Digital Access to Health Information

The G&A OHT Digital Health Working Group (DHWG) will assist our partners to complete the following tasks in order to provide our patients with at least some digital access to their health information:

– Optimize and expand use of System Coordinated Access (SCA) eReferral which sends emails to patients to confirm and provide information about their appointment. This includes appointment details, prep instructions and provides patients the ability to confirm their appointment by email. It then updates the referring physician record once complete.

– Expand the use of CognisantMD (OCEAN) secure patient messaging application to provide patients with the opportunity to acquire and send their Personal Health Information.

– Expand the use of existing online appointment booking systems (e.g. Caredove) which also give patients digital access to their appointment information and secure messaging. Guelph FHT physicians are already using online booking and EWFHT will start using an online booking system in October.

Additionally, the DHWG will explore the feasibility of expanding other current digital access applications including the following:

– MyChart as a regional portal for patient information including care plans for our priority populations

– Current practices at CMHAWW will be supported, sustained and considered for spread to other patient populations within the OHT. These include sending PHI to CMHAWW patients via email encrypted attachments such as a “Next Steps” letter confirming the next steps in their care an

– A longer-term objective will be to complete the development of the Waterloo Wellington Mental Health and Addictions Portal (WW MH&AP), hosted by CMHAWW CaseWorks. Currently the WW MH&AP allows 10 mental health and addiction agencies (including hospital MH&A outpatient services) to access referral information and manage waitlists. Further development could allow patient digital access to their mental health and addiction health information. Once established for this population this functionality cou

Solution Review Criteria

Proposed addition or expansion of applications to address Digital Access to information will be reviewed by the DHWG using these criteria:

  1. Solution applies to our Year 1 priority patient populations
  2. Solution is scalable to all attributed regional patient populations
  3. Solution is sustainable because of:

– Funding
– Change management support
– Approval of Admins, Clinicians and Patients
– Clinical Value confirmed from tested organizational
workflows including in the emerging Integrated Primary Care Team (IPCT) model
– Operational Value confirmed from tested patient, family caregiver, provider and organizational workflows
– Feasible interoperability with regional partners systems solutions

4. Patient Safety – Risks have been evaluated and controlled as required

5. Security and Privacy risk assessments – Acceptable impact on security and privacy policies and procedures

Background on our recommended solutions

System Coordinated Access (SCA) eReferral

The eHealth Centre of Excellence (eCE) is the regional delivery partner of the System Coordinated Access (SCA) Program, outlined in the Ontario Health Teams: Digital Health Playbook (August 2019). The SCA Program deploys the Ocean eReferral technology developed from an innovation procurement (with a consortium consisting of Think Research, CognisantMD and the Centre for Effective Practice) delivering more than 60,000 eReferrals integrated from within primary care EMRs (Telus PSS, QHR Accuro, OSCAR).

A key component of the Ocean eReferral technology developed by the consortium is how it builds on long-term patient / clinician relationships that assists in a shared interpretation of information. Patients who have consented with their primary care provider, receive information about their referral and can confirm appointments through e-mail in a way that securely updates their record in both the referring clinician and receiving clinician records.

CognisantMD (OCEAN) secure patient messaging

Cognisant MD (OCEAN) Patient Messages allows providers to securely send messages and attachments with PHI to patients. Additionally, patients can interact with their providers by completing forms and questionnaires online. With Ocean’s EMR integration, patient records are seamlessly updated without any scanning, typing, or manual staff involvement.

Achieving the 10-15% target will be moderately difficult for the following reasons:

– Sustainable funding is required to support the MyChart platform once the Canada Health Infoway funding expires. We are committed to evaluating the implementation options and exploring partnerships with community, regional and provincial partners to support the spread of existing instances of MyChart to optimize the sustainability of the MyChart platform.

– SCA, “Next Step” letters, eReferrals all require on-the-ground resources to enable the collection of email consents from primary care patients. We will leverage existing infrastructure and the continued support of the eCE QBIC team to support this work.

– Provincial funding is required to support the completion of the development of the Caseworks Access Portal. If that funding becomes available, we will explore how the Caseworks Access Portal can be leveraged to support patients with mental health and addictions needs, as well as other patient cohorts, by providing digital access to their health information.

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