SUMMARY 1/27/15
South Caucasus Health Information Project
Study Tour
14 September – 3 October 2003
OTTAWA AND HALIFAX
Part...
SUMMARY 1/27/15
Contact Dr. Denis Caro: 562-5800 (4742)
drcaro@uottawa.ca
Tuesday, September 16
Peter Tugwell, Director,
C...
SUMMARY 1/27/15
Thursday, September 18
Meeting at Ottawa General to discuss the
Evidence-Based Medicine curriculum,
with T...
SUMMARY 1/27/15
South Caucasus Health Information Project
Study Tour – HALIFAX, NOVA SCOTIA
September 20 - 27, 2003
Monday...
SUMMARY 1/27/15
Department of Health
Government of Nova Scotia
1690 Hollis Street
Phone: (902) 424-2605
E-mail: paganid@go...
SUMMARY 1/27/15
Arrival of Irina Zarnadze and Revaz
Chanturia
Thursday September 25
Dan Mahar, Manager of Learning
Service...
SUMMARY 1/27/15
Overview of Canadian Population
Health Initiative (CPHI),
presentation by Steven Samos,
Manager, CPHI.
Mr....
SUMMARY 1/27/15
Valerie Gamache-O’Leary,
Director, Information Systems,
The Ottawa Hospital
Email:
VGamache@ottawahospital...
SUMMARY 1/27/15
physicians and clinical practice
guidelines, using EBM practices and
collected case studies to build
“deci...
SUMMARY 1/27/15
Paul Shekelle, Director, Southern
California Evidence-Based Practice
Centre, RAND
herbal treatment, which ...
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Health Informatics Study Tour

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Transcript of "Health Informatics Study Tour"

  1. 1. SUMMARY 1/27/15 South Caucasus Health Information Project Study Tour 14 September – 3 October 2003 OTTAWA AND HALIFAX Participants: Seyran Kocharian: Department of Biophysics, Yerevan State Medical University, Armenia Tigran Oganyan: Department of Biostatistics, National Institute of Health, Armenia Irina Zarnadze: Department of Public Health and Health Management, Tbilisi State Medical University, Georgia Revaz Chanturia: Department of Public Health and Epidemiology, Tbilisi State Medical Academy, Georgia Sanan Karimov: Vice-Rector, Azerbaijan State Advanced Training Institute for Doctors Mir-Riad Javadzade: Department of Dermatology, Azerbaijan State Advanced Training Institute for Doctors Program for OTTAWA, ONTARIO -- 14-20 September, 2003 MEETINGS COMMENTS Sunday, September 14 Arrival of Seyran Kocharian and Tigran Oganyan Monday, September 15 SCHIP team meets with participants in lobby of Novotel for orientation Dr. Jeff Turnbull, Chair of Medicine, and Dr. Steven Kravcik, Associate Professor, The Ottawa Hospital Dr. Turnbull discussed how the University of Ottawa Medical Curriculum is organized and the requirement for admission. Tuition fees for foreign students were discussed, as well as the program for students from developing countries. Dr. Gordon Wallace, Director, Medical Learning and Technology Office, focus on the development of the Digital Curriculum for the Faculty of Medicine, University of Ottawa: gwallace@uottawa.ca Dr. Wallace described the year-by-year development of the digital curriculum on a Web CT design-tool. The digital curriculum was demonstrated and the possibility of a “guest password” was discussed. “Planning And Development Of Information Systems” course at University of Ottawa, A lecture on object-oriented systems and Rapid Application Development, plus an in-class exercise on tele-cardiology. SUMMARY Page 1
  2. 2. SUMMARY 1/27/15 Contact Dr. Denis Caro: 562-5800 (4742) drcaro@uottawa.ca Tuesday, September 16 Peter Tugwell, Director, Centre for Global Health, Institute of Population Health, University of Ottawa 1 Stewart Street, Ottawa The Institute of Population Health (IPH) is a consortium of nine faculties of the University of Ottawa (Arts, Education, Health Sciences, Law, Science, Social Sciences, Medicine, Administration and Engineering). As a consortium, the IPH coordinates, initiates, and supports interfaculty and multiparty, transdisciplinary research and training in Population Health. The University has named population health as one of its priority areas for development by the University. Dr.Tugwell discussed the theory and practice of Evidence-based Medicine and problem-based learning in the Medical curriculum. Two EBM textbooks outlining the 20 