1. CONNECTING Ontario NORTHERN AND EASTERN REGION PRESENTATION

2. ConnectingOntario Northern and Eastern Region
Purpose
Provide an overview of the program
Explain the benefits the program will deliver to Patients and Clinicians
Physicians
Nurses
Other Health Providers
Administrative Staff
Learn how you can participate

3. Change Management Coordinator Communications Officer
Who we are:
The Northwest Health Alliance (NWHA) is a shared service organization that facilitates collaboration and integration among health service providers to improve the delivery of health care for patients in Northwestern Ontario.
The project management and decision support offices collaborate to manage regional initiatives such as ConnectingOntario Northern and Eastern Region (ConnectingOntario NER) and Resource Matching and Referral (RM&R) programs.
Key Message: The ultimate benefit for patients will be better and more timely care because a patient’s information will follow them and be accessible at the time of care.
There will be reduced redundancies and patient frustration that arise from:
missing clinical information,
duplicate tests, and the
repeating of the patient’s health history.
In addition, ConnectingOntario will also reducing delays and errors in clinicians’ manually collecting and transferring their patients’ records. X
Caroline Harding
Project Manager
Heidi Smith
Change Management Coordinator
Lawrence Badanai
Communications Officer 3

4. What is ConnectingOntario Northern and Eastern Region?

5. The problem:
Health information and records are still fragmented and scattered across electronic health information systems.
Key Message: Patient information is fragmented and scattered across care continuum.
As patient health information is increasingly captured and managed electronically, health information and records are still fragmented and scattered across electronic health information systems.
There is a lack of accessible, and integrated Electronic Health Records (EHRs), - which really impacts the quality of our health system.
There’s no single source for all the patient information regardless of where it originates and who ordered it.
There is, unfortunately, a lack of accessible, and integrated Electronic Health Records (EHRs), - which really impacts the quality of our health system.
Incomplete
Medical
Information
Delays
in Delivery
of Care
Untimely
Diagnosis
Gaps
in Discharge
Adverse Drug
Interactions 5

6. “We would like to reduce
What is needed to fix the problem?
It is…
Designed by clinicians for clinicians
A system to provide secure and easy access to electronic patient health information no matter where the patient received care in the province.
Based on clinician feedback, we heard…
“We would like to reduce
the administrative burden of manually collecting patient information and managing
paper-based records.”
“We would like an easy process of accessing our patients’ health information such as lab reports, diagnostic imaging and emergency department reports.”
Key Message: Clinicians informed us that they need a single point of access to patients’ electronic health information.
Through stakeholder forums, clinicians expressed a desire to have a single point of access to patients’ electronic health information in a secure and timely manner. They indicated that they want to be able to view this information in one central location as opposed to viewing it through multiple channels. 6

7. What is ConnectingOntario Northern and Eastern Region?
ConnectingOntario Northern and Eastern Region is one of three province-wide ehealth programs, funded by eHealth Ontario*, that will deliver electronic health record (EHR) services:
Previously cNEO
ConnectingOntario Northern and Eastern Region
Led by The Ottawa Hospital
(Program Delivery Partner)
Previously cGTA
ConnectingOntario Greater Toronto Area
Led by Sunnybrook Health Sciences Centre
(Program Delivery Partner)
Connecting South West Ontario
Led by London Health Sciences Centre
(Program Delivery Partner)
ConnectingOntario Northern and Eastern Region, previously referred to as cNEO, is one of three province-wide regional integration programs that will deliver electronic health record (EHR) services:
1. ConnectingOntario Northern and Eastern Region, previously referred to as Connecting Northern and Eastern Ontario (cNEO) – encompasses: South East, Champlain, North East and North West;
2. ConnectingOntario Central Region, previously referred to as Connecting Greater Toronto Area (cGTA) – encompasses the Greater Toronto Area: Central, Central East, Central West, Mississauga-Halton, Toronto Central and North Simcoe Muskoka; and
3. ConnectingOntario Southwest Region, previously referred to as Connecting South West Ontario (cSWO) – encompasses: Erie St. Clair, Hamilton Niagara Haldimand Brant, South West and Waterloo Wellington.
The ultimate goal of all three eHealth programs is to be able to integrate and ‘connect’ electronic patient health records throughout the region so that these records are easily accessible (in a timely and secure manner) by clinicians through a single viewer. This will be done ‘connecting’ existing HSPs and integrating electronic health care systems.
Each regional eHealth program is working closely with their respective LHINs, eHealth Ontario, and stakeholders in Ontario to ensure the success of their strategy. Together, we are sharing best practices and “lessons learned,” and regularly communicate with stakeholders to ensure that their needs and priorities are continuously aligned as the programs progress. 7
*eHealth Ontario is leading the integration of electronic health care systems across the province. Together with the Local Health Integration Networks (LHINs) and health service providers, eHealth Ontario is working to deliver integrated health care for Ontarians.

