A strategic roadmap for oncology electronic medical records (EMRs) in Ontario’s complex multiregional health care system.

Abstract

159 Background: Ontario’s cancer system comprises 14 regions; from large and sparsely populated to dense urban areas. Each region, and the hospitals within it, is responsible for its own IT solutions to support oncology. In 2011 Oncology EMRs in 4 regions were funded as there are no oncology specific Health Information Systems (HIS). Cancer Care Ontario (CCO) also obtained funding to develop standards, and a roadmap for their use, from eHealth Ontario. Methods: Early work focused on establishing standards based on the integrated patient cancer journey. Work-streams included functional standards, an interoperability framework for CCO tools and provincial assets and information standards to be supported through EMRs. These were evaluated through internal and external review and validation processes. The strategic IT roadmap was developed via interviews with leaders in the clinical, management and IT domains to obtain input on how the standards might be used and what role CCO should play. Results of the consultations were consolidated into key themes and validated through a facilitated workshop with an expert panel. Results: Standards can be incorporated into EMRs in a consistent way by basing the design around the patient journey and by working with the point of care tools that clinicians need to support accurate, timely and relevant data at each stage of the patient journey. This approach is location and vendor neutral. Focusing on the data needed at point of care provides insight into reporting needs and how data can be exchanged between systems; directly, via a provincial repository or via CCO provided tools. CCO’s role should be to provide support to the regions through standards and advocacy with stakeholders rather than development of tools. Conclusions: Oncology has unique IT needs that may not be fully incorporated in hospital wide IT strategic plans or decisions. The standards and roadmap provide a basis for oncology programs to ensure that IT decisions meet their needs. The role of CCO should evolve toward strategic counsel and advocacy rather than provision of IT tools.