concepts of EBM were suggested as references. Users Guide to the Medical Literature: A Manual for Evidence-Based Clinical Practice -- G Guyatt and D Rennie Evidence Based Medicine: How to practice and teach EBM -- DL Sackett Wednesday, September 17 Overview of Health Information in Canada: the role of the Canadian Institute for Health Information in the Canadian health system, Presentation by Director, Louise Ogilvy Canadian Institute for Health Information 377 Dalhousie Street, Suite 200 Ottawa, Ontario K1N 9N8 Created by Canada’s Health Ministers, the Canadian Institute for Health Information (CIHI) is an independent, national, not-for-profit organization working to improve the health of Canadians by providing quality health information. Ms. Ogilvy described CIHI’s role in the Canadian health information system, as the centre which collects data from the provinces and major hospitals, which feeds 20 national databases. CIHI publishes annual reports, special studies and supports health research. CIHI also feeds Canadian data to the OECD and helps develop data standards for Electronic Health Records. SUMMARY Page 2
  3. 3. SUMMARY 1/27/15 Thursday, September 18 Meeting at Ottawa General to discuss the Evidence-Based Medicine curriculum, with Tom Elmslie, Mariella Peca, Steve Kravcik and Dr. Linda N. Peterson, Assistant Dean, Undergraduate Medical Education University of Ottawa, Faculty of Medicine Room 2039, 451 Smyth Road, Ottawa peterson@uottawa.ca Dr. Elmslie presented how EBM is taught at the University of Ottawa; commenting that EBM has been taught there for 12 years and is constantly evolving. Group lectures and individual work build throughout the 4-year medical school program, where students appraise articles and systematic reviews, which lead to clinical practice guidelines. Students learn what is required to write a reputable study report. Dr. Elmslie also teaches EBM to practicing family physicians Valérie Gamache-O'Leary Director, Information Systems The Ottawa Hospital Tel: (613) 737-8446 Pager: (613) 715-7127 Email: vgamache@ottawahospital.on.ca Ms. Gamache-O’Leary explained how each of the 4 facilities of the integrated Ottawa Hospital had their own Patient Registries, lab and financial information systems, which all had to be integrated. Her current project has been the development of an electronic patient record, including a clinical information system for front line staff using an OACIS interfacing system. A doctor can now check on a patient’s test results from any of the 4500 computers located in the 4 facilities. Friday, September 19 Critical Appraisal rounds at Ottawa General Hospital, with Steve Kravcik Visitors observed weekly morning resident’s presentation of an article of a recent study to discuss with other residents and medical students Review of Literature Searching (Module 2) and using Cochrane database with Jessie McGowan (ext. 2359 jmcgowan@uottawa.ca) Ms. McGowan described the Cochrane Collaboration as a library of systemic analyses of medical studies, however Medline is best for current research. Review of Modules 3+4 (Biostatistics and Critical Appraisal) with Steve Kravcik The two modules are currently being revised to add more description. Saturday, September 20 Depart for Halifax SUMMARY Page 3
  4. 4. SUMMARY 1/27/15 South Caucasus Health Information Project Study Tour – HALIFAX, NOVA SCOTIA September 20 - 27, 2003 Monday, September 22 Tom Rathwell, Director of the School of Health Services Administration Dalhousie University 5599 Fenwick St., Halifax Contact Steve Jreige sjreige@dal.ca Tel: (902) 494-7083 Dr. Rathwell discussed the various programs run by the School for Health Services Administration, including two on-line diploma courses shared with other schools in the Maritimes. Group to sit in on Computer Networking class of Prof. Ernst Grundke, Dalhousie University Observe class, focusing on queuing theory Review Module 7, “Database Management” with Steve Jreige Questions focused on the prerequisites for this module (Module 1, to follow, will cover the computer basics needed). It was also suggested to add more practical examples and exercises for students Arrival of Sanan