Integrated care refers to the coordinated continuum of care provided to patients even if they are not in the same physical location as the care provider. Integrated care delivery enables providers and health systems to improve health outcomes through real-time collaboration, access to system navigation services, and seamless transition throughout the patient-care journey.
Ontario Health Teams, therefore, are a new model of integrated care set up to innovate care delivery within a geographic region. The eventual goal of the OHTs is to provide integrated services to patients, families, and communities to improve health care in Ontario.
Integrated care across the OHTs is possible by following these tenets of health care delivery:
- Timely access to patient health information for decision making at point-of-care;
- Smoother patient transitions between health care providers and geographies;
- Better coordination of care between multiple practitioners, and within health care teams;
- More efficient workflow and reduced dependency on paper-based systems;
- Lower cost, better-quality patient experience by eliminating duplicate tests;
- Improved monitoring over time to support chronic disease management;
- Fewer gaps in patient information as patients move between hospital, practitioner’s office, home care and long-term settings; and
- Continuous improvement in the delivery of care with data to support a population health approach and research activities
Each serving up to 300,000 people, Ontario Health Teams will share funding as well accountability as they bring providers together. Funding will now incentivize care for patients who are in most need, instead of the earlier preference given to a patient’s age and sex, which made healthcare providers prefer admitting healthier patients.
Some Pre-requisites for Delivering Integrated Care
- Ontario maintains a series of provincial data repositories containing important patient records and digital health information. These repositories include historic as well as current data gathered from care and diagnostic settings across the province. Such repositories can help support Ontario’s transformation toward integrated care delivery and health sector efficiency.
- The direction set by four general digital health policies will support the implementation and/or use of all the digital health systems:
- Digital Health Information Exchange Policy
- Digital Health Investment and Value for Money Policy
- Digital Health Access, Privacy and Security Policy
- Digital Health Reporting and Performance Policy
- A robust in-house digital strategy or with home-grown health IT companies to deliver disruptive solutions such as real time care team collaboration, secure messaging, and secure EHR data access.
Benefits of Integrated Care in OHTs
Eventually the care delivered through OHTs would be connected and fully shared across the Ontario Health Teams network including hospitals, home care providers, acute care providers, primary care providers, doctors’ offices and mental health providers. This approach is expected to reduce duplication of efforts through effective coordination, which would ultimately benefit the patients and their caregivers. Among other things, OHTs will help:
- Connected care teams in the OHT (including in social service agencies) address social factors which are the root cause of illness, like unemployment, housing and poverty.
- Reduce gaps in providing home care services and mental health services.
- Meet expectations at a lower cost than a pre-established benchmark, and thus help keep a portion of the savings to invest in improving direct patient care.
- Enable digital solutions like patient, portals, secure messaging, virtual provider visits and virtual consultations.
Finally, Integrated Care is quintessential for the OHTs to succeed and achieve common goals related to patient experience, provider collaboration, improved health outcomes, and value based care. And while different OHTs will have different approaches to reach this common goal of providing integrated care, it will help create a coordinated continuum of care which would improve healthcare in Ontario by leaps and bounds.
The Ontario Health Teams are being introduced as an innovative model of care, set to transform the healthcare landscape in Ontario with new ways to organize and deliver services to patients and achieve better health outcomes. This connected health care system will be centered around patients, families, and caregivers, enabling patients to navigate the system and transition between providers. With its high-performing, integrated care delivery system, an OHT will offer seamless, coordinated care for patients, improving population health in the province.
Why the need for Ontario Health Teams?
No one can deny the fact that healthcare delivery in Ontario today needs to be revamped and re-imagined to stay sustainable and to deliver on its promise of improving care outcomes. In order to understand why there’s a need to overhaul the current system with Ontario Health Teams, it is important to understand the lacunas in the current system at play.
Some of the results of a disconnected, siloed healthcare system in Ontario are:
- Patients are kept waiting for very long periods, on all levels of care needed. The wait periods are growing everywhere.
- Hospitals are resorting to hallway care, jeopardizing the health and well-being of both patients and their caregivers alike, as hospital beds are underutilized and funding for new beds is not meeting the growth in demand.
- Leveraging technology to treat patients when and where they need it most and to get patients involved in their own care is an absolute need of the hour.