8. What is ConnectingOntario Northern and Eastern Region?}
Provincial Data Repository
You using the ConnectingOntario Clinical Viewer
Laboratory Results
CCAC Reports
Hospital Reports & Visits
Diagnostic Imaging -Common Services (2017/18)*
Medications and Drug Profiles (2017/18)*
Patient
Demographics
*Targeted date

9. What is ConnectingOntario Northern and Eastern Region?
Clinical Sectors
Hospitals
Community Health Centres
Aboriginal Health Access Centres
Long-Term
Care Facilities
Public Health
Units
Community
Support Services
Primary Care Teams
Solo Practitioners
Specialists
Mental Health
& Addictions
Key Message: ConnectingOntario will improve the patient-health care provider relationship because health care providers will have the information they need to better inform and involve patients in care decisions:
reliable access to relevant records
more comprehensive information allowing for better informed decisions.
over time, more complete information will be available to monitor progress.
It will also improve patient transition between health care providers through better coordinated and seamless information exchange.
NOTE: All other health providers (e.g. Pharmacists) can adopt as agents of a health information custodian (HIC) that is already part of ConnectingOntario NER adoption (from ConnectingOntario NER target sectors).
Community Care
Access Centres
Other Health
Providers
18,000+ clinician adopters 9

10. What is ConnectingOntario Northern and Eastern Region?
Clinician Benefits
Integrates electronic patient health information
Improves efficiency of clinical decision-making
Reduces administrative burdens
Improves ability to plan, coordinate and manage care
Key Message: ConnectingOntario will improve the patient-health care provider relationship because health care providers will have the information they need to better inform and involve patients in care decisions:
reliable access to relevant records
more comprehensive information allowing for better informed decisions.
over time, more complete information will be available to monitor progress.
It will also improve patient transition between health care providers through better coordinated and seamless information exchange.
FREE! No cost to you to use the ClinicalViewer 10

11. What is ConnectingOntario Northern and Eastern Region?
Patient Benefits
Improves quality of care and safety
Reduces wait times
Improves continuity of care
Reduces duplicate tests
Key Message: The ultimate benefit for patients will be better and more timely care because a patient’s information will follow them and be accessible at the time of care.
There will be reduced redundancies and patient frustration that arise from:
missing clinical information,
duplicate tests, and the
repeating of the patient’s health history.
In addition, ConnectingOntario will also reducing delays and errors in clinicians’ manually collecting and transferring their patients’ records. 11

12. ClinicalViewer Privacy & Security
In order for you to participate in ConnectingOntario, your organization will undergo a Privacy and Security Assessment with eHealth Ontario and will address any gaps in privacy and security .
Once using the ClinicalViewer:
Audits: Your organization requests an audit be conducted by eHealth Ontario. There are various audit reports that a site can request, such as patient specific and clinician specific reports.
Consent Directives: Patients can apply consent directives on their information at the hospital, the CCAC, or through OLIS. This can be applied to a site, an individual, or to anyone in general, and these consents can be applied to all or some information based on the patient’s request.
Key Message: The ultimate benefit for patients will be better and more timely care because a patient’s information will follow them and be accessible at the time of care.
There will be reduced redundancies and patient frustration that arise from:
missing clinical information,
duplicate tests, and the
repeating of the patient’s health history.
In addition, ConnectingOntario will also reducing delays and errors in clinicians’ manually collecting and transferring their patients’ records.
Detailed Privacy & Security information will be provided upon adoption of the ClinicalViewer. 12