Karimov and Mir- Riad Javad- Zade Tuesday September 23 Review of Modules 5+6 (“Decision- Support Applications and Population Health Databases”), with David Persaud at Dalhousie Dr. Persaud reviewed Modules 5+6 and discussed how tracking evidence with Health Information Systems help to proved outcomes from specific treatments. Two examples of Critical Pathways/decision-trees were distributed as outcomes of this process. Two texts were suggested for reference: Information Systems for Health Care Management, 6th Edition, 2003—Austin and Boxerman Health Care Outcomes: Clinical Practice Guidelines, 1998 – Flarey and Smith Blancett Dieter Pagani, Director Information Technology Services Health Services Support In discussing the development of the data collection system for health care in Nova Scotia, Mr. Pagani explained how Nova Scotia is becoming the first SUMMARY Page 4
  5. 5. SUMMARY 1/27/15 Department of Health Government of Nova Scotia 1690 Hollis Street Phone: (902) 424-2605 E-mail: paganid@gov.ns.ca province to have a unified data network, which includes every hospital and health care centre in 9 districts (34 hospitals in total). The Electronic Health Record has been developed in Nova Scotia for 3 years for a population of 1 million and a health system of approximately 2600 beds using a unique identifier number. Mr. Pagani will be following up with an electronic copy of his presentation. Wednesday September 24 Contact Marian Kelly Manager, Operations Information Technology IWK Health Centre marian.kelly@iwk.nshealth.ca tel. 902.470.7151 fax 902.470.7458 0845 Meet & greet with coffee/tea 0900 Overview of IT acquisition history 0920 Overview of the MEDITECH Health Centre Information System as implemented at IWK 1030 Discussion on benefits, effectiveness, efficiencies gained 1130 Tour of Computer Room 1200 Lunch provided by Nutritional Services Dept. at IWK Centre 1300 Demo of Order Entry and Patient Care Inquiry applications, including PACS MEDITECH was chosen as the health information system vendor for the child/maternity hospital in 1989, when 15 applications were purchased for $400,000 US, plus a maintenance contract of $15,000/year. MEDITECH is now being used by every hospital in Nova Scotia except for the QE II. IT Director, Marc LeBlanc discussed the benefits of the MEDITECH system: - one-time registration of patient means no loss of paper/information - information is available to everyone all the time - tests can be ordered immediately - results are available immediately - better patient care, less frustration; patients do not have to carry their file around with them or offer personal information more than once - reporting to government is easier - more data can be kept in data repositories, allowing for better decision-making - MEDITECH has a test environment which allows for a demonstration of test data without affecting live data Queen Elizabeth II (QEII) Health Sciences Centre Contact Sandra Cascadden (902)473-5628 sandra.cascadden@cdha.nshealth.ca The team at the QEII provided the group with copies of their presentation, which discussed the creation of the Capital Health District and the roll- out of their hospital-based health information system (HIS) to the other facilities in the Capital health district; the creation of the Provincial Data Network; the information management plan and the best-of-cluster systems architecture. SUMMARY Page 5
  6. 6. SUMMARY 1/27/15 Arrival of Irina Zarnadze and Revaz Chanturia Thursday September 25 Dan Mahar, Manager of Learning Services Online in the library of Dalhousie University Mr. Mahar explained how WebCT is used to design online courses and tools for teachers and students. Each registered student has an individual password which only allows access to the course they are registering in. Tests can be done online with a time limit. An example of Continuing Education courses can be found at www.dal.ca. Find more information at www.WebCT.com Return to Ottawa Friday September 26 – OTTAWA REVISITED Overview of Canada’s Healthcare System, presentation by Maija Kagis. Senior Policy Advisor Primary Health Care and Public Health Directorate, First Nations and Inuit