• Background
  Ontario's Ministry of Health and Long-Term Care serves the healthcare needs of 13 million people in Canada's largest province.
• Challenge
  The province needs a comprehensive EMPI, also known as a client registry, to support its Wait Time Strategy to reduce patient wait times for healthcare delivery.
• Solution
  Ontario deploys Initiate software as its EMPI/client registry for its Wait Time Strategy information system.
• Results
  The usability and accuracy of patient data has dramatically improved due to the ability to link and match information for more than 44 million records from 100+ source systems.

The Ministry of Health and Long-Term Care is responsible for administering the healthcare system and providing services to the citizens of Ontario through a number of programs. These programs include health insurance, drug benefits, assistive devices, care for the mentally ill, long-term care, home care, community and public health, health promotion and disease prevention. The Ministry also regulates hospitals and nursing homes, operates psychiatric hospitals and medical laboratories, and coordinates emergency health services.

When George Smitherman, Minister of Health and Long-Term Care, launched Ontario’s Wait Time Strategy in November 2004, the announcement was good news for the majority of Canadians who expressed in a 2004 opinion poll that they were waiting too long for the delivery of healthcare services and diagnostic test results. The Ontario government recognized that long wait times were actually a symptom of a more serious problem – slow access to patient care.

Ontario’s Wait Time Strategy was the first step in an ongoing process to improve access to healthcare services, and therefore reduce wait times across Canada’s healthcare enterprise. Ontario’s strategy was geared to five key areas: cancer surgery, selected cardiac procedures, cataract surgery, hip and knee total joint replacements, and MRI/CT scans. The goal was to achieve significant Wait Time improvements in Ontario by December 2006.

Canada’s Ministers of Health identified the need for a comprehensive provincial surgical information system that would enable patient information to be collected and securely shared by healthcare organizations throughout the country. As a part of the overall information management plan, a client registry would need to be implemented to provide accurate, consistently updated patient information to help physicians prioritize patients within the five key areas and deliver care based on the urgency of the patient’s condition. A client registry is also known as an enterprise master person index (EMPI), which is a specialized form of master data management (MDM). 

Because the registry will also over time support an electronic health record (EHR), it needed to maintain data integrity and be secure to address patients’ privacy concerns. Moreover, the registry will need to deliver accurate, up-to-date patient information to help physicians monitor outcomes of interventions and treatments. In other words, the patient registry and its information would be the lifeblood of this ambitious strategy.

On behalf of the province of Ontario, Cancer Care Ontario contracted with Initiate Systems to implement Initiate software as the client registry throughout the Province. Phase I of the project included six hospitals and went live on schedule at the end of March 2006. Phase II includes approximately 50 additional hospitals and is scheduled to go live in groups by the end of 2006.

"With 6.5 million records in production for six hospitals, Ontario has just begun to fulfill the mission of our Wait Time Strategy," said Sarah Kramer, Lead, Wait Times Information Management Strategy, Vice President and Chief Information Officer, Cancer Care Ontario. "By the end of the year, with the help of the Initiate services organization, we will be serving millions of Ontario patients."

Initiate Systems provides software and services for healthcare organizations that want to create complete views of patient information from data dispersed across multiple facilities, application systems and databases, and deliver a comprehensive picture of each patient in real time to all points of service. Initiate Systems' EMPI/client registry enables patient-focused strategies by providing clinical and operational applications with the most complete, accurate, up-to-the-moment data on patients, providers and payers. Initiate software, the industry-leading EMPI, improves the data integrity within sources, accurately integrates data across disparate sources, and delivers synchronized information throughout an organization.

Initiate Systems met all of the defined requirements and objectives of Cancer Care Ontario, which was responsible for procuring the client registry solution for the project on behalf of the Ministry of Health and Long Term Care. Because Initiate Systems is "vendor agnostic," meaning it integrates easily with other hardware and software systems, Ontario's Ministry of Health and Long-Term Care will have the flexibility to adopt systems and solutions that benefit their e-health strategy the most. Initiate Systems is also the only client-registry vendor to have a memorandum of understanding with Canada Health Infoway, an independent, not-for-profit organization whose members are Canada’s 14 federal, provincial and territorial Deputy Ministers of Health.

Just a few months after implementing Initiate software as part of its Wait Time Strategy, Ontario's citizens are already seeing improvements in access to healthcare services and shorter wait times for diagnostic test results. In a May 18, 2006 press release, Smitherman noted an "encouraging" trend with "double-digit drops in wait times for a number of key health services."

Overall, by using Initiate software as the EMPI/client registry, provinces and territories in Canada will be able to provide a provincial client registry deployment to create and maintain a single provincial view of the patient over time.

"Initiate Systems has exceeded our expectations in terms of implementation time, flexibility, scalability and ease of use," Kramer said. "Initiate's EMPI solution was a very important factor in achieving the successful launch of the Wait Time Strategy."