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K. Hay



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    OS14 - Leveraging Successes and Lessons Learned (ID 21)

    • Event: e-Health 2018 Virtual Meeting
    • Type: Oral Session
    • Track: Clinical Delivery
    • Presentations: 1
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      OS14.01 - Ontario’s Digital Health Immunization Repository (ID 526)

      K. Hay, Ministry of Health and Long Term Care; Toronto/CA

      • Abstract
      • Slides

      Purpose/Objectives: To enable the vision of a provincial immunization system where individuals, healthcare providers, and public health all have real-time access to the same immunization information, Ontario is taking an innovative, coordinated approach to facilitate easier collection of and access to complete, accurate, and timely immunization information. Our goal is to improve health outcomes by making comprehensive immunization information accessible in real-time to support healthcare providers in clinical practice and to engage the public as active partners in the management of their own health.

      Methodology/Approach: Employing HL7 FHIR® messaging and SNOMED-CT® terminology standards, the Ontario Ministry of Health & Long-Term Care has created a technology and policy infrastructure around the provincial Digital Health Immunization Repository (DHIR) that forms the foundation of a broader interoperable ecosystem for immunization data in Ontario.

      Finding/Results: Ontario’s Digital Health Immunization Repository (DHIR) is a clinical data repository containing more than 96 million immunization records for more than 6.5 million Ontarians. The DHIR is currently accessed by Ontario’s 36 public health units through a web-based tool (Panorama), in support of population and public health programs. The ministry has developed a number of integrated extensions to support public health units’ immunization activities. We are working towards enabling the public to update and view their immunization records in the provincial DHIR through a web-based service called Immunization Connect Ontario (ICON) or the Digital Yellow Card. The ministry is trialling a number of approaches to public authentication through ICON, starting with public health unit public identity verification and credentialing, moving to use of the Health Number, and piloting the use of banking credentials. Lessons learned will inform future approaches to public authentication for access to health data online. The DHIR’s corresponding secure web services will enable broader provincial Electronic Health Record (EHR) integration. The ministry is now provisioning for health care providers to submit and look up immunization records in the DHIR through a clinical version of ICON, and through direct DHIR integration with electronic medical records (EMRs) and regional clinical viewers. Expanded consumer access to immunization records beyond ICON will be accomplished through integration of the DHIR with consumer mobile applications and patient portals.

      Conclusion/Implications/Recommendations: The DHIR advances Ontario’s digital health goals and objectives, helping to ensure a population that is optimally protected against vaccine-preventable diseases.

      140 Character Summary: An HL7 FHIR® based technology ecosystem that supports clinician, public health, and consumer access to immunization information in Ontario.

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    OS23 - Labs, Drugs and Rock & Roll (ID 42)

    • Event: e-Health 2018 Virtual Meeting
    • Type: Oral Session
    • Track: Clinical Delivery
    • Presentations: 1
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      OS23.02 - Ontario's Digital Health Drug Repository (ID 350)

      K. Hay, Ministry of Health and Long Term Care; Toronto/CA

      • Abstract
      • Slides

      Purpose/Objectives: Ontario’s Comprehensive Drug Profile Strategy (CDPS) aims to improve the health and wellness of Ontarians and the quality of care received from health care providers through integrated secure access to a patient drug profile for all Ontarians. The CDPS will enable the Best Possible Medication History for a patient, and supports Ontario’s response to the opioid crisis. The CDPS leverages existing assets where possible to build a comprehensive drug profile that captures information on dispensed drug events (and potentially prescribed events in the future) for all Ontario residents. The Digital Health Drug Repository (DHDR), the foundational first project of CDPS, provides a clinical data repository and corresponding secure web services that enable provincial Electronic Health Record (EHR) integration and facilitate expanded access to ministry drug data holdings (i.e., Ontario Drug Benefit (ODB) claims data and Narcotics Monitoring System (NMS) data). This data store provides the capacity and security necessary to share clinical data appropriately and meet user access demands expected of the system, as well as support the long-term CDPS vision of a repository containing ‘All Drugs, All People’ and contribute to the broader goal of a fully integrated EHR in the province.

      Methodology/Approach: Using a HL7 FHIR® enabled repository, the DHDR provides access to patients’ medication information, including ODB claims and NMS data. The DHDR is currently available to Ontario clinicians through regional clinical viewers (Clinical Connect and Connecting Ontario). Clinical access will be expanded to include integration with hospital information systems and electronic medical records. Public access to their drug data will be enabled by DHDR integration with consumer portals and applications. In the future, DHDR will be expanded to include additional clinically relevant data (e.g., dosage information) as well as additional data sets (e.g., electronic prescriptions and privately-paid and other medication event data).

      Finding/Results: The DHDR provides clinicians in Ontario access to more complete information on patients’ medication history to improve the health and wellness of Ontarians and the quality of care received from health care providers through integrated, secure access to a patient drug profile, enabling the Best Possible Medication History and supporting the Ontario Opioid Strategy.

      Conclusion/Implications/Recommendations: The DHDR advances the goals and objectives of the CDPS vision of ‘All Drugs, All People’ and contributes to the broader goal of a fully integrated EHR in the province by providing clinicians and consumers access to a patient’s medication information.

      140 Character Summary: Development of a HL7 FHIR® based repository that supports clinician and consumer access to patient medication information in Ontario.

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