Championing Information Management to Improve System Performance and Patient Care

Transcription

1 Championing Information Management to Improve System Performance and Patient Care Michael Sherar President and CEO Cancer Care Ontario December 1, 2011

2 Overview Cancer Care Ontario Elements of Cancer Care Ontario s Performance Improvement Cycle Championing Information Management to Improve System Performance and Patient Care Colorectal Screening Ontario Cancer Symptom Management Collaborative

3 Cancer Care Ontario (CCO) is a provincial government agency Directs and oversees more than $800 million to hospitals and other cancer care providers to deliver high quality, timely cancer and healthcare services Uses information technology/management, informatics, project management and clinical expertise to execute provincial strategies Three lines of business: Cancer CCO s core mandate since 1943 as mandated by the provincial Cancer Act Access to Care Building on Ontario s Wait Times Strategy Chronic Kidney Disease Ontario Renal Network launched June

4 Cancer Care Ontario s Core Competencies Mandated Service Key Levers Cancer Access to Care Chronic Kidney Disease Data and Information Clinical Engagement Policy and Planning Funding Driving quality, accountability and innovation Accountability Program Management Performance Management Leadership 4

5 A Burning Platform: Our Challenge It is estimated that 45% 40% of men and of women will develop cancer in their lifetime

6 Moving Forward 6

7 Performance Improvement Cycle Clinicians engaged in all components Monitoring performance 1. Data/Information Identifying quality improvement opportunities Horizon-scanning and championing innovation 4. Performance Management 2. Knowledge Developing and implementing improvement strategies 3. Transfer Standardizing development and guidelines

8 The Patient Journey A framework for examining the performance of the entire system from prevention to recovery and end-of-life care Focus on the Patient Experience Stronger link to Primary Care Providers :Provincial Primary Care Network Greater/Stronger Cancer System Performance and Efficiency 8

9 IM Tools Instrumenting the Patient Journey: Screening

10 Integrated Cancer Screening GOAL Accelerate reduction in cancer mortality by implementing a coordinated, organized cancer screening program across Ontario 10

11 INTEGRATED CANCER SCREENING Ontario Breast Screening Program launch Three cancer screening programs Different stages of development Different information systems 11

12 Colon Colon Cervical Breast Other Screening Screening moving to a new business model Single Screening Program Multiple Integrated Screening Programs InScreen Channels InScreen Channels Direct Mail Call Centre Direct Mail Call Centre Internet Single Screening Program: Organized for CCC program CCC specific performance measurement CCC specific functionality Centralized program delivery Integrated Screening: Organized by Participant Integrated & program specific performance measurement Common standard functionality Decentralized delivery

13 InScreen overview increases awareness initiates contact supports population-based cancer screening provides view of screening journey informs practices screening activity Almost four million electronic screening records are available in InScreen!

14 Participation (%) Colorectal Screening FOBT CCO Program Target = 40% Year 14

15 Colonoscopy Volume ( ) CCO Standard: >200/year 792 endoscopists 24% did not achieve this 15

16 Median wait time (weeks) Colonoscopy Wait Times Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q FOBT+ Family History Symptomatic 16

17 FOBT+ Follow-Up Colonoscopy in Six Months (2009) 17

18 IM Tools Instrumenting the Patient Journey: Ontario Cancer Symptom Management Collaborative (OCSMC) 18

19 OCSMC: Targeting improvements in cancer patients physical and emotional symptoms Rationale Inconsistency in cancer symptom management practices Clinicians can fail to recognize patient concerns Poor system/patient outcomes Purpose Earlier identification and communication of symptoms Improved symptom management Improved collaborative care planning for patients Approach Implement and assist in adoption of common tools for: symptom assessment and management Host and support etool (ISAAC)* Establish and monitor improvement aims, regional targets 70% of all cancer patients screened with ESAS** *Interactive Symptom Assessment and Collection (ISAAC) **Edmonton Symptom Assessment System (ESAS)

20 Giving patients a voice ISAAC Accessible at clinic via touch-screen kiosk or from home via internet Tracks symptoms over time Puts patients in control of their own symptom assessment Results available across the patient s circle of care Clinicians are notified by when the score exceeds certain parameters

21 ISAAC has uses ranging from individual patient care to system planning and performance Improving patient care Guide regional improvement and clinical practice Performance measurement Monitoring patients symptoms over time and across care settings Regional monthly progress reports Provider level reports CCO s quarterly reviews CCO s performance scorecard Public reporting Cancer System Quality Index (CSQI) Inform planning; impact on system outcomes Researchers accessing Symptom Management database

22 ISAAC: Enabling Public Reporting on Regional Progress 22

23 Making Knowledge Accessible at Point-of-Care More than18,000 downloads of Symptom Management Guides from website (Sept Oct. 2011) Symptom management point-of-care decision support More than 2,400 downloads of CCO s first mobile app (Feb. Oct. 2011) Named one of nine Best Medical apps by The Medical Post (June 2011)

24 Primary Care The Ontario Cancer Plan (OCP) S I X G O A L S 1 Develop and implement a focused approach to cancer risk reduction 2 Implement integrated cancer screening 3 4 Continue to improve patient outcomes through accessible, safe, high quality care Continue to asses and improve the patient experience 5 Develop and Implement innovative models of care delivery 6 Expand our efforts in personalized medicine 24

25 Thank You