Newfoundland jump-starts its work in health analytics

ST. JOHN’S, NL – The province of Newfoundland and Labrador is investing $3.8 million in a Health Data Lab that’s focusing on analytics and artificial intelligence to improve healthcare delivery. The project may very well become the most advanced of its sort in Canada, as it brings near real-time data flows from across the jurisdiction into a secure, consolidated repository.

“Most of the data sets are no more than 24 hours old,” commented Jill Grant, Director of EHR Operations at the Newfoundland and Labrador Centre for Health Information. She noted the goal was to capitalize on the vast, rich data sets accumulated since the launch of the provincial Electronic Health Record, HEALTHe NL, and to provide an advanced, secure and robust analytics environment with leading edge technology.

Traditionally, the data sets used in the healthcare sector to perform analytics are quite old – they’re out of date by weeks, if not months. By the time analysts gain access, conditions have changed and their insights are no longer relevant.

By obtaining current data, the decision support can be much more useful.

For their part, the project team in Newfoundland and Labrador intend to combine the data with predictive analytics to obtain new insights on how to improve healthcare investments and where to build up resources. They’re also hoping to spur the rise of innovation and entrepreneurial activities.

The Newfoundland and Labrador Centre for Health Information (NLCHI) is spearheading the project, and it’s one of three areas of investment made possible by a $9 million grant from the federal government’s Atlantic Canada Opportunities Agency (ACOA).

The two other project areas are focused on expanding its existing telehealth services and electronic ordering.

The Health Data Lab is currently working on enhancing its existing data warehouse so that it’s capable of handling a variety of data streams, from multiple provincial clinical source systems across the province. Such data sets include lab, pharmacy and the MEDITECH system that’s used in hospitals in Newfoundland and Labrador.

NLCHI is in the process of working with multiple vendors to enhance the provinces health analytics environment such that stakeholders will be able to use and interact with health data and information in new ways while also mitigating risks associated with data disclosure.

In the end, there are three groups who will benefit from the data – health system users, researchers and innovators.

Grant noted the Health Data Lab will be producing a portal for health system users. “As an initial pilot, we will be providing access to an up-to-date dashboard for healthcare providers,” she said. “So, for example, physicians will be able to log-in to look at their medication prescribing habits, and to compare themselves with their peers across the province.”

Indeed, improving care at the primary care level is one of the major goals of the project.

Secure access is also being provided to researchers, including experts at Memorial University of Newfoundland. “Having access to provincial-level data, in a secure and timely manner, holds a lot of potential for researchers,” said Grant.

Finally, there will be access for entrepreneurs, through programs like Hacking Health, and to health IT vendors. It’s believed that use of data – in a secure, private and anonymized way – will help produce new innovations and also help seed economic growth in the province.

“We’re opening the door to innovation,” said Grant.

She observed that a good deal of policy work has gone into the project, to ensure the right security and privacy features are in place. The provincial government has worked closely with the NLCHI, too, to help usher in the policy changes needed for the project.

A significant investment has also been made into the infrastructure to support additional analytical software capabilities.

Regarding the other initiatives, Grant noted the e-ordering project involves a $1.8 million investment. e-Ordering will enable clinicians to request a referral for service from another health care provider electronically, rather than by fax or mail. The technology will review both the referral and the patient’s medical profile in addition to clinical best practice and provide advice on the recommended course of action.

Pilots have been developed in two areas, the cardiac catheterization lab and the vascular imaging lab. “They’re both areas where there are wait lists,” said Grant.

The goal is to convert the paper-based processes used in ordering to electronic methods, to improve quality, enhance patient safety and care while increasing throughput and productivity.

Both clinical areas, cardiac catheterization and vascular labs, have centralized intakes, so it’s somewhat easier to digitize the ordering process than for others.

The cardiac cath solution, myCCath, went live in June 2018, with Nova Scotia-based MOBIA as the main vendor partner. The vascular lab solution was in progress at the time of writing, and Orion Health, of Toronto, is the key vendor.

“We’re working closely with our clinical staff on the vascular lab system, and we’re aiming for a spring 2019 rollout deployment of the electronic requisition form for vascular imaging exams in HEALTHe NL, the provincial electronic health record, with integration into eDOCSNL,” said Grant. “Once these two ordering solutions are in full swing, an evaluation will be done. Based on the evaluations of these pilots we will look at other clinical areas to expand.”

A key feature of the solution is the intelligence that’s built in, Grant said. In particular, the acuity of the patient is recognized and prioritized, so that urgent cases go to the top of the queue.

By tying into the provincial electronic health record, Healthe NL, clinicians will have access to data from labs, pharmacies and hospital records as they’re working on the orders, which helps with decision-making.

For its part, the telehealth expansion project involves a $3.4 million investment. The emphasis is on expanding service into rural areas, and also into new clinical areas such as mental health and addictions.

“We also want to expand the service into physician offices and into homes of patients,” said Grant. “This will greatly reduce health care costs for both the patient and health care provider. It also allows continuity of care, increased capacity and reducing barriers to health care, such as waitlist reduction.”

With virtual visits, there’s a need to increase the capacity available in the system, and also to ensure that services are secure. To support this, the project has placed significant investment on enhancing the Telehealth infrastructure to support the expanded access through a more cost effective, sustainable and secure technology solution.

Video visits will be a boon to the aging population, and to rural patients who don’t have easy access to medical professionals. Using telehealth in homes and physician offices, the playing field will be leveled.

Grant said the ACOA funding has been transformational. “It has enabled us to build the foundation for the future,” she observed.