1. Dr. Chris O’Connor (OSOS established 2006)

2. Institutional Advantages to POS  Standardizes treatment protocol for patients -> provides consistency  √ hospital safety standards = Accreditation  Supports Canadian Rx Standards (CHEST)  Reduces prescribing errors  Reduces length of stay and re-admissions  Reduces workload  Used as cost-control mechanism  ≠ Legal liability of treating Clinician and Staff

3. Protocol Development How:  Historically individualized per Institution  Inpatient and Outpatient = 2 streams  Based on evidence-based medicine, guidelines, personal experience and belief

4. Protocol Development How Long:  Many months Time to gain consensus and time to implement Process requires approval from all affected departments and committees (e.g. Joint Practice Teams, Lab, Pharmacy, Safety Committee etc.) Costly:  Labor (creating & managing protocols) & Distribution and Printing

5. Multidisciplinary team Required Approval by applicable Joint Practice Teams (e.g. Ortho, ER, ICU etc.) Approval by Lab General Circulation for comments Assess for Standard Formatting Approval by MAC Approval by P&T Approval by Pharmacy Approval by other committees (e.g. AB Use, AC Committee) Approval by other committees (e.g. AB Use, AC Committee) Any one can initiate a protocol

6. Types of Protocols for Innohep  Ambulatory, ER and Inpatient settings: ◦ initiation, bridge, switch and discharge TBD  Cancer Patients  Renal Patients  Surgical Patients

7. INNOVATIVE SOLUTION

8. Patient Order Sets (POS)  POS (formerly OSOS) is a collaborative network dedicated to improving healthcare through the use of evidence-based order sets http://www.PatientOrderSets.com  Dr. Chris O’Connor, ICU MD, Trillium  Endorsed by OHA and OHTAC = Bill 46 (Excellent Care for All Act 2010) OHQC  POS has created a comprehensive order set solution including: content ~ design ~ lifecycle best practice, sharing and project support -> Entry Point platform

9. POS History  Dr. Chris O’Connor founded Open Source Order Sets in 2006  It is now known as Patient Order Sets http://PatientOrderSets.com/http://PatientOrderSets.com/  Critical Care Physician at Trillium Health Centre (2000 to present) and Director of Medical Informatics (2003-2008); Dr. O’Connor received the ‘Emerging Leader in Canadian Informatics Award’ in 2007  In 2006, the Trillium order set project won the first Ministry of Health and Long Term Care award for innovation in patient safety and quality for improvements in patient care  Endorsed by the OHA as a recommended best practice in Ontario Hospitals  100% Member renewal rate

10. POS History Since being founded in 2006, PatientOrderSets.com has:  Grown into a network of over 140 hospitals in 5 provinces in Canada = reads like a ‘who’s who’ of our major HC partners  Demonstrated improvements in patient safety, quality of care, reduced patient length-of-stay and reduced re-admission to hospitals  The only order set solution selected in Canada in over 3 years  Has been implemented across the health care system from small rural hospitals to large teaching institutions, hospital networks, chronic care and mental health

11. Sample of a POS

12. SAM Value Proposition Concept  Sponsor a Cancer Centre ~ Institution ~ Renal Centre to membership with the committed ROI of allowing LEO access to the POS network -> and the predetermined partnership project of creating and disseminating Innohep protocols  Sponsor an organization like CHEST and offer the opportunity for them to post updated guidelines (Dr. Bill Geerts or Dr. Mark Crowther may agree to spearhead this all in advance of the anticipated February 2012 new guideline release; and LEO could support the formation of their independent advisory council = arms length compass group  Determine whether, through an unrestricted grant, access would be extended to LEO as an official business partner. HTX just entered this realm by providing $750 K for the purpose of integrating the current network with CPOE and EMR systems = Entry Point platform