
telehealth
• Public health
surveillance
Source: 2015 Commonwealth Fund International Survey of Primary Care Physicians

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THE THIRD WAVE:
EMPOWERING PATIENTS
• Improving
the
patient
experience
• Enhancing
patient
safetyWhat Patients say they want access to:
Online Appointment Booking
E-consultations/visits
Online lab results/views
Online prescription renewal

10.
Access to results drives value for patients
10
Source: Impacts of direct patient access to laboratory results – Final Report 2015

11.
Change Management
Framework
Benefits Evaluation
Framework
Clinical Engagement
Strategy
Clinical Adoption: Accelerate Adoption & Benefits Realization

12.
Pan-Canadian Benefits Realization

13.
Overall impact on Quality of Care – Clinicians
Perspective
Sources:
2014 Infoway-CNA National Nurses Survey, 2014 Infoway National Survey of Community Pharmacists and National Physician
Survey (2014) * % Not sure or No Reponses not reported

14.
Transformative Leadership
• Change leadership is the strategic, systematic approach that supports
people and their organizations in the successful transition and adoption of
electronic health solutions.
• The outcomes of ‘change leadership’ results in adoption and the full
realization of benefits and clinical transformation.
A Focused Approach to change management that
incorporates these six elements noted in the CM
Framework helps to ensure alignment of activities,
solution adoption and realization of benefits.
Change Management Framework
Clinical Adoption Framework

15.
Q1. What has helped the most to lead change in your
organization?
Q2. What are the barriers to successful change in your
organization?
Top 3 Change BarriersTop 3 Change Enablers
Leadership is the top Change Enabler
• Visible/engaged senior
leadership
• Stakeholder engagement
• Clinical/change champions
• Competing priorities
• Lack of visible/engaged
senior leadership
• Lack of effective
communications

16.
Transforming Clinical Practice
‘‘CurrentCurrent
State’State’
Where are we now?Where are we now?
‘‘DesiredDesired
State’State’
Where do we want to be?Where do we want to be?
 Visible Clinical & IT Leadership
 Budget for Change Management
 Selected Change Approach/Methodology
 Engaged Clinicians & Informatics Specialists
 Communication Plan & Key Messages
 Workflow Analysis & Practice Process Redesign
 Role Specific Training & Education
 Ongoing Technical, Operational & Clinical Support
 Pre & Post Change Indicators & Evaluation
GAP Analysis:
What type of support is required to get there?

17.
Why is change so hard?
17
Amygdala – ‘Flight or Fight’
Stuck_on_an_escalator.wmv

18.
Clinical Engagement Strategy

19.
Beliefs, Attitudes,
Behaviors, Benefits ?
…allow you to use more of your time providing patient/client/resident care while enabling you to act
more informed to improve patient/client/resident experiences and outcomes, even save lives.

20.
Transforming Practice, Improving Care
Collaboration &
Communication
Improves
Efficiencies &
Avoids Duplication
Decision Support
& Workflow
Information Management
& Education
Timely Access to
Information

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Nursing Electronic Health Record Reference
Document
https://www.infoway-inforoute.ca/index.php/resources/guides-workbooks

22.
Pan-Canadian Clinical Peer Leader Networks
Clinical Peer Leaders
working with their
colleagues providing
clinical leadership,
support, mentoring and
coaching to facilitate
learning and use of
technology in practice.

23.
Transforming health care –clinical leadership
• 96% of Peer Leaders
‘agree/strongly agree’ they
are positively influencing
their colleagues
understanding and
adoption of EMR/other
technology systems in
their practice settings
• 89% of Peer Leaders
‘agree/strongly agree’ that
the Peer Network is
beneficial to clinicians

24.
• To ensure that clinicians in training are ready to
practice in, and gain value from, an technology
enabled environment when they graduate
• To develop and integrate competencies related to
the use of technology into the curricula design/
educational processes of the Faculties of Medicine,
Nursing and Pharmacy
• To establish Faculty Peer Leader Networks to
provide mentorship, engagement and influence
culture change related to the effective use of
technology in clinical practice and Consumer Health
solutions through innovative teaching strategies
Infoway’s Next Generation Strategy

25.
These successes positioned Infoway as a strategic investor in eHealth within Canada
The Next Generation - Impact

26.
Entry-to-Practice Competencies for RNs
Uses information and
communication technologies (ICT)
to support information synthesis in
accordance with professional and
regulatory standards in the
delivery of patient/client care:
•Uses relevant information and
knowledge to support the delivery of
evidence informed patient care.
•Uses ICTs in accordance with
professional and regulatory standards
and workplace policies.
•Uses information and communication
technologies in the delivery of
patient/client care.
Indicators (a few examples):
1.Analyses, interprets, and documents
pertinent nursing data and patient data
using standardized nursing and other
clinical terminologies to support clinical
decision making and nursing practice
improvements.
2.Identifies and reports system process
and functional issues according to
organizational policies and procedures.
3.Uses decision support tools to assist
clinical judgment and safe patient care.

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TWO AMBITIOUS GOALS FOR 2016-2017
• Establish a multi-
jurisdiction e-
prescribing
solution
• Expand
telehomecare and
patient online
services

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OUR SOLUTION
• Will enable
prescribers to
electronically
transmit a
prescription to
a patient’s
pharmacy of
choice
• This will:
• Reduce use of
paper
prescriptions
• Optimize
existing drug
system
investments
• Enhance patient

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TELEHOMECARE AND PATIENT ONLINE SERVICES
• Telehomecare
is ready to be
immediately
scaled
• Improves
quality of
life for
patients with
chronic
conditions
• Fewer
emergency
room visits
and hospital
stays
• Continue to

30.
ePractice
Connecting
the Team
Communication&
Collaboration
Connecting to
Evidence
Based
Information
Knowledge
Based Practice
Connecting to
Quality Measures
Data Analytics
Connecting
the Patient
Self –
Management

31.
Clinical Leadership – Transforming
Practice
We need to build
capacity and
integrate
the required
digital health
competencies into
Professional
Practice
Frameworks
and Models of Care

32.
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Technologies are not
simply inventions which
people employ but are
the means by which
people are reinvented.
Technologies are not
simply inventions which
people employ but are
the means by which
people are reinvented.
We shape our tools and thereafterWe shape our tools and thereafter
our tools shape us.our tools shape us.

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THANK YOU!
clinicaladoption@infoway-inforoute.ca