13. How Will ConnectingOntario Work?

14. How will the ClinicalViewer be accessed?
Primary care, Specialist physicians and Community Care clinicians can access patient information via the:
Hospital clinicians and Community Care Access Centre (CCAC) clinicians can access patient information via:
ConnectingOntario Clinical Viewer Internet browser using ONE ID (Web Access)
Single Sign-On to the ConnectingOntario ClinicalViewer (Hospital information system (HIS) at hospitals), Client Health and Related Information System (CHRIS)
Key Message:
In the short-term, hospitals, Community Care Access Centres (CCACs) and Ontario Laboratories Information System (OLIS) will be contributing patients’ health information so that clinicians from all sectors can view this information from the ConnectingOntario viewer.
In the long-term, the goal is for all health care organizations in northern and eastern Ontario (hospitals, primary care and community care) to contribute their patients’ health information so that all other clinicians can also access this information using the ConnectingOntario viewer and/or OntarioMD-certified EMR system.
Specifically for the EMR/HRM option, unfortunately at this time, only some patient health information will be available in a clinician’s EMR through the Hospital Report Manager; a service that will push the reports into a clinician’s EMR rather than an application to access reports.
For example CCAC reports will be available in the ConnectingOntario viewer but CCAC reports will be available in the EMR at a later date in the future.
ConnectingOntario is working with OntarioMD to confirm when this would occur.
While such EMR integration is the long-term plan, this effort is in the initial stages in advance of requirements gathering. OntarioMD and eHealth Ontario are starting a proof of concept relating to single sign-on from an EMR to an external provincial service that is expected to run for a year. After that, the lessons learned from the proof of concept will be incorporated into requirements for the EMR specification, which will then then be incorporated into all OntarioMD-certified EMRs.
Key Message: Community care clinicians will be able to access all personal health information from the various sources across the province using the ConnectingOntario viewer.
Clinicians will need to:
Register with ONE® ID service via the web; and
Have their organization enroll them to the ConnectingOntario viewer to enable access.
The clinicians can then use their web browser (such as Internet Explorer or Chrome) to log in to the ConnectingOntario viewer using their ONE® ID username and password.
Key Message: Hospital based clinicians will not need to re-authenticate to access the ConnectingOntario viewer; a shortcut to the viewer will be available directly from their current hospital information system. The viewer will launch within an Internet browser window (e.g. Internet Explorer or Chrome) without the need to enter a username and password.
Clinicians will not need to search for that same patient again (i.e. single sign-on, patient context capability) when the viewer is launched.
When clinicians use their hospital information system (HIS), and then seek their patients’ health information, the systems will be integrated. The patient’s information will automatically be placed into the clinical viewer, without the need to search for that same patient again.
NOTE: ConnectingOntario viewer is complementary to the clinician’s current clinical system.
Key Message: Clinicians from Community Care Access Centres will not need to re-authenticate to access the ConnectingOntario viewer; a shortcut to the viewer will be available directly from their current information system (CHRIS). The viewer will launch within an Internet browser window (e.g. Internet Explorer or Chrome) without the need to enter a username and password.
In the short-term, hospitals, Community Care Access Centres (CCACs) and Ontario Laboratories Information System (OLIS) will be contributing patients’/clients’ health information so that clinicians from all sectors can view this information from the ConnectingOntario viewer. 14

