1. Sandy Lum University of Toronto Candidate MHSc in Clinical Engineering The Totally Integrated Electronic Patient Record (EPR)

2. Problem  Unconnected islands of hardware, software and data  ADT  PACs, RIS  Cardiac Data Management Systems  Medical Devices ADT PACS CLINICAL FUNCTIONALITY CLINICIAN FRUSTRATION NAVIGATIONAL COMPLEXITY CARDIOLOGY DATA Mngt.

3. Problem  Access to patient information isn’t quick or easy  Multiple user ids/passwords to remember  Not all available clinical information is being used

4. Solution A Totally Integrated EPR

5. Integrated EPR - Goals  Complete and dynamic clinical information  Real-time access to ALL information and active clinical functionality any time, anywhere, and from any device  Efficient workflows and processes that adapt to a changing health care environment  Improve security and privacy of health records  Improved quality of care and patient safety

6. Barriers  Information stored in silos  Vendor Compliance  Proprietary protocols  Legacy systems  Incompatible standards

7. Achieving Integration DICOM IHE Integration CCOW HL7

8. CCOW  Applications are visually integrated when they work together in ways that the user can see in order to enhance the user's ability to incorporate information technology as part of the care delivery process.

9. Integrating Health Enterprise (IHE)  Promotes coordinated integration of information systems throughout the healthcare enterprise (IHE Technical Framework)  Defines implementation profiles for the transactions between information systems  Patient synchronized applications  Enterprise User Authentication  Demonstrate efficiency and increased functionality of interoperability

10. Current Integration Options  Portals  Web based integration of disparate systems

11. Current Integration Options  Visual Based Integration

12. Medical Devices  Infusion Pumps  Patient Monitors  Dialysis Equipment  Bar-coding Applications  Medical Administration Records

13. Significance  Increasing need to capture information electronically  Need to be aware of IT constraints in equipment selection  How are we going to get vendor compliance?

14. Conclusions  A fully integrated information system will provide caregivers with tools :  Improve patient safety  Support the delivery of effective patient care  Facilitate management of chronic conditions  Improve workflow efficiencies  Increase utilization of Patient Records by reducing user frustration

15. Questions?