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Karl Mallory



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    OS13 - PHR Storms Across Canada (ID 19)

    • Event: e-Health 2017 Virtual Meeting
    • Type: Oral Session
    • Track: Clinical and Executive
    • Presentations: 1
    • Coordinates: 6/06/2017, 01:00 PM - 02:00 PM, Room 201CD
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      OS13.01 - Mustimuhw Citizen Health Portal – Centering Patients in First Nation Healthcare (ID 243)

      Karl Mallory, Mallory Consulting Ltd.; Victoria/CA

      • Abstract
      • Slides

      Purpose/Objectives: First Nations have built an approach to health around an empowerment philosophy where the patient is an active member in their care. However, this approach has historically not included a patient’s ability to electronically communicate with their providers, nor have easy access and input to their own health records. The Mustimuhw Citizen Health Portal changes that. With funding from Canada Health Infoway, a project was launched in April 2016 to evaluate consumer health models in a First Nation community where patients are interacting with on-reserve health centre clinical providers and with physicians in the local division of family practice. Typically, barriers to effective clinical information sharing have impeded interaction between health centre providers and physicians and caused challenges for effective circle-of-care models. Patients have also not had the ability to directly interact with their health records, or communicate electronically with members of their care team. As the largest First Nation in BC, Cowichan Tribes is a national leader in leveraging health information management to enable member-driven, or consumer-driven, health services and care. The Mustimuhw Citizen Health Portal, now deployed, extends the consumer-driven healthcare model further by leveraging the use of increasingly popular PHR technology and connecting patients and providers. With the project proving successful, and foundational PHR interoperability established, the Mustimuhw Citizen Health Portal can now be extended to other First Nations both in BC and in other provinces where consumer-driven healthcare models may benefit the community and enhance coordination and information sharing between providers.

      Methodology/Approach: The Mustimuhw Citizen Health Portal uses an Infoway-Certified PHR Platform that enables patients to provide and access targeted personal health information. Health Centre providers and local physicians are aligned and enabled to provide this information to their shared patients and to consume patient-provided information. Patients are empowered to self-manage privacy and access across providers, and within their family, to enhance the continuity of information to their benefit. Interoperability efforts have focused on information flow between the RelayHealth PHR, the Mustimuhw cEMR, physician EMRs and a private lab while parallel efforts focused on patient and provider engagement and PHR adoption and use.

      Finding/Results: To date, response and willingness to adopt has been strong by the target user groups. Efforts are currently underway to improve interoperability, increase adoption, and support ongoing use of the PHR solution by patients and providers. Activities are now underway to extend the use the Mustimuhw Citizen Portal in other locations, and extend the scope of data and functionality.

      Conclusion/Implication/Recommendations: Early results indicate that a PHR solution is a viable and beneficial consumer health tool within First Nations communities. Use of a PHR can address longstanding issues and challenges that previously have impeded patient access to health services and provider access to important patient data. Given that there are many similar health care requirements across First Nations communities in Canada, and many similarities in the challenges posed to effective information sharing between First Nations and provincial providers, a recommendation can be made to extend this project’s model to other First Nations within Canada.

      140 Character Summary: The Strengthening the Circle of Care project brings a practical consumer health solution to First Nations through use of the Mustimuhw Citizen Health Portal.

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    OS16 - Evolving Access for Remote Communities (ID 22)

    • Event: e-Health 2017 Virtual Meeting
    • Type: Oral Session
    • Track: Clinical
    • Presentations: 2
    • Coordinates: 6/06/2017, 01:00 PM - 02:00 PM, Room 202CD
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      OS16.03 - First Nations in Ontario – New Focus on Practical eHealth Pathways (ID 241)

      Karl Mallory, Mallory Consulting Ltd.; Victoria/CA

      • Abstract
      • Slides

      Purpose/Objectives: In another abstract an updated approach for the First Nations Panorama Deployment in Ontario (FNPDiO) project was explained. This presentation provides examples of project success/challenges at the level of the individual First Nation Health Service Organizations (FNHSOs) the project works with. Overall, the FNPDiO project has a goal to support FNHSOs in Ontario to identify and develop practical health information management processes. Our scope began with access to provincial immunizations tools and data, but has grown to incorporate broader requirements. Analysis makes a few things clear. First, FNHSO access to provincial eHealth tools is necessary to support effective circle of care for First Nations. Second, many challenges impede access to provincial eHealth tools. Third, provincial eHealth tools on their own are not complete solutions for FNHSOs as they are not designed to support specific First Nation requirements, and as a result local eHealth tools and solutions are also required. Given this clarity, the project developed a suite of eHealth “pathways” that are meaningful and relevant to FNHSOs. The term “pathway” describes an identified health information management priority, plus the methodology, templates, etc. that enable access to relevant systems/tools. By focusing our discussion on three FNHSOs working through the various FNPDiO “pathways” we will describe how progress is being made, how challenges are being resolved and how the overall model is validated/refined for possible expansion to other FNHSOs. Our examples will highlight access to provincial immunization data and systems (DHIR), implementation and use of community electronic medical records (cEMR), access to provincial clinical viewers (ConnectingOntario), and use of Personal Health Records in conjunction with other local health care providers. Multiple pathways may be applicable to a specific FNHSO, and local capacities for enabling and sustaining these pathways may vary between FNHSOs. However, the underlying requirements that must be met to enable any pathway are similar (e.g. network connectivity, P&S frameworks, etc.) and these will also be discussed.

