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Karl Mallory



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    OS12 - Smart Consumers (ID 21)

    • Event: e-Health 2019 Virtual Meeting
    • Type: Oral Session
    • Track: Health Business Process
    • Presentations: 1
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      OS12.04 - Closing the Circle of Care in First Nations Communities (ID 53)

      Karl Mallory, Mallory Consulting Ltd.; Victoria/CA

      • Abstract
      • Slides

      Purpose/Objectives:
      Over the past year, the Closing the Circle of Care Project has made excellent progress. A partnership between Cowichan Tribes and Canada Health Infoway supports First Nations across Canada to adopt purpose-built digital health tools. 100+ First Nations are working with us to improve digital health capacity and enable patients with access to their health records. We are collaborating with First Nations and their healthcare partners to advance interoperability, clinical workflow coordination and patient access ? all with the objective of closing the circle of care for First Nations community members.


      Methodology/Approach:
      Cowichan Tribes is a leader in digital health solutions and understands the challenges of implementing digital health tools in First Nations health centres. Canada Health Infoway has a long, successful record of digital health tools implementation. Combining our knowledge, we have developed a comprehensive implementation methodology that addresses the many challenges on-reserve health centres encounter when they transition from siloed, paper-based health systems towards transformative digital health tools. Our National Expansion Project works with interested First Nations across the country to enhance privacy and security capacity, address technical infrastructure gaps, migrate data, manage change, and support adoption and use of new digital health tools for both health centre providers and community members. This comprehensive approach resonates with the First Nations we?re working with and up to 137 First Nations organizations across Canada are implementing the Mustimuhw community EMR (cEMR) and Mustimuhw Citizen Health Portal (an interoperable Personal Health Record). Many First Nations have gone live and are beginning to benefit from their new digital health foundation. Many are now seeking to leverage the interoperability within their new digital health tools to create more tightly coordinated care models with their healthcare partners while increasing the scope and value of patient-accessible health records in the Citizen Health Portal.


      Finding/Results:
      Since our presentation at this conference last year, the number of First Nations participating in our project has increased significantly. As workflows transition from paper-based to electronic, many opportunities for standardization are being identified and advanced. We are working with funding and support agencies to bring efficiencies to screening activities, reporting functions, transitions of care and other areas of day-to-day operations. We are working with regional groups to explore how the growing use of these tools can support surveillance, epidemiology, program evaluation, health transformation, Nation-based capacity development and First Nations Health Data Sovereignty. But perhaps most importantly, hundreds of health care providers in First Nations health centres are now benefiting from practical digital health tools, and their patients are able to access their own health records, communicate electronically with their care providers and participate meaningfully in their circle of care.


      Conclusion/Implications/Recommendations:
      Our results continue to indicate that the implementation of a foundational cEMR and an interoperable PHR solution is a viable, practical and efficient digital health strategy for First Nations. Provincial health care partners should continue their work with First Nations communities, leverage this new digital health capacity and advance opportunities to improve circle of care coordination for First Nation community members.


      140 Character Summary:
      The Mustimuhw cEMR and Citizen Health Portal are advancing capacity and circle of care coordination for First Nations health teams and community members

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    PS06 - Digital Health Innovation Across Canada (ID 41)

    • Event: e-Health 2019 Virtual Meeting
    • Type: Panel Session
    • Track: Executive
    • Presentations: 1
    • Coordinates: 5/28/2019, 02:30 PM - 03:30 PM, Pod 4
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      PS06.02 - Digital Health Roadmap: A First Nations-Led Strategy in Ontario (ID 79)

      Karl Mallory, Mallory Consulting Ltd.; Victoria/CA

      • Abstract
      • Slides

      Purpose/Objectives:
      A foundational level of digital health capacity is a necessity for First Nations health centres to manage their service delivery responsibilities. Not only is this true simply for efficiency, client-safety and privacy, but interacting electronically is the de-facto standard for coordinating care with provincial partners ? essential given the limited scope of health services available on-reserve. Recognizing the importance and urgency for digital health capacity in First Nations health centres, the First Nations Health Information Management in Ontario Initiative (FNHIMiO) developed a Digital Health Roadmap to support transition from paper-based processes and position First Nations in Ontario to access and use digital health tools best suited to their needs. Guided by a group of experienced First Nations Health Directors and clinical champions, FNHIMiO has systematically assessed requirements, identified corresponding tools, developed implementation processes and successfully supported several First Nations to build a foundation to effectively work in a 21st Century healthcare environment.


      Methodology/Approach:
      The FNHIMiO Roadmap approach follows a simple, pragmatic sequence: First Nation Health Centre Health Information Needs Review and Initial Change Management Privacy and Security Enhancement and Change Management Assist with Local System Adoption, Use and Change Management Support Access To/Use of Provincial eHealth Systems Develop and Implement Sustainment Model Key to this is the willingness of an initial group of First Nations to experiment with, refine and validate the Roadmap approach. Once validated, the approach is extended to other interested First Nations. In this way, FNHIMiO is now extending foundational P&S support to many First Nations, establishing information sharing agreements with provincial agencies, enabling immunization program coordination with provincial systems, and enabling access to provincial digital health assets.


      Finding/Results:
      The Roadmap approach is currently being followed by several First Nations across Ontario. The number of First Nations health centres who are benefiting from enhanced P&S capacity, digitally-enabled communications with provincial partners, and local digital health tools that improve efficiency, ease reporting burdens and improve client safety is steadily growing. Requests from other First Nations for assistance is similarly growing, as is support from First Nations leadership to leverage the work of FNHIMiO, and digital health capacity in general, to address inequities in health care for First Nations community members and support First Nations Health Transformation objectives.


      Conclusion/Implications/Recommendations:
      The FNHIMiO Roadmap approach is working. It is helping First Nations take a needs-based approach to build digital health capacity. By taking a methodological and pragmatic approach to integrate care processes with provincial partners, FNHIMiO is reducing overhead and enabling the adoption of standard models that can be extended and sustained. It is recommended that provincial partners explore opportunities to coordinate around the Roadmap approach and that First Nations in other regions explore its adaptability for their own benefit.


      140 Character Summary:
      A digital health Roadmap is bringing benefits to First Nations clients, providers and partners and supporting Health Transformation.

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