15. Timeline (snapshot of history) Lab and Pathology Results
How will ConnectingOntario work?
The northern and eastern region is using the ConnectingOntario ClinicalViewer
Patient Demographics
Timeline (snapshot of history)
Visits/ Encounters
Documents/ Notes
Lab and Pathology Results
Mandatory Slide
Key Message: The ConnectingOntario viewer (previously referred to as the provincial clinical viewer or cGTA viewer) was designed by clinicians for clinicians.
ConnectingOntario worked with clinicians to design the system to ensure that it is:
Easy to use
Quick and to fit in with their workflow
Private and Secure
Bring clinical value.
To do this, the ConnectingOntario viewer is designed in such a way that it will be capable of being accessed and integrated seamlessly with and into existing technologies such as through a hospital information system in a hospital setting. In the future the ConnectingOntario viewer access may be integrated in clinic EMRs.
Privacy has been a major focus throughout this initiative with great care and detail going into the planning.
Information will exclusively be accessed for direct clinical care, audit will be robust and penalties for intentional breech swift and harsh.
Patients will have control over which information they do not want to be accessible.
ConnectingOntario will provide clinicians with the ConnectingOntario viewer (previously referred to as the provincial viewer or cGTA viewer) currently being adopted by clinicians in the cGTA – which is our program counterpart in the greater Toronto area.
This clinical viewer:
Provides both a 360 view of a patients current status as well as a longitudinal view over time of their care journey;
is being used currently by clinicians in cGTA; and
is being very well received and is becoming part of their daily workflow.
Clinicians have found that the clinical viewer:
Is complimentary to their existing technologies; and
Fills some gaps into their current clinical processes.
ConnectingOntario is working with OntarioMD to explore integration with office based EMRs.
The clinical viewer does not allow open-ended searches.
The search controls are as follows:
Search by Health Number, Gender and last name
Search by MRN and Organization name
Advanced search by one or more of the following parameters: first name, last name, middle name, DoB, gender, street address, city, postal code, phone number, organization
Patient Banner:
Patient Demographics:
Name, Health Care Number, Date of Birth, Gender, Contact & Address, MRN
Timeline:
Summary of patient interactions within a given period
Timeline of patients hospitalizations as well as emergency department visits. Provides a good at a glance view of any type of patterns that may present.
Portlets:
Visits/Encounters and Summary Reports:
Discharge summaries, ambulatory consult
Clinicans can use to support transitions/transfers
Examples: Inpatient; Outpatient; Emergency; Recurring; Pre-admit.
Documents/Notes:
Any document that is related to care or a procedure that is not diagnostic in nature.
Examples: Cardiac Note; Discharge Summary; Progress Note
Lab and Pathology Results:
Any lab results as provided through the Ontario Laboratories Information System (OLIS).
Can view previous blood work that has been done for better reassurance
Examples: Hematology; Chemistry; Pathology; Blood bank; Microbiology; Other (Allergen, Immunology, Serology)
Diagnostic Imaging Reports:
In this view of the Portlet, you will see any diagnostic imaging report with a procedure date / time within the timeline you have selected to view. Diagnostic images are not typically available in the ConnectingGTA Portal; however you will see reports related to the imaging.
Examples: General Radiology report; CT report; Nuclear Medicine report; Ultrasound report; Mammogram report; MR report; Special Procedures report.
Other Results:
Any document that is related to a diagnostic procedure.
The information you see in this Portlet is dictated by the timeline that you selected. There are two tabs, “All” and “Cardiology”.
Examples: Speech Language Diagnostic Report; Neurology Diagnostic Report.
Community:
In this Portlet, you will be able to view any CCAC referral that started, finished or is ongoing within the timeline you selected.
Examples: Homecare Referrals; Client Assessments; Client Risks; Long and short stay Referrals; Medical Equipment and Supplies; Service Details; Safety Information.
Any CCAC referral that started, finished or is ongoing within the selected timeline will display in this Portlet
Other Results
DI Reports
Community 15

16. How will ConnectingOntario work?
ConnectingOntario ClinicalViewer video
Instructions: Please use this slide to play the video if you do have Quicktime installed. 16

24. What does this mean for patient care?

25. What does this mean for patient care?
Meet Mr. Michael Johnson.
Male, 75 years old
Key Message: This scenario is a “real life” example from an actual family physician’s practice (names of course have been changed to protect the privacy of patients). This type of example scenario is explained to clinicians when ConnectingOntario delivers presentations like this one to clinicians.
*NOTE: The northern and eastern Ontario SDPs can assist in identifying “clinician champions” for your region: 1) to help illustrate real-life scenario examples such as this; and 2) to participate as a clinician adopter.
Meet Mr. Michael Johnson
A patient at a Family Health Clinic
Male, 75 years old
Grade 6 education, on a limited pension
History of obesity, hypertension and high cholesterol, but no known heart disease
1 month ago, he had a right knee replacement
Is currently traveling to Toronto to visit family…
History of obesity, hypertension and high cholesterol

26. Michael presents himself to the ER.
Is experiencing chest pain and shortness of breath;
Is treated and then discharged.
Key Message: Michael presents himself to the Toronto General Hospital’s Emergency Department (ED) for chest pain and shortness of breath on Monday.
He is treated at the hospital, held overnight, and then discharged home the next morning.