      Methodology/Approach: With advice from our Advisory Group, the project team developed a set of detailed processes to enable the pathways that address priority FNHSO health information management needs. Our presentation will describe the pathways process from the perspective of three of our Initial Subscriber FNHSOs. We will identify and discuss the commonalities across pathways, describe the necessary collaboration with provincial partners, and share our experiences on FNHSO-level change management efforts and strategies.

      Finding/Results: The pathways developed through the project are proving successful with the project’s Initial Subscriber FNHSOs. Through our work with them and their provincial partners, the pathways approach is being refined and communicated to other FNHSOs in hope that the outputs of the project can be beneficial more broadly to First Nations in Ontario and support meaningful advances in First Nations eHealth.

      Conclusion/Implication/Recommendations: The project has been successful in using a systematic methodology to identify and support FNHSO health information management priorities. This approach can improve workflow and circle of care coordination with provincial partners. Other FNHSOs in Ontario should be supported to benefit from the project’s success.

      140 Character Summary: A “pathways” approach is being used in Ontario to bring practical and meaningful solutions to First Nation health centre information management priorities.

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      OS16.04 - First Nation Health Information Management – Aligning with Ontario eHealth Strategies (ID 168)

      Karl Mallory, Mallory Consulting Ltd.; Victoria/CA

      • Abstract
      • Slides

      Purpose/Objectives: In 2008, the First Nation Panorama Deployment in Ontario (FNPDiO) project began between Chiefs of Ontario, First Nations and Inuit Health Branch Ontario Region and the Ontario Ministry of Health and Long-Term Care with a goal to support First Nations use of the Panorama Public Health Surveillance System. Time has passed and eHealth strategies have changed, including how Panorama is used in Ontario. However, the pressing need for on-reserve health information management tools and processes, including interoperability with provincial providers, remains largely unfulfilled. In response, the project restructured with expanded scope, emphasis on aligning First Nations requirements with evolving provincial eHealth strategies, and with a practical circle-of-care focus that includes significant collaboration with First Nations, Public Health Units and Local Health Integration Network staff. Immunization information management is still a priority interest, but it’s become clear that a more holistic view of health centre information management is needed. To this end, the project team is now supporting First Nations Health Organizations to assess their need for information management across their range of clinical program management and then match identified needs to eHealth systems available in the environment – from ConnectingOntario clinical viewers, to interaction with the Ontario Digital Health Immunization Repository (DHIR), to use of community EMRs, to Personal Health Records. Properly enabled, this broader range of systems can address long-standing challenges that have impeded First Nation from taking advantage of eHealth advances.

      Methodology/Approach: The FNPDiO project follows a needs assessment, provincial integration, and implementation toolkit methodology proven successful in similar First Nations eHealth projects. Guided by a First Nations-led Advisory Group, the project team developed tools to identify discreet health centre information management requirements and priorities and match these to available systems. The approach also supports facilitating system access/implementation. The methodology is flexible and accommodates varying requirements and priorities across health centres, plus it aligns strongly where necessary to the evolving and expanding set of eHealth tools and services being introduced by the province of Ontario (e.g. DHIR, ConnectingOntario, PHIX, ICON, etc.). At its core, the project methodology also takes into consideration the many non-system enablers of eHealth system access/use (e.g. P&S, information governance, ongoing support, etc.) and establishes a foundation that builds eHealth capacity within First Nations Health Organizations.

      Finding/Results: First Nations Health Organizations in Ontario have begun to access and use required eHealth systems through the project. We are now working to extend the successful methodology to others while continuing to work with partners to identify and support new system access/use models in an ever-evolving eHealth world.

      Conclusion/Implication/Recommendations: The First Nation eHealth environment is complicated. However, experience has demonstrated that with patience and a focus on practical clinical requirements, progress can be made. The methodology used to support First Nations in Ontario to improve their eHealth capacity should be made available to all who have a demonstrated need. This methodology and its outcomes likely have relevance in other provinces as well. Success on the FNPDiO project should be shared wherever possible.

      140 Character Summary: The FNPDiO project has developed an approach to support First Nation health info mgmt. priorities in alignment with provincial strategies. It is working.

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    OS22 - National First Nations eHealth Innovations in Healthcare (ID 49)

    • Event: e-Health 2017 Virtual Meeting
    • Type: Oral Session
    • Track: Not Rated
    • Presentations: 2
    • Coordinates: 6/07/2017, 08:30 AM - 10:00 AM, Room 201EF
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      OS22.03 - BC First Nations Panorama Implementation (ID 387)

      Karl Mallory, Mallory Consulting Ltd.; Victoria/CA

      • Abstract
      • Slides

      Abstract not provided

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      OS22.05 - Mustimuhw Peer-To-Peer Network: Community-Based Best Practice Development (ID 389)

      Karl Mallory, Mallory Consulting Ltd.; Victoria/CA

      • Abstract
      • Slides

      Abstract not provided

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