ITAC Online - The Health Informatics Issue - December 2010
In ITAliCs

Recognizing excellence

The Canadian Health Informatics Awards recognize excellence in the application of information and communications technology in health care. Co-sponsored by ITAC Health and COACH, Canada's Health Informatics Association, the awards recognize the demonstrable achievements of individuals, health care organizations and companies.

Selected by a blue-ribbon panel of health CIOs from across Canada, four awards sponsored by ITAC Health are given jointly to companies and their customers in the following areas: Project Team for Innovation and Care Delivery, Project Team for Patient Care Innovation, Corporate Citizenship, and Project Implementation Team of the Year.

ITAC congratulates this year’s award winners; GoldCare, Cerner Canada and North York General Hospital, Healthtech and Ontario Shores Centre for Mental Health Sciences.

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Technology that makes a difference

Paula Hucko – Vice-President, Sales and Marketing, GoldCare Paula Hucko – Vice-President, Sales and Marketing, GoldCare

The Canadian ehealth sector is characterized by passionate people who are heavily invested in the end-users of their products or services. But, even in that group, Paula Hucko, Vice-President of Sales and Marketing for GoldCare, stands out for her enthusiasm. “The rubber hits the road at the client and patient level for us. When you hear parents talk about what technology means to the care of their children, and what integrated care has meant to their journey in the healthcare system, that’s when it resonates and makes a real difference.”

Small wonder, then, that GoldCare won this year’s Canadian Health Informatics Award for Corporate Citizenship.

Nominated by the Closing the Gap Healthcare Group, GoldCare attributes its victory to its reputation for “actively seeking and driving continuous process improvements in the home, community and long-term care sectors.”

Based in Kitchener-Waterloo, the company is also active in Australia and New Zealand, serving about 200 clients overall.

“During the past 23 years,” says Hucko, “GoldCare has evolved from being a facility-oriented supplier focused on the residential care sector, to an organization that has a much wider-spread capability with its software to support electronic health records, whether it’s in children’s or adult services.”

An early adopter and advocate of government initiatives and pilot projects—including interRAI MDS 2.0, interRAI Community Health Assessment, the eReferral & Access Tracking Project and others—the company pursues an integrated approach to care management and support. Not surprisingly, in making the case for integration, Hucko speaks from the heart, as a consumer of healthcare.

“It’s really a fragmented system right now. I’ve personally experienced it recently with my mother, who had to go from her home into residential care, and then into long-term care, which involved various hospital and acute-care visits. I found myself mired in this fragmented system, and I was frustrated. It’s something a lot of us in the so-called Sandwich Generation can relate to, whether it’s your aging parent you’re advocating for, or your child. Any organization that can bring a better understanding to that environment is doing a great job, whether it’s GoldCare or any other vendor.

“When we talk about integration, it occurs at several levels. All of our systems are modular but tightly integrated. When you enter data in one place, it flows seamlessly right through our entire system. We have applications for employee-client management, clinical management, staff scheduling and management, and the supporting financial/administrative management, including payroll and human resources. We also have a mobility solution that is tightly integrated with our main application.”

Hucko points out that GoldCare will also integrate its systems with a wide range of third-party applications—a particular concern in the home/community, long-term and co-ordinated care sectors. “We don’t walk into any kind of environment thinking that it’s going to be entirely GoldCare. We will work with the client’s business processes to initiate or support the best workflow, which includes integration with the systems they might be using internally, as well as third-party systems. Integration for us is internal as well as external. What that means for the consumer is that, hopefully, they will be have access to the services they need, when they need them, as made possible by integrated and consolidated information. That will increase the capacity of the system, because things will be done right the first time, as opposed to consumers having to relate their issues over and over; paper information being transmitted and lost; and tests being repeated because access to that information isn’t readily available.”

To emphasize the difference this can make in real terms, she points to a letter written in support of GoldCare by the mother of a seven-year-old girl named Jessica. In the letter, the woman recounts the power of integrated systems and shared information: “Finally, all these professionals from different fields and different providers were joined together to help Jessica. They were communicating directly with each other without me having to be the mediator. They were brainstorming together on the best possible ways to help Jessica. I have to tell you that I cried with relief.”

“To me,” says Hucko, “those kinds of stories allow you to see the real vision of the future that we can all achieve.”

Unfortunately, she adds, Canada is a long way from hitting the goal of seamless access to health information and interoperability by 2015. She cites security and policy issues as major hurdles. “It’s a complex environment, and although I don’t think we’re close to the 2015 goal, there are pockets of it already happening. And I do think we’ll see more of that interoperability occurring; and the consumer is going to drive a lot of that change. As consumers, we interact with technology all the time.  There’s a perception of ‘If I can interact with my financial records and all different parts of the consumer sector, why I can’t do it with the healthcare sector?’ I don’t think it’s an IT issue; I think it’s an adoption issue. It’s a political issue. It’s a security issue. Healthcare has a complex infrastructure that is far more complicated than people realize. But we will get there.”