27. One day later.
Michael has persisting symptoms and visits his Family Physician.
He tells the physician:
Hospital did “tests”
He saw several doctors
Was prescribed medication.
Key Message: One day later, Michael presents himself to an after-hours Family Health Clinic with symptoms that are persisting.
He tells his family physician that the hospital did “tests” and the tests indicated that he “did not have a heart attack.”
But, other than that, he does not know any other specifics.
He was prescribed a medication, but he does not know what it is called and does not have the prescription container with him.
It has only been 1 day since Michael’s initial visit at the Toronto hospital.
His family physician has not received a paper copy of the Emergency Department report. (Or, if the family physician has a paper copy, it is faded, non-legible, and indecipherable).
His family physician is not able to access lab results that were completed at the hospital.
His family physician also has no reports of any imaging tests that were done, so his family physician cannot tell which tests were done, nor their results.
So, now, his family physician has to initiate a phone call to the hospital to get Michaels Emergency Department report and results, as well as initiate a phone call to the pharmacy to get the name of the medication he was prescribed.
His Family Physician has not received a paper copy of the Emergency Department report.

28. Because of ConnectingOntario - Positive Outcomes…
Michael’s family physician is able to:
Access the Emergency Department Report and Test Results;
Treat Michael quickly and efficiently.
Key Message:
As a result of ConnectingOntario, on the same day of Michael’s hospital visit, his family physician knows that he/she will be able to access a wealth of essential information.
His family physician now has access and can view an electronic copy of Michael’s Emergency Department report and test results from the provincial clinical viewer.
His family physician can gain access to this using his/her ONE® ID account via the Web.

29. Michael and his family physician are confident in the care plan.
Because of ConnectingOntario - Positive Outcomes…
Saved time;
Duplicate tests were avoided;
Increased confidence;
Appropriate care was provided.
Key Message: As a result of ConnectingOntario, both the clinician and the patient are happy.
Michael and his family physician are confident in the care plan.
Michael is now on the road to recovery.
Michael and his family physician are confident in the care plan.

30. Who is participating IN THE region?

31. Who is participating in the region?
Regional and Local Physician Leads & Patient Advisors
Physicians Leads
Patient Advisors
Donna Perrin
Dr. Martin Vogel, Northern and Eastern Region
Dr. Stephen Viherjoki, North West
Coming Soon: North East
Donna Perrin
Mandatory Slide
Key Message: ConnectingOntario Northern and Eastern Region has confirmed the commitment of physician/clinician leads to help build awareness, garner support and participation from their clinician colleagues.
The Physician Lead for the program is responsible:
To serve as the spokesperson for the program’s awareness campaigns and adoption presentations – to provide a clinician perspective;
To develop and execute the program’s adoption and training;
To provide clinician leadership across all work streams including: change management and privacy and security;
To supports clinician-related activities including clinical use-case scenarios and performance measurement.
Northern and Eastern Region Service Delivery Partner Physician/Clinician Leads are responsible: (North West, North East, Champlain & South East)
To act as the Service Delivery Partner spokespeople for their local region;
To encourage local clinician support, participation and adoption;
To deliver local speaking engagements, presentations, information sessions, meetings and special events.
Dr. Thérèse Hodgson, Champlain
Dr. Aly Abdulla, Champlain
Coming Soon: South East
Keith Taylor 31

32. Who is participating in the region?
Clinician Adopters (Users)
Health Service Providers (HSPs)
Organizations
Partner
Service Delivery Partners (SDPs)
South East –
Kingston General Hospital
Champlain –
The Ottawa
Hospital
North East -
Health Sciences
North
North West -
Northwest Health
Alliance
The Ottawa Hospital
OPTIONAL Slide
Key Message: This is a graphic depiction of all the parties involved, and shows how they relate to each other. Please note the Service Delivery Partner who is the local contact in your region.
Partnerships and collaboration are critical to the success of this complex initiative.
Importance of clearly-defined roles and responsibilities cannot be overemphasized.
[Differentiate between the PDP vs. SDP vs. HSP]
Program Delivery Partner (PDP)
Integration Networks
Local Health
Sponsor
eHealth Ontario
Ministry of Health and Long-Term Care 32

