Linking providers

In health care, efficient communication of information can be a tricky thing – but it’s key to providing the best patient care possible. That’s why Ontario’s Smart Systems for Health Agency (SSHA) has taken up the task of enabling the electronic interchange of data between health care providers.

According to Linda Weaver, the organization’s chief technology officer (CTO), SSHA’s goal is “to provide the information technology infrastructure for health care provider communication. “Our mandate is to deploy an infrastructure to enable them to communicate with each other and store and communicate information in a secure manner.”

Weaver said the SSHA, which formally began operating as an arm’s-length agency of the Ontario government in January of 2003, has a five-year deployment plan to get the entire sector connected – 20,000 network sites and 150,000 e-mail and PKI users.

The goal is to improve the way personal health information is shared among doctors’ offices, hospitals, public health offices, pharmacies, labs and community care centres in Ontario – whether that be prescriptions, medical images or lab test results.

In order to achieve this, SSHA is building an infrastructure that, through the use of a secure, private network and data centres for secure information storage, will link health care providers. One of the ways to connect them is through e-mail.

“We don’t mean to replace the entire e-mail system in the health care sector,” Weaver said. “The purpose is to design something that will allow hospitals to send physicians information on patients in urgent circumstances; it will allow people to move information around with the confidence that the information is only going to get to the person that it is sent to and that it is secure in the process of getting there.”

Weaver said EDS finished building the SSHA’s secure e-mail system last fall.

The SSHA will eventually provide “a common place to access health records or to get to different parts of the health community,” Weaver said. As a first step toward creating a central repository for electronic patient records, the Integrated Services for Children division of Ontario’s Ministry of Health and Long-Term Care moved its information system into the data centre last month.

The SSHA will also have the infrastructure to provide portal hosting, an online directory (like health care White Pages), and hosting services for its clients.

As a step toward realizing its goal, the SSHA in February signed a $30-million outsourcing deal with Hewlett-Packard (Canada) Co. Under the contract, HP Services has completed the initial configuration of two customized and highly available secure data centre environments.

“They are providing us with an environment that doesn’t flip off every time we have a blackout,” Weaver said. “The data centre floor space they are providing us is a secure and reliable place to put our core infrastructure.”

HP is putting walls around the floor space and managing access in and around the building, as well as the power and heat, lights and air conditioning.

The agency also has agreements with network providers like Allstream, Bell and HydroOne Networks. Qunara, a subsidiary of Manitoba Telecom Services, was contracted to build the PKI and registration system. Microsoft also works with the SSHA on a day-to-day basis, and a “huge number of other vendors” are contributing their technology to the infrastructure.

The SSHA’s initiative is not intended to be a substitute for other health information sharing strategies already out there. “There are tonnes of health information technology initiatives in the government and hospitals and we’re not replacing any work that is going on in them,” she said.

Weaver said the SSHA provides the “glue” to enable providers to move the information they have to other providers who need it. “It’s intended to leverage those (other initiatives) and make them more effective. We’re creating the in-between space…that will enable all those things to be able to communicate. It will allow (health care providers) to get access to things, send things more rapidly and make sure that they are doing it while maintaining security.”

Wally Hogan, managing director of managed services for HP Canada, said SSHA’s initiative is really about breaking new ground. “They are changing the whole playing field with respect to the e-health agenda…. When you look at all of this, to be able to pull all this information together and manage it in a central and controllable way has tremendous benefits. It’s all very complex but it’s one step toward accomplishing that goal — to provide that IT infrastructure capability and the policies and procedures around it. That makes it a launching pad that will enable us to move along the e-health agenda’s path.”

Apart from security concerns, which health care providers “constantly have to deal with,” Weaver said one of the biggest challenges for e-health is the sheer enormity of the health care sector.

“(It’s) huge – there is a lot of activity, a lot of pressures on cutting costs and making things more efficient. It is very hard to have anything that’s coordinated. Until the hospitals have all their information in electronic form and all move to an electronic environment, e-health won’t succeed. But they all agree that it’s a good thing to do this, and each part of the health care system, as well as other players, including the Ministry, have their role.”

Weaver said the province of Ontario has done a lot of work to draw all the pieces of e-health together. “We have a common agreement about what we are trying to get at.”

Ontario has its own E-Health Council in which hospitals, physicians, continuing care and the Ministry are participants. “They’re communicating about what e-health is and what it means,” Weaver said, “and they’re trying to figure out what their role is in the whole process, what to do to get to the next level.”

Patricia Pickett is a department editor at ComputerWorld Canada who specializes in IT workplace and management issues. She can be reached at

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