Kim Wieringa, Assistant Deputy Minister of Health Information Systems at Alberta Health, the provincial government’s health ministry, in conversation with Contributing Editor, Andy Shaw.
CHT: Kim, Alberta has a reputation for being innovative and far-reaching when it comes to health information systems, so we have a lot we can talk about. But let’s start with you first. What would you say you personally bring to the job you have now?
Wieringa: Well, it’s been a journey to get here. I spent a lot of time in my early career as a business analyst working in corporate systems. I’ve also had six years of academic training, including certifications in human resources, information technology and project management. My goal in anything I do is to serve the end-user in a way that makes sense to that individual, but also serves the organization well. My background means I can take a concept from legislation and make it operational in a real-life environment.
CHT: I understand you left Alberta Health and were out of healthcare and IT for seven years, but returned in 2013 to head up Alberta Health’s electronic record services branch before being promoted to your current position. You’ve been ADM going on two years now, so you can probably tell us exactly what your Health Information Systems division does these days.
Wieringa: Our division administers the Heath Information Act, which sets out the rules for the collection, use, disclosure and protection of health information. We also oversee three e-health systems: the personal health record, Alberta Netcare (the province’s electronic health record) and the Provincial Health Information Exchange. We also operate a number of Alberta Health systems such as the provincial health outbreak surveillance system and the Pharmaceutical Information Network, as well as all systems that are used to pay doctors.
CHT: Wow, that’s a lot to look after. Do you ever get time to go home?
Wieringa: It’s a busy job, for sure. But it also has a tremendous impact, both for healthcare providers and Albertans. And I have a great team working with me.
CHT: How busy are you these days with Alberta’s patient portal?
Wieringa: We are continuing to expand its functions and increase the amount of information that’s available through the patient health record. Right now, we are in a testing phase with about 1,200 volunteer users. We’re moving forward in a prudent way, because we want to make absolutely sure we have a secure way of identifying users and providing the best possible protection of people’s health information. To that end, we are working with Service Alberta on a digital identity program that will actually allow Albertans to validate their individual identities and create an online login that will then be used to access other government services online. The personal health record is the first service to use the government’s My Alberta Digital Identification system.
CHT: How much health information will patients be able to access via the portal?
Wieringa: Patients can currently access information about dispensed drugs, and the personal health record will soon have over 50 different lab test results available to early enrollment users. It’s also important to point out the huge potential for the personal health record to be used as a wellness tool where users will be able to track their weight, BMI (body mass index), blood pressure, diabetes, etc. When it’s fully launched, it will be optimized for mobile and will have the capability to sync with other well-known fitness devices.
Another feature of the personal health record is that it’s linked to myhealth.alberta.ca, which launched in 2008 and is a trusted source of health information for Albertans. So in future, let’s say you receive a lab test result you’re concerned about, right away you can find helpful information about it on myhealth.alberta.ca.
CHT: How will people actually start accessing their records?
Wieringa: They will first login to the myhealth.alberta.ca website and apply for an ID, which will send them to Service Alberta to get their virtual digital identity. For that, they’ll need either a driver’s licence or an Alberta identity card. Once they have confirmed who they are, they will be sent a PIN number through the mail, just like the banks do. The PIN will be used to activate the ID and gain access to their personal health record.
We’re really excited about that, because once we can get people to that stage, then the sky is the limit for what else we might do for them. We can start to think about offering a full range of what we call digital health services.
CHT: You’ve described yourself as an “Air Force brat” who moved often. So even as a child, you’ve experienced healthcare in jurisdictions outside of Alberta. No doubt as an adult administrator now you’ve looked across the country and beyond to see what can be learned from other healthcare systems.
Wieringa: Yes, certainly in Alberta we are always looking for innovations and best practices that we can implement in our province, and I definitely think jurisdictions in Canada are learning from each other. Formally, Canada Health Infoway brings the country’s healthcare CIOs together at least three times a year. And we’re all quite transparent and open about sharing our best practices and lessons learned.
I see a number of interesting things happening across Canada. For example, Nova Scotia is doing some really impressive things with its Health Connect system. Saskatchewan also has something similar going with its CHIP or Citizen’s Health Information Program.
In the United States, Kaiser Permanente has done a marvelous job of digitizing health services. They do it with high satisfaction from providers, as well as from patients. What really stands out is that they are able to leverage their digitized services to improve patient care, to identify where gaps in care exist or where they can streamline or introduce other services. At the clinical level, it helps to curb problems such as overtreatment if you know exactly how many lab tests a patient has already had before ordering more tests. So there’s a financial benefit too.
CHT: Which brings us all the way back to Alberta. And I am wondering before we finish if, with a series of quick questions and short answers, you might give us a snapshot of how you see the state of electronic healthcare in your province?
Wieringa: Sure. Let’s go for it!
CHT: Great. So what do you see as the e-health priorities in Alberta?
Wieringa: Our e-health priorities are the same as other priorities in the health system, and that is to provide the best possible healthcare for Albertans. That means providing the right services, in the right places, at the right times, with the right health providers and the right information.
CHT: How much does Alberta spend on e-health IT?
Wieringa: In our most recent budget, we have an operational expenditure of $594 million and a capital expenditure of $22.3 million. Of that $400 million has been allocated over the next four years to build a province-wide clinical information system.
CHT: In terms of other IT systems related to healthcare, what have you hooked up or not hooked up yet?
Wieringa: Our goal is to build an integrated system – and that remains a work in progress. Alberta Netcare is the province’s electronic health care record system where patient-centred records are stored and referenced by physicians. Netcare today connects with physician offices and pharmacies throughout the province, and we’re in the process of expanding the system to connect with chiropractors, dentists, and optometrists. The long-term vision is to continue to expand Netcare to bridge all parts of our healthcare system – and provide that information to Albertans through a user-friendly personal health record.
CHT: Finally, then, is there something you’d like to add that we haven’t touched on?
Wieringa: I’d like to say that e-health is really the foundation for a new and transformed healthcare system – one that connects people, care providers and health information in ways that were never possible before. The ultimate aim is to empower patients as full partners with their care-providers in managing their health. This is an incredible opportunity to transform healthcare, and it’s within reach with the tools we’re building.