33. What about other electronic health Record (EHR) initiatives?

34. What about other EHR initiatives?
Clinical Value Projects
The northern and eastern region and Service Delivery Partners are collaborating with the LHINs, health service provider organizations and eHealth Ontario on the transition strategy for the clinical value projects such as:
NER
EMR
HIS
EHR
CVP
HSP
CVD
Physician Office Integration (POI) (North West & North East regions); and
Eastern Ontario Clinical Document Repository (EOCDR) (Champlain & South East regions).
Key Message: The northern and eastern region and Service Delivery Partners are collaborating with the LHINs, health service provider organizations and eHealth Ontario on the transition strategy for clinical value projects such as POI and EOCDR. 34

35. What about other EHR initiatives?
Regional EHR Services
Eastern Ontario Clinical Document Repository (EOCDR)
Champlain BASE Project - eConsultation (eConsult)
Northern and Eastern Ontario Diagnostic Imaging Network (NEODIN) Viewer
Physician Office Integration (POI) - North East region
Physician Office Integration (POI) - North West region
Provincial EHR Services
Diagnostic Imaging – Common Services (DICS)
Drug Profile Viewer (DPV)
Electronic Children’s Health Network (eCHN)
Integrated Assessment Record (IAR)
ONE Services
Ontario Laboratories Information System (OLIS)
Ontario Telemedicine Network (OTN)
Panorama
The Northern and Eastern Region has fact sheets available for the following electronic health record services
Key Message: The program recognizes that there are other regional and provincial EHR services that provide value to clinicians.
As per stakeholders’ request, the program has developed fact sheets to explain about each service available.
These fact sheets are available on the ConnectingOntario website at: 35
For more information, visit:

36. How will connectingontario make this happen?

37. Stage 2 December 2015 – May 2017 (In Progress)
NWHA Progress
Implementation Timeline
Stage 1 March 2015 – November 2015
Hospital and CCAC Due Diligence 
Stage 2 December 2015 – May 2017 (In Progress)
Hospital Development, Testing, Contribution Go-Live
Hospital Single Sign-On
View-Only Site Engagement and Due Diligence
Stage 3 June – March
End User Training and Registration
Mandatory Slide
Key Message: We are now in the implementation of the program. This diagram summarizes what this involves, including scope, delivery and associated timing.
ConnectingOntario implementation consists of three (3) streams of activity:
Clinical Viewer Delivery Pilot Project -
Hospitals & CCAC providing clinical data for integration into the provincial clinical viewer -
18,000+ clinicians participating as ConnectingOntario adopters - 37

38. How to Participate
Learn about the northern and eastern region program via the region’s eBulletin.
A great snap shot of progress updates.
Tell us what you think.
Lend your support.
Participate as a regional partner site and/or clinician adopter!
Mandatory Slide
Work with you LHIN to reach the SDP
Find out about the program
Work with your community to identify the opportunities and the challenges
Develop recommendations for collaborative way forward 38

39. Clinician Feedback – Here Add Local Examples
“We are excited to be a part of the solution in improving the efficiency of information exchange!“
Jocelyne Maxwell
Executive Director
Centre de Santé Communautaire du Temiskaming
“We have gained valuable information about the journey of ConnectingOntario, and we will continue to do our best to contribute to this great program. We believe that participation in in the program will always bring value to our organization and our patients.”
El Mostafa Bouattane
Chief Privacy Officer, Montfort Hospital
"For me, ConnectingOntario will help improve the efficiency of my decision-making process since it will provide me with timely and secure access to electronic patient documents and reports.“
Dr. Chris Bourdon, MD
Vice President, Medical & Academic Affairs, Health Sciences North
Mandatory Appendix

40. questions?
Contact us at: Northwest Health Alliance 290 Munro Street, Suite 2100 Thunder Bay, ON P7A 7T1 Phone: Fax: