The healthcare system in Ontario is over-burdened and strained. Patients languish in the hallways of hospitals, lying on stretchers or waiting in emergency rooms, waiting to be allotted to a room so that their treatment can begin. This situation is not normal. Patients and their caregivers come under immense stress due to a lack of access to proper health services, supervision and follow-up, comfort and even a basic right to privacy. Navigating the system is very hard, getting a family member into long-term care is even harder while securing cancer care carries its own challenges. The condition of many patients worsens daily as they wait interminably in the hallway, waiting for a bed. What’s more, access to mental health and addiction services is often denied to patients who need it on an urgent basis.
The reasons for this are many:
- Overcrowding due to a surge in demand for beds, as in the annual flu season. Occupancy is found to be unsustainable at almost all times.
- 15% of the acute care beds (about 3000 beds) are generally occupied by patients who are medically discharged but waiting for an “alternate level of care” to be arranged, like a long-term care space, rehab bed or adequate home care arrangements.
- Too many patients go to hospital emergency rooms which are open 24×7, for conditions that could get treated elsewhere.
- Hospitals fail to use existing beds as efficiently as possible.
- Home care and community-based mental health care have insufficient capacity with an inadequate number of beds to meet the health needs of the province and its population.
Let’s look at some numbers for Ontario’s healthcare processes:
- Average wait times in Ontario: 16.3 hours in June 2019 against 14.4 hours in June 2018, while touching a peak of 18.3 hours in the flu season in January 2019.
- The lowest time of 3.6 hours was recorded at the four-bed Lion’s Head Hospital in rural Bruce Peninsula while the Greater Niagara General Hospital clocked an average wait time of 37.3 hours in June.
- Target time of 8 hours was only met for 34% of patients
- Number of acute-care beds in Ontario hospitals is just 20,000
- However, 6000 more long-term care beds are being built across Ontario.
Ontario Health Teams – A pathway to offer efficient Health Care
Ontario Health Teams plan to ensure that the patient is put at the centre of health care service delivery, which is expected to be built resiliently and managed efficiently. The vision of OHTs includes tackling and ending the problem of hallway care. This has brought a new vision and hope to patients, caregivers as well as health care providers. As an OHT increases the collaboration among health care providers and services become more accessible to patients, we will see Ontario offering a futuristic, more reliable health care system, for its communities.
Technology to the Rescue
The operations of OHTs shall be based on 8 building blocks, of which digital health is one. The aim is to record and share all the digital health records of a patient, among an OHT’s partners. Such adoption of digital health tools helps to streamline and integrate point-of-service systems and use the patient’s health data for effective healthcare delivery, decision support, operational insights, ongoing quality and performance improvement, and better patient experience.
With just one phone call or a visit to one website, patients will be able to access the health system and secure the services they need, for themselves or their family members. Digitized health records will enable emergency departments to access a new patient’s entire medical history, including recent lab reports using their Ontario Health Insurance Plan (OHIP) card to provide the best health care possible, in the shortest possible window of time. Health IT in Ontario makes it possible to provide virtual care to a senior patient at home, without a trip to the hospital!
An integrated health care system built around centrally accessible electronic health records shall improve health care processes and make it possible for resources to follow the patient, instead of having the patient come in and experience an agonizing wait in a hospital’s hallway.
The province of Ontario is set to create an integrated, digitized, innovative and efficient health care system which will be able to respond to the long and short-term needs of its patients. This bold vision for the province of Ontario has four set objectives. These objectives are aligned with an internationally recognized framework known as the ‘Quadruple Aim’, which informs the design and delivery of effective health care systems.
The government of Ontario is committed to adopting the four objectives of the Quadruple Aim, which are as follows:
- Improving the patient and caregiver experience;
- Improving the health of populations;
- Reducing the per capita cost of health care; and,
- Improving the work life of care providers.
All the recommendations and actions under the new vision are expected to bring about a positive change in each of the areas listed under the Quadruple Aim, in accordance with the broader vision of providing every patient in Ontario access to the services of an Ontario Health Team.
How Digitization Helps Realize the Major Goals of OHTs
The various OHTs aim to create integrated care delivery systems in Ontario with their own leadership, accountability and governance models. The OHTs will have to meet performance expectations and ensure that the care provided is connected, coordinated and comprehensive, meeting the vision set by the Quadruple Aim. These goals can all be realized through digitization which makes it possible for all the members of the OHTs to have access to the health records of a patient with their permission.
Digitized records enable the caregivers to analyze any milestone in the journey of a patient through the health care data, and offers the following benefits:
- The new approach to health care adopts a digital first approach and enables virtual care. This ensures that patients need not go to an emergency department to access basic services and even helps them to avoid admission to a hospital, if not necessary.
- Patients get connected to the right level of care at the right time and get easy access to services throughout the health care system.
- Care providers will have the access needed to the medical records of patients and will not need to re-order a fresh set of identical tests or waste time by waiting for them.
- The fact that the hospital, the home-care agency and family doctors will all belong to one team now makes the sharing of health records easier.
- Resolves the issues leading to hallway care across the hospitals in Ontario or of patients being discharged without arranging for any follow-up care.
- It becomes easy to know what kind of follow-up care will be required by them, either at a different facility or at home after they get discharged from the hospital.
- Enables a patient to journey through the health system smoothly, as the OHTs provide integrated care, ably supported by common resources, performance expectations and planning tools at the provincial level.
While there is no prescribed right or wrong way to set an OHT up and there will also be no supervisory interference into the functioning of an OHT, digitization of records is the right way to go. Nothing can replace its effectiveness in enabling OHT’s members to work collaboratively. This will ensure that the continuum of care envisioned by the province of Ontario gets delivered to the residents of the province, when they need medical attention.
Microsoft finally released Azure API for FHIR in general availability to azure customers, thereby becoming the first cloud with a first-party service to ingest, persist and manage healthcare data in FHIR format.
Azure API for FHIR helps manage and exchange health data in HL7 FHIR format in the cloud. Through this service healthcare providers and payers (including developers, researchers, device makers, or anyone working with health data) can easily connect existing data sources such as electronic health record systems and research databases.
With FHIR becoming the standard of choice for exchanging and managing healthcare information in electronic format, this turnkey platform from Microsoft is capable to spin a new cloud-based FHIR service within minutes and begin securely managing PHI data in Azure. To that extent, FHIR has truly revolutionized healthcare interoperability.
Also, because of normalized data in FHIR format it is now easy to merge and understand differently configured data sets for accelerated machine learning development. And as providers test, develop and research optimal models for their health systems, the normalized data output can be securely and easily exchanged with any application interface that works with FHIR API.
Therefore, some of the benefits that Azure API for FHIR brings to healthcare teams include– pay what you use, optimized latency and performance, and providing on-demand, scalable machine learning tools with built in controls for security and intelligence.
Some key features of the Azure API for FHIR are:
- Enable and start running an enterprise-grade, managed FHIR service in just a few minutes without considerable development team effort
- Support for R3 and R4 of the FHIR Standard
- Track audit logs for access, creation, modification, and reads within each data store
- Secure compliance in the cloud: ISO 27001:2013 certified, supports HIPAA and GDPR, and built on the HITRUST-certified Azure platform
- Role Based Access Control (RBAC) – allowing you to manage access to your data at scale
- Global Availability and Protection of your data with multi-region failover
- SMART on FHIR functionality
Whether it’s improving operational efficiency or a need for secure data exchange and interoperability platform, the Azure API for FHIR available for all Azure customers is a game changer. This is why Azure on FHIR is now fueling the potential of machine learning and life sciences in healthcare to deliver better health outcomes.
To learn more about Azure API for FHIR, read here.