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Driving clinical transformation

Terri LeFort – Vice-President, MEDITECH Division, Healthtech Anne-Marie Charron – Director of Business Development, Healthtech

One of Canada’s most experienced vendors of MEDITECH healthcare information systems, Healthtech Consultants is a company that knows technology alone is not enough to guarantee success.

“We have very deep expertise in terms of implementation,” says Terri LeFort, Healthtech’s Vice-President, MEDITECH division. “We blend strong project management and an understanding of change management in a way that actually leads to clinical transformation. We understand what it takes to be successful and make the shift—the true shift—that leads to clinician adoption of technology in healthcare.”

That focus on managing the change that technology can fulfill resulted in the 28-year-old company winning two Canadian Health Informatics Awards, in conjunction with Ontario Shores Centre for Mental Health Sciences: Project Implementation Team of the Year, and Project Patient Care Innovation Team of the Year. Based in Whitby, a city of 115,000 east of Toronto, Ontario Shores used Healthtech to help it integrate MEDITECH 6.0 throughout its main location and seven outpatient clinics.

LeFort credits Healthtech’s “unique skill set” with helping the two organizations win the awards. “Ontario Shores had some legacy systems that didn’t really talk to each other, and didn’t touch any of the clinical areas. They were going from being very paper-based to fully electronic, and they were going from 0 to 60 in just over 18 months”.

“We were able to help them anticipate the types of decisions they were going to make, the impact of those decisions, the types of committee and decision-making structures they need to make those decisions. We helped them to draft indicators and measures. We know how important it is at the beginning of an initiative like this to actually look at some measures of achievement… measure patient safety and patient quality indicators.”

Founded by Susanne Flett in 1983, Healthtech now has more than 55 full-time consultants and another 25 associates who are contracted as needed. Headquartered in Toronto at the foot of University Avenue, the company works across the country and in 2010 successfully completed more than 200 healthcare IM/IT projects.

“The company was founded to help healthcare organizations leverage technology to improve the delivery of patient care, and that vision has remained the same,” says Anne-Marie Charron, Director of Business Development. “Basically, we’re a healthcare consulting firm that provides IM/IT services in settings from one-site hospital environments to large regions.”

The relationship with MEDITECH, which is based in Massachusetts and has more than 2,200 customers worldwide, has been a constant. “We’ve always had a fair bit of expertise in relation to MEDITECH’s systems implementation,” says LeFort. “That’s based on the fact that, in the acute care realm, somewhere between 40 and 60 percent of healthcare organizations across Canada use the MEDITECH system.”

Recently, she says, Healthtech has split into two divisions: one focusing on MEDITECH clients, doing planning, implementation, optimization and evaluation; and the other an ehealth division that provides services in other clinical settings.

The company’s scope and longevity have given it a panoramic overview of Canada’s ehealth evolution.

“We’ve seen a slower adaptation in terms of advanced clinicals,” says LeFort. “I think that’s primarily due to budget constraints and the lengthy approval processes we have. We definitely know that, by implementing those types of systems and pushing ahead the agenda around ehealth, it’s going to produce safer healthcare, better outcomes for the patients. It’s also going to, in the long run, provide better control on the cost of healthcare.”

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ITAC Events

December 5, 2011

Telecom Mission to India - December 5 to 9, 2011

December 6, 2011

The Digi Awards - Toronto

December 6, 2011

Lexpert Events “2011 Best Practice: IT Agreements” - Calgary

December 8, 2011

Measure Up Your Marketing: Technology That Tracks

December 15, 2011

Legal Affairs Forum

January 11, 2012

Ontario Public Sector Business Committee Meeting


For a full event listing, and to register for ITAC events, go to: itac.ca/event_cal

ITAC News

Shared Services Canada Update

On November 30, ITAC had its second in a series of meetings with Shared Services Canada (SSC).

In her opening remarks for the meeting, Liseanne Forhand reported that SSC is currently consumed with operational stability. They have brought 5,300 people onboard, as well as physical resources and budgets, and soon will total close to 6,500 people. Grant Westcott confirmed that the preferred approach is to consult industry associations to secure input as they begin plans for low-cost, effective technology choices for their three target areas: email, networks and data centers. The focus will be on outcomes.

Innovation is a new thread permeating conversation with government as senior bureaucrats all seem to have read the Jenkins report on R&D spending in Canada. SSC is considering how to deal with innovation, as well as SMEs, while keeping an eye on the costs.

ITAC President and CEO Karna Gupta was able to keep the conversation at a high level and to reserve detailed comments for a more thoughtful response. ITAC believes we have started the relationship on a very good basis, and we look forward to our work with SSC’s senior team.

