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Government & policy

eHealth Ontario to refine EMR communication for doctors

TORONTO – eHealth Ontario’s Physician eHealth Program is seeking to launch an Electronic Medical Record (EMR) Health Information Exchange Proof-of-Concept project to demonstrate how data within EMRs can be securely and efficiently delivered to other authorized clinician EMRs, clinical repositories and healthcare research organizations.

According to eHealth Ontario, only rudimentary data transfer methods exist today and require access, policy and data sharing agreements in each situation, and often bypass foundational ehealth services (e.g., user identity, auditing, logging.)

The existing approach for transferring data adopts a many-to-many model where EMRs “push” data directly to receiving organizations or healthcare settings, requiring each stakeholder needing that data to manage customized network connections with potentially thousands of user accounts.

Existing arrangements also require: Point-to-point connections between each EMR instance, and each stakeholder must be established and managed separately (including separate security keys and certificates); Network connections are separate and additional to connections used to support data (e.g., Ontario Laboratories Information System, Hospital Report Manager); Potentially thousands of user accounts are required for each stakeholder to access and transfer data over the network connection from each EMR instance; EMR vendors must identify the data to be extracted and the method of transferring data for each stakeholder.

An alternate approach is required that includes a more robust data routing mechanism which will allow:

• Alignment with eHealth Ontario foundational services, utilizing existing eHealth Ontario delivery mechanisms.

• Secure, reliable data transfer, with Message queuing; guaranteed delivery; feedback and error management; translation of messaging formats between stakeholders and EMRs; anonymization; business rules for pre-validating message integrity prior to transfer.

• Repeatable, expandable, extendable data transfer, with only one channel for each Electronic Medical Record (EMR) to exchange information through: One registration, one link per EMR instance, one set of credentials/security keys versus separate registrations, authentications, keys for each EMR instance for each vendor for each target stakeholder (thousands). The communications channel should be able to be leveraged for both EMR data in and data out.

• One channel for each stakeholder to receive data through; one registration for each stakeholder receiving data; one set of credentials/security keys versus one for each EMR instance (thousands); EMRs ‘enrol’ with target stakeholders (e.g.: CIHI, BORN, etc.) to direct outputs accordingly.

This EMR Health Information Exchange Proof-of-Concept will leverage a select group of stakeholders with immediate and well defined EMR Health Information Exchange requirements (potentially CIHI and BORN) to effectively demonstrate an alternate approach that will enable secure and reliable data transfers and require less customization and management for EMR users, EMR vendors and health care organizations.

The purpose of the EMR Health Information Exchange Proof-of-Concept project is to:

• Demonstrate a provincially expandable and extendable mechanism through which data residing within EMRs can be securely and reliably delivered to other authorized health care provider EMRs, clinical repositories, health care and/or health system research organizations;

• Demonstrate use of a shared secure channel through which to transfer EMR data;

• Identify required supporting processes and governance;

• Demonstrate EMR functionality for registering, selecting and configuring “data out” transfer;

• Develop high level provincial deployment strategy.

Posted July 4, 2013