- At the end of a clinical interaction, clinicians may refer patients to other providers, prescribe drugs, order lab tests or imaging, or apply for supports such as assistive device coverage. Conventionally, these activities are fax-and-paper-based, resulting in significant administrative burden and provider burnout.
- The digital tools developed to address these problems have been developed in siloes, and there is significant fragmentation and that leads to too many solutions that are not interoperable.
- EMR integration is also not consistently available for all eService solutions, or all EMR users.
Therefore, to help create a more integrated ecosystem for patients and providers alike, the concept of Ontario Health Teams took seed. Here are some of the important questions that OHTs will answer once fully operational.
What does OHT mean for providers?
With Ontario Health Teams, knowledge and experience of healthcare providers will now be leveraged to provide integrated care to Ontarians with:
- Timely access to updated information
- Improved communication and collaboration with other HCPs
- Avoidance of duplication and unnecessary costs
- Increased productivity and efficiency
- Access to learning resources
- Improved information management
- Improved clinical decision-making and quality of care
- Reduced administrative burden
What does OHT mean for patients?
With fully operational Ontario Health Teams, patients will be able to experience connected care – one where their primary care teams and specialists collaborate over a single platform to improve care outcomes.
- Patients can expect to be closely monitored and experience seamless healthcare journey across various points-of-care.
- The ER doctor will be able to access provincial data, with the patient’s consent, and check medication records.
- The patients need not repeat their medical history multiple number of times nor will they have to repeat tests which have been already issued.
- At the time of discharge, the patient will receive a care plan and may be eReferred to a different specialist. They may also go through an eConsultation if the specialist is not available.
- Their family physician will receive eNotifications informing them of the hospital admission and treatment received by the patient.
- The patient’s recovery may be monitored by a specialist through a virtual video visit with the findings recorded in their integrated health record.
Eventually the care delivered through Ontario Health Teams would be connected and fully shared across the Ontario Health Teams network including hospitals, home care providers, acute care providers, primary care providers, doctors’ offices and mental health providers.
To learn more about enabling integrated care solutions in an Ontario Health Team, visit here.
Ontario Health Teams (OHT), a path-breaking initiative taken by the Ontario government to end hallway health care is slowly taking shape. This new healthcare system will focus on delivering connected care centered around patients and their families. Through OHT, doctors, hospitals, community and home care providers will be able to collaborate and deliver integrated care no matter where they are located. As a result, the idea of a connected team helping patients traverse the healthcare system is paving way for modern healthcare innovation.
The Ministry of Health started the process of shortlisting applicants with an open call for self-assessment for Ontario Health Teams. Consequently, based on the self-assessment forms, the teams were classified on their level of readiness. In total, 31 teams were deemed to be well-positioned for completing the full application. Here’s the list of the 31 teams invited for full-application for Ontario Health Teams.
Ontario Health Teams – Locations
Ontario Health Teams – Full Application List
||Team Name (Provisional)
||Muskoka and Area OHT
||Connected Care Halton OHT
||Hills of Headwater
|Toronto – North West
||North Toronto OHT
||West York OHT
||North York Central Health System OHT
||Southlake Community OHT
||Eastern York Region and North Durham OHT
||Great Barrie Area OHT
||Guelph and Area OHT
||Brampton, Bramalea, North Etobicoke, Malton and West Woodbridge OHT
||Ottawa Health Team/Équipe Santé Ottawa
|Ottawa – East
||ÉSO Ottawa-Est/Ottawa East OHT
||All Nations Health Partners OHT(Kenora)
||Near North Health and Wellness OHT
|Sault Ste. Marie
||Équipe Santé Sudbury and Districts OHT
|Toronto – North East
||North Toronto OHT
||East Toronto Health Partners
||Huron Perth and Area OHT
||Chatham Kent OHT
Apart from 31 full applications, 41 other applications were deemed in-development after readiness assessment. The number of Ontario health teams is expected to increase with time, and therefore the vision of a web of connected healthcare teams oriented towards patient-centered care is bound to help end hallway care in Ontario.
Keeping this goal in mind, Corolar FHIR Server for Microsoft Teams is helping ease the transition for healthcare teams to a more integrated approach to care by extending patient data from EHRs to Teams. Corolar FHIR Server, therefore, enables care-coordination, clinical consults, secure messaging, telehealth and much more for Ontario Health Teams. To learn more about our solutions for Ontario Health Teams click here or book a meeting with our healthcare specialist here.
