Newfoundland is on the last lap of its journey to create an interoperable electronic health record.
The Newfoundland and Labrador Centre for Health Information recently signed agreements with Telus Communications Co.’s health division and with Toronto’s Orion Health, a software company, to put the final pieces together for an iEHR.
When complete in two years the solution will allow clinicians across the province to see patient medical and lab records meeting standards set by Canada Health Infoway, said Mike Barron, CEO of the centre. The centre is a Crown agency that acts as the health CIO for the province.
“We see this as the closure of the first provincial Infoway-compliant blueprint E.H.R. in the country,” he said in an interview.
“I won’t say it’s the end of the journey, because in some ways it’s the beginning of another. But it’s the end of the E.H.R, journey we began in 2001.”
Overall the project will cost between $26 million and $28 million.
Telus [TSX: T] laid the foundation for the system in 2009 ago by creating the provincial Health Information Access Layer (HIAL), which manages interactions between clinical systems held by hospitals, pharmacy management systems, provincial repositories of medical data and personal data.
As part of the HIAL, Telus Health also created a network connecting pharmacies in the province to a drug information system. It lets participating pharmacists see medication dispensing records for some 185,000 patients (about 34 per cent of the province).
In the latest agreement, Telus will add the ability of medical lab reports – including digital imagery – and what area called shared health records – such as radiologist reports attached to X-rays — to be accessed by clinicians through the HIAL.
It will also integrate the Privacy eSuite consent management service of Health Information Protection And Associated Technologies (HIPAAT) into the HIAL. This solution allows patients to approve which clinicians are allowed to see what parts of their medical records.
Orion, which specializes in eHealth applications, will provide its Concerto Clinical Data Repository as the database for the lab results and shared health records. As part of that it will also have to develop a standard (or what Barron called a data dictionary) so all labs can contribute their results.
Finally, Orion will provide its Concerto Clinical Portal, a desktop client viewer that will allow authorized clinicians to see the all personal data, including hospital records.
“We think this is a very significant win for us,” said Gary Folker, Orion’s senior vice-president. Aside from a small project several years ago, it’s the company’s first important contract in Newfoundland. It also has implementations in five other provinces.
Glenn De Roy, Telus’ vice-president of health delivery services, said the deal is an extension of the carrier’s relationship with the centre, which began in 2006 when it was awarded the contract to create the HIAL.
When the access layer was built it didn’t have all of the capabilities that are needed today, De Roy said in an interview. The latest contract allows those to be added.
Ultimately, he also said, Telus hopes to sell the HIAL in other jurisdictions.
Initially, Barron said, the unified iEHR will be available in one of the four provincial health regions, but it will eventually be extended to all of them.
In the end, he said, there will be a “provincial enterprise health architecture” giving authorized clinicians a “one stop” online location with a consolidated view of all hospital information.
The next challenge will be adding personal health records held by doctors.