eReferral and Systems Integration in the Champlain LHIN

Integrated healthcare throughout the province has been made a priority by the government of Ontario.¹ Such a healthcare system will aim to connect healthcare providers and allow the patient’s health information to be shared seamlessly.¹ Digital health is the recommended method to achieving these goals, however, integrating multiple health technology solutions is a complex task.²

In addition to integration, interoperability, the ability for technical systems to effectively operate together and share information. Without interoperability, the consistent and reliable sharing of data is limited.¹ Interoperability is the key feature that will encourage end-users to start and continue to use the digital health tool.³ Ocean currently enables the sharing of information from three of the most commonly used electronic medical records (EMRs) in Ontario and is working to integrate with additional solutions to enable end-to-end flow of information. To support an integrated and interoperable system, the System Coordinated Access (SCA) Program has deployed Ocean eReferrals in three of the five (West, East and North) Ontario Health Regions to date.

In April 2018, the ISAEC program was implemented throughout the province to provide rapid low back pain assessments as part of the Ministry of Health’s vision for musculoskeletal (MSK) care.⁴ Early in the process, Champlain region’s ISAEC program considered a fax-based referral process, requiring manual transcription of referrals in the electronic clinical management system (CMS). However, the team decided to digitize their referral system by choosing to only accept electronic referrals. Ahead of other participants in the province, the Champlain ISAEC program developed an integration between their Regional Collaboration Space (LHINWorks) and the ISAEC CMS (Excelicare). Integration was then required between Ocean and LHINWorks to complete the flow of information from primary care through to the ISAEC central intake.

A digital referral process was chosen to improve the efficiency and the quality of the referral process by decreasing manual data entry and receiving more complete referrals. Ocean eReferral enables the referral to flow directly from the referring clinicians’ EMR into Ocean. With this integration, the East Region enhanced the workflow within the Champlain ISAEC program for both the referring clinicians as well as the administrative staff at the ISAEC central intake.

Since deployment of Ocean eReferrals in February 2019, over 600 eReferrals have been sent to the Champlain ISAEC central intake from over 130 different referrers. Key stakeholders described that deploying Ocean eReferral to support the ISAEC referral pathway has created program-wide benefits in Champlain:

About the SCA Program

The System Coordinated Access (SCA) Program was originally initiated to support the development and adoption of electronic referral in the Waterloo Wellington region. As a result of an investment by the Ontario Government, the program, in collaboration with the Think Research Consortium (Think Research, CognisantMD and Centre for Effective Practice), has now expanded to support the implementation of Ocean
eReferrals to three of five Ontario Health regions.

eReferral replaces paper-based faxes with electronic referrals. Through a secure integration with electronic medical records, referrals are sent, tracked and updated right from the patient’s electronic chart. The local SCA deployment teams provide training, solution set-up and support.

If you have questions or would like more information on this Benefits Realization (BR) case study, please contact:
Kayla Wierts, QIKT Specialist, eCE
Communications@ehealthCE.ca

This document is not to be reprinted without permission from the eHealth Centre of Excellence.

¹Ontario Health. (2019). Ontario Health Teams: Digital Health Playbook. Retrieved from: http://health.gov.on.ca/en/pro/programs/connectedcare/oht/docs/dig_health_playbook_en.pdf

²Kitsiou, S., Manthou, V., & Vlachopoulou, M. (2006). A framework for the evaluation of integration technology approaches in healthcare. Proceedings of the IEEE in Information and Communication Technologies in Bioinformatics, 28-30.

³Ross, J., Stevenson, F., Lau, R., & Murray, E. (2016). Factors that influence the implementation of e-health: a systematic review of systematic reviews (an update). Implementation science, 11(1), 146.

⁴Inter-professional Spine Assessment and Education . (n.d.). Retrieved from http://www.isaec.org/