Health data interoperability has been one of the biggest talking points for the healthcare industry in 2019. As providers, vendors, and developers navigate the murky waters of incoherent data standards, the Fast Healthcare Interoperability Resource standards or FHIR standards have been helpful in enabling seamless, on-demand information exchange.
Recently, CMS (Centers for Medicare and Medicaid Services) came up with a proposal outlining the future approach to information blocking, the use of FHIR, and the role of APIs in interoperability. While the healthcare industry had been using the FHIR standard on a voluntary basis for some time, the proposed guidelines by ONC (Office of the National Coordinator) have made FHIR the required standard for development. Going forward, the standardization of FHIR will be critical for health IT teams to meet the obligations as 2015 Edition Certified EHR Technology (CEHRT) vendors.
The FHIR standard helps build a set of resources which aim to define the information contents and structure for the core information set which is shared amongst disparate systems.
“FHIR resources can be used to build documents that represent a composition: a set of coherent information that is a statement of healthcare information, particularly including clinical observations and services,” HL7 says. “A document is an immutable set of resources with a fixed presentation that is authored and/or attested by humans, organizations and devices.”
A FHIR resource, therefore, can include metadata, text or different data elements to create clinical documents, accessible and usable by multiple disparate systems. With the release of FHIR R4, the developers will have the capability to offer normative content for the data standard, something that is critical to implement FHIR consistently and uniformly.
While the use of FHIR for CEHRT and the latest guidelines by ONC to establish FHIR as the standard of choice has really pushed the envelope for improving interoperability, a lot of healthcare providers still need handholding to venture into the complex world of health data standards.
Corolar CDR (Clinical Data Repository) through FHIR
Corolar CDR connects to any existing Integration Engine through a FHIR Server. It ingests both clinical and non clinical data into a data repository. Corolar CDR can easily run on premise as a Microsoft SQL instance or in the cloud as an instance of Azure SQL.
Corolar FHIR Server for Health Analytics
Corolar FHIR Server enables Healthcare Organizations to ingest clinical and non-clinical data from any existing Integration Engine, through a FHIR Server, into a CDR (Clinical Data Repository). Leveraging Microsoft Power BI, this data repository can be harnessed by Healthcare Organizations for Health Analytics (customized reporting and dashboards) and for Machine Learning, all of which results in better efficiency and outcomes for patients.
Corolar FHIR Server for Microsoft Teams
Corolar FHIR Server for Microsoft Teams is an HL7-FHIR compliant FHIR API integration solution. This Solution ingests clinical and non clinical data from any existing Integration Engine, through a FHIR Server. This solution brings clinical EHR data, in HL7 format, into Teams in FHIR format for efficient care coordination. Thus, our solution enables clinicians at adopting provider facilities to leverage the incredible collaborative capability of Teams while easily accessing clinical data from EHR systems like MEDITECH, Epic, Cerner, etc. using FHIR APIs. Our solution makes it easy for Health IT to support clinician requests for secure, private, and easy to use collaboration scenarios.
Dapasoft’s Expertise In FHIR in the Cloud
Today, the most agile healthcare organisations are looking to bridge old and new technologies and Dapasoft’s cloud solutions are easing this transition. As your organization’s FHIR projects grow you can now be assured full support for FHIR STU3 standards on Microsoft Azure using Corolar Cloud. We provide LogicApps components native to Azure to handle FHIR requests, FHIR responses, HL7 to FHIR transformations, and FHIR ACK for healthcare enterprises.
Server mis-configuration is turning to a key vulnerability leading to PHI breaches. In a major health data leak, the University of Washington Medicine disclosed that data related to 974,000 patients was left exposed on the internet for three weeks because of a misconfigured server. This is the latest instance of patient data privacy at risk due to improper use of healthcare systems.
The breach came to light when one of the patients found a file with their own data while searching for their name on Google. The matter was brought to the attention of UW Medicine after which an internal investigation was carried out. It was later found that protected health information reporting files were visible by search on the internet from Dec. 4, 2018.