Health Branch, Health Canada One Nicholas, 2nd floor conference room Email: Maija_kagis@hc-sc-gc.ca Ms. Kagis gave an overview of the evolution of Medicare and the current health system in Canada. An electronic copy of her presentation is being sent out to participants. Debriefing session Saturday September 27 Departure of Tigran & Seyran Monday September 29 Overview of the Canadian Institute for Health Information (CIHI), presentation by Jennifer Zelmer, Vice President, CIHI. Canadian Institute for Health Information 377 Dalhousie Street, Suite 200 Ms. Zelmer described CIHI’s role in the Canadian health information system, as the centre which collects data from the provinces and major hospitals, which feeds 20 national databases. CIHI publishes annual reports, special studies and supports health research. CIHI also feeds Canadian data to the OECD and helps develop data standards for Electronic Health Records. SUMMARY Page 6
  7. 7. SUMMARY 1/27/15 Overview of Canadian Population Health Initiative (CPHI), presentation by Steven Samos, Manager, CPHI. Mr. Samos discussed the CPHI mandate, “to provide information of the health of the Canadian Population” by examining the key determinants of health and developing policy options. CPHI funds research under five themes and provides access to population health databases for researchers. Tuesday September 30 Patti O’Brien, Project Leader, (on behalf of Dr. Gordon Wallace, Director, Medical Learning and Technology Office, University of Ottawa), Faculty of Medicine. Gordon Wallace: 562-5800 x. 8129 Email: gwallace@uottawa.ca pobrien@uottawa.ca Ms. O’Brien described the four- year medical program and the corresponding digital curriculum on a Web CT design-tool. A demonstration of the curriculum can be seen at www.med.uottawa.ca/medweb/demo_site Presenter: Dr. Geoff Dunkley, Associate Medical Officer of Health, City of Ottawa Evidence-Based Decision-Making Seminar, Centre for Surveillance Coordination, Health Canada A copy of the PowerPoint presentation “The Experience of SARS” was made available to all attendees. Peter Tugwell, Director, Centre for Global Health, Institute of Population Health, University of Ottawa. Dr.Tugwell discussed the theory and practice of Evidence-based Medicine and problem-based learning in the Medical curriculum. Considering the problem of English-only articles on the Internet, he mentioned the example of Mexican doctors who have translated 45 abstracts in the form of bulletins for primary care, which are updated every three years. Wednesday October 1 Dr. Jeff Turnbull, Chair of Medicine, The Ottawa Hospital Dr. Turnbull discussed how the University of Ottawa Medical Curriculum is organized and distributed the schedules for all 4 years plus the Faculty of Medicine calendar. Tour of General Hospital with Dr. Steve Kravcik and discussion of Modules 3+4 on biostatistics and critical appraisal SUMMARY Page 7
  8. 8. SUMMARY 1/27/15 Valerie Gamache-O’Leary, Director, Information Systems, The Ottawa Hospital Email: VGamache@ottawahospital.on.ca Ms. Gamache-O’Leary explained how each of the 4 facilities of the integrated Ottawa Hospital had their own Patient Registries, lab and financial information systems, which all had to be integrated. Her current project has been the development of an electronic patient record, including a clinical information system for front line staff using an OACIS interfacing system. A doctor can now check on a patient test results from any of the 4500 computers located in the 4 facilities. Tom Elmslie, Associate Professor, Department of Family Medicine, Faculty of Medicine, University of Ottawa 451 Smyth Road Contact Mariella Peca: 562-5800 x. 8281 Email: peca@uottawa.ca Dr. Elmslie presented how EBM is taught at the University of Ottawa;. Group lectures and individual work build throughout the 4-year medical school program, where students appraise articles and systematic reviews, which lead to clinical practice guidelines. Dr. Elmslie also teaches EBM to practicing family physicians, through self-instructional manuals and facilitators to get credits required by the Royal College of Family Physicians. The PEARLS booklets can be found at: http://www.cfpc.ca/English/cfpc/cme/pearls/default .asp?s=1 Thursday October 2 Jessie McGowan, Senior Information Scientist, University of Ottawa, Institute of Population Health. 