ITAC has been asked to actively engage with SCC to develop issues and questions beyond what was reviewed, and start framing responses that will be used for possible directions. Grant has asked to receive input from ITAC, and if needed will hold additional meetings. ITAC members can contribute to this work through the PSBC, where the executive of the PSBC will assist the board in creating our response. We rely on our members to provide support and assistance so that the input we provide to SSC will feed into our strategic plan.

For more information, contact Linda Oliver.

ITAC Makes Headway on Government Cloud Computing

ITAC held a very successful meeting with senior government officials on cloud computing in the federal government. David MacDonald, CEO of Softchoice, is the ITAC champion working to raise the level of adoption of transformative technologies such as cloud computing within the federal government. Through his committee, he combined the need to use transformative technologies with a new collaborative approach with government. This approach created a greenfield environment where Canada’s CIO and CIOs from many departments felt comfortable hearing from industry and discussing the use of cloud computing—while they were still in the information-gathering stage.

As a result, we are participating in the creation of new approaches that the government might follow regarding cloud computing—a breakthrough for ITAC.

We have already heard that government will want to continue the dialogue, and we will continue to work to initiate new dialogue using the greenfield approach. It is one small win on the road to achieving better outcomes with government. Thanks to David Mac Donald for investing his time and energy to help this happen, and to all the other representatives of our membership who participated.

Congratulations Robert Courteau, PhD

ITAC is a community well populated with PhDs. These ranks grew by one more this week as our former Chair, Robert Courteau (currently the President of SAP America), received an honourary Doctorate of Laws from Concordia University.  Well done!

The Implications of BC's HST Rollback

By Audrey Diamant, Partner, Tax Services, PricewaterhouseCoopers LLP

"Everything old is new again," "Back to the future", all catchphrases welcome as the Province of British Columbia agrees to roll back the BC HST, to be replaced by the soon-to-be-resuscitated BC provincial sales tax (PST).

The fate of the BC HST hung on the outcome of a referendum, with the population ultimately voting 54.73% to 45.27% to abolish the newly minted but unpopular BC HST. The tentative date for replacement is April 1, 2013, with the government developing an action plan and transitional rules to guide the process. The Province has stated that the PST will be levied at the old rate of 7%, "with all permanent PST exemptions" and some "common sense administrative improvements to streamline" the tax. Although this statement does not contemplate substantive changes to the BC PST as it existed at June 30, 2010, many are nevertheless looking at the transitional period as an opportunity not only to push for greater administrative efficiencies but also to lobby for expanded exemptions and to remove the most complex and business unfriendly elements of the tax. Business that were able to recover BC HST but not PST on their inputs, will be looking for some expanded relief under a new PST – they've had a taste of the good life and may need incentives in order to dissuade the most portable of them not to re-establish their business footprint in Alberta or parts east.

So what should businesses do in contemplation of the rollback? Understandably, little information has been released however, quarterly updates on progress have been promised by the government. While they develop the transitional rules and reconstruct the infrastructure necessary to support a PST, those interested in lobbying for change beyond the limited elements suggested in the government's statement should begin the process, likely in concert with like-minded industry members and proactive associations. Businesses should also plot the timeline necessary to complete the tasks relevant to re-establishing the PST, and re-constituting, within that timeframe, the internal group or task force responsible for specific implementation steps – tax, IT, purchasing, sales and legal should all have a place at the table.

The reintroduction of the PST will impact longer-term budgeting, and needs to be contemplated in any legal agreements involving transactions straddling the implementation date. The transitional rules, when released, will impact fixed price contracts, returned goods, inventory and capital acquisitions. Major purchases may either be accelerated or deferred depending on whether a business is currently able to claim input tax credits, or would enjoy PST exemptions on certain of its inputs. PST self-assessment, exemption certification, and non-resident registration under the 'super-registration rules' may again form part of the sales tax lexicon in BC. It's "déjà vu all over again."

Jim Haslett and Kirk Mandy Honoured for Their Contributions to Microelectronics

A highlight of the recent Executive Forum on Microelectronics, the 17th such event, was the presentation of this year’s Outstanding Service Awards. Nominations for these awards came from the attendees of previous events, and the recipients this year continued a fine tradition that has been in place since 1999.

Over 41 years of research in analog and digital circuit design, Dr. Jim Haslett has excelled at solving real world industrial problems for high temperature oil field instrumentation, satellite instrumentation and wireless communications. He has graduated more than 40 Masters and Doctorate students and is currently the “Faculty Professor” in the Department of Electrical and Computer Engineering, within the Schulich School of Engineering at the University of Calgary.

Kirk Mandy led Zarlink Semiconductor (formerly Mitel Semiconductor) to become a world-leading microelectronics company but still found the extra time and energy to contribute to our Microelectronics community through the Strategic Microelectronics Corporation; the Canadian Microelectronics Corp.; the Ottawa Center for Research and Innovation; Micronet; the Telecommunications Research Center of Ontario; the National Research Council's Innovation Forum; and the Ottawa Partnership.

Submit your nomination for next year’s awards to Lynda Leonard, leonard@itac.ca.