The misconfiguration occurred because of a coding error when data was being moved onto a new server. The files, according to UW Medicine, ‘contained patients’ names, medical record numbers, and a description and purpose of the information. The files did not contain any medical records, patient financial information or Social Security numbers.’ However, for some patients, the files did include the names of lab tests but not the results.
The breach was discovered on 26th Dec and UW Medicine took steps to remove the information from their site and any other third-party sites which might have saved the information related to patient data.
“Because Google had saved some of the files before December 26, 2018, UW Medicine worked with Google to remove the saved versions and prevent them from showing up in search results,” officials said in a statement. “All saved files were completely removed from Google’s servers by Jan. 10, 2019.”
It must be noted that this is the second instance of data breach at UW Medicine. Back in 2013, social security numbers and medical data of 90,000 patients became vulnerable when an employee opened an attachment containing malware. At that time, the provider paid almost $750,000 over the breach with an assessment to address patient data risks and vulnerabilities.
This time around UW Medicine officials have said that they will be reviewing their protocols and procedures to prevent such similar breaches in the future. For now, the breach has been reported with the Office for Civil Rights.
Server mis-configuration such as the one at UW is likely to overtake ‘phishing’ as a top source of breached data according to the Chief Security Officer at Box and current partner at Andreessen Horowitz Joel de la Garza.
A prime example of other instances such as UW medicine is the server security mishap at Rubrik, an enterprise software company focused on cloud data management. There, a misconfigured AWS Elasticsearch server led to private data exposure of major customers of Rubrik.
In a high-risk environment, organisations need to be wary of data leaks such as these. And while it’s safe to assume that this trend is poised to continue, the need of the hour is to educate the IT teams and staff about cybersecurity, data privacy, and data integrity.
Source: UW Medicine/Newsroom
In December last year, a report by Spiceworks pegged Microsoft Teams as the second most used business chat app, ahead of Slack and behind Skype for business. This incredible growth and fast adoption of Teams has been phenomenal, especially considering that the app just launched two years ago.
So, how did Microsoft Teams go from just a fringe chat app with minimal adoption to being the fastest growing business app in Microsoft’s history?
Real-time collaboration and chat applications have become new age communication tools which append the usefulness of workplace emails by providing a secure and team-based platform. These new applications work across multiple operating systems and offer multi-disciplinary functionalities including group chat, video conferencing, meetings, and data sharing. For any organization big or small, a single tool which is resourceful enough to replace various internal disparate communication systems, brings immense value.
From 2016 to 2018, Microsoft Teams grew from 3 percent to 21 percent in terms of app penetration. This growth was amplified by Microsoft’s decision in 2017 to make the app available to business users of Office 365, for free. While other competitor applications like Slack also offer free versions, Microsoft amped the product with functionalities which specifically targeted industries like healthcare. This led to Microsoft Teams defining its own niche within the business app category and beating the competition at its own game.
A good example of this strategy from Microsoft is the schedule-management feature that debuted with rave reviews. Using the schedule-management feature in Teams, managers can create, share, and edit staff schedules within employee groups. The employees too can swap shifts, and request time off using this functionality.
Another example of Teams as an innovator in niche industries like healthcare is the new patient-care coordination offering. Although right now in private preview, the new offering integrates the platform with electronic health records and provides secure messaging which is highly relevant in the healthcare industry. Secure messaging helps healthcare professional stay HIPAA-compliant when sharing patient data and information through chat apps.
“New experiences for Firstline workers will roll out to Teams over time. With this expanded feature set, Teams is the hub for teamwork for all workers,” a spokesperson had said back in September 2018. These new features coupled with the fact that 87 of the Fortune 100 companies are currently on the platform establishes Teams as the go-to workplace collaboration app.
A string of new functionalities provided a shot in the arm for the Teams app, but its success is based on more than just workplace productivity features. Teams is the perceived leader for security, manageability, and cost-effectiveness, which makes it the preferred choice over Slack, even though both apps are neck-to-neck in terms of reliability, compatibility, and user-friendliness.
While it’s difficult for collaboration apps to replace conventional communication tools like emails completely, applications like Teams help in making workplace communication faster and efficient. The end goal for business users, therefore, is to leverage apps like Teams for real-time group collaboration without worrying about the security of such communication.
Integrating FHIR-enabled electronic health records with Microsoft Teams is now available in exclusive Private Preview. To learn more and register, click here.