1 Stewart Street, Ottawa Jessie McGowan: 562-5800 x. 2359 Email: jmcgowan@uottawa.ca Review of Literature Searching (Module 2). Ms. McGowan described the Cochrane Collaboration as a library of systemic analyses of medical studies prepared by 56 volunteer groups, each focusing on a specific specialization. A Russian website www.cochrane.ru has links to the English site, and a subscription comes with passwords to the site plus a CD update every quarter. Subscription info can be found at www.update-software.com and the guide (form) for hand (non-Internet) searched articles for submission the CENTRAL database can be found at http://www.cochrane.us/manage.htm Jeremy Grimshaw, Director, Clinical Epidemiology Program, Ottawa Health Research Institute to discuss his work with family The Ottawa Health Research Institute (OHRI) is the research arm of the Ottawa Hospital, and a major part of the University of Ottawa Faculties of Medicine and Health Science. With more than 200 SUMMARY Page 8
  9. 9. SUMMARY 1/27/15 physicians and clinical practice guidelines, using EBM practices and collected case studies to build “decision-trees”. scientists, 225 students and 400 support staff, and $42 million in external funding, the OHRI is one of the fastest growing, and most respected hospital- based research institutes in Canada. Formed on April 1, 2001 by the merger of the Loeb Health Research Institute and the Ottawa General Hospital Research Institute, the OHRI's mission is to excel in research, education and innovative patient care. Dr. Grimshaw did his Ph.D. in Health Services, focusing on how to improve the quality of care by using clinical practice guidelines. While his background is largely in the UK and now Canada, he mentioned that international collaboration on writing CPGs is useful as it takes a great amount of time and resources to review the literature and write a guideline. For a guideline development handbook, see www.sign.ac.uk and to appraise guidelines for research and evaluation, see the Agree appraisal instrument at www.agreecollaboration.org which may soon have a Russian project. Michelle Albagli, Executive Director, Canadian Dermatology Association and Senior Dermatologist Dr. Jean Pierre DesGroseilliers Royal College of Physicians and Surgeons of Canada (RCPSC) Dr. DesGroseilliers commented that clinical practices guidelines are developed on an ad hoc basis in Canada. For instance, CDA receives guidelines from the US Dermatology Association, and also develops some specific Canadian Guidelines. While on the Board of Education for the RCPSC, he worked on the Maintenance of Certification program, which requires licensed members to earn 400 credits every five years. CANMEDs 2000 was distributed to participants, which stands for Canadian Medical Education Directions for Specialists, evaluating residents on general inter-personal skills as Communicator, Administrator, Collaborator, Manager, Scholar, Professional, Health Advocate and Clinical Decision-Maker. Friday October 3 Clinical Epidemiology Seminar/Rounds Guest Speaker: Dr. Dr. Shekelle discussed a number of examples of systematic reviews of case studies on a specific SUMMARY Page 9
  10. 10. SUMMARY 1/27/15 Paul Shekelle, Director, Southern California Evidence-Based Practice Centre, RAND herbal treatment, which RAND has been asked to complete. A copy of the PowerPoint presentation was made available to all attendees Debriefing at CSIH office, One Nicholas, Suite 1105 Next steps were discussed, which include sending the revisions of the seven modules, and having translations finalized. Also, participants were encouraged to register their institutions with HINARI, which should allow free access to Cochrane Library and many other medical journals. http://www.healthinternetwork.org/src/registration. php Departure of Irina Zarnadze & Revaz Chanturia Saturday October 4 Departure of Sanan Karimov & Mir-Riad Javadzada SUMMARY Page 10

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