- The document discusses healthcare accountability and reporting requirements in Ontario, Canada which includes performance indicators reported by hospitals, community care access centers, mental health and addiction services, and other organizations. - It describes problems small organizations have with analyzing large amounts of healthcare data and making evidence-based decisions. - The solution presented is a decision support system that analyzes uploaded healthcare data and calculates performance indicators to generate easy-to-understand reports that can help improve healthcare planning and management.

2. Agenda
• Agenda
• Acknowledgements
• Special Thanks
• Healthcare Accountability & Reporting requirements in Ontario, Canada
• Ontario Healthcare Reporting Standards
• Performance Indicators in Ontario
• The Problem
• The Solution / Technology
• How it Works
• Samples
• Summary
• Product Thanks

3. Acknowledgments
• Speakers
– Jonathan Teich, MD, PhD, FHIMSS, FACMI
Chief Medical Information Officer, Elsevier
– Lyle Berkowitz, MD
Medical Director, Clinical Informatics, Northwestern Memorial Physicians Group
– Dave Garets, FHIMSS
Executive Director, Advisory Board Company
• Guests, Voters, media, HIMSS professionals and the HI-Curious

4. Special Thanks
Thank you to:
• HIMSS
– For the invitation to come pitch our healthcare Decision Support
System @ HIT Geeks got Talent?
– Organizing and inviting my attendance to HIT X.0 Beyond the Edge
• Joanne Bartley, HIMSS Manager of Education and Professional
Development, CompuSystems and the Orange County Convention Centre
– For their professionalism and prompt assistance in preparation for the conference

5. Healthcare Accountability & Reporting
requirements in Ontario, Canada
Off the top of my head
• OHRS – all M-SAA signed Health Service Providers below, see next
• Hospitals (150): DAD, NACRS, RAI, OMHRS, WERS(budget), ERNI(ED
performance), c-diff , selected Wait Times, local fund specific indicators,
accreditation ,etc
• CCACs (14): HCDB, RAI-HC, WERS, Prov-Wide Patient Satisfaction, etc
– Community Care Access Centres, co-ordinate post-acute, in-home child & elderly support
and in-school care, LTCHomes priority-lists
• CMH&A (400): WERS, DATIS, CDS-MH, RAI-MH, CAPs
– Community Mental Health & Addictions
• Community Support Services: (700) WERS, CAPs ….
– Meals on wheels, etc

6. Ontario Healthcare Reporting Standards
• OHRS/MIS Trial Balance 3x/yr quarterly
– Complete financial and statistical data submission
– Based on WHO healthcare MIS, rolled up by CIHI for provincial
comparison
– Edit checked, 6 stages against both accuracy and reasonability
– Hundreds of thousands of primary-secondary account combinations
• Functional Area + Financial & Statistical Data
– HR (hours, worked, paid, OT, PT, Sick, etc)
– Patient statistics, admit, visits discharge, assessments, times-
to by Age Group and Patient Type
– Detailed Financials

7. Accountability in Ontario Health Care
Health Service Providers: Financial/Statistical Indicators
• Hospitals (150)
• Community Care Access Centres(14)
– in home, care in schools
• Community Mental Health & Addictions (400)
• Community Support Services (700)
• Coming Soon
– Long-Term Care Homes (60 so far)
– Family Health Teams

8. Accountability in Ontario Health Care
Is primarily through Financial/Statistical Indicators,
Budget (WERS) and Actual (OHRS)
• Hospitals (150)
• Community Care Access Centres(14)
– in home, care in schools
• Community Mental Health & Addictions (400)
• Community Support Services (700)
• Coming Soon
– Long-Term Care Homes (60 so far)
– Family Health Teams

9. Ontario Healthcare Reporting Standards
– Currently hundreds of indicators are calculated from the
OHRS for each facility, sector, planning region and
provincial summaries and made available to HSPs in
Ontario.
– Well over 1,000,000 indicator data points are available
across more than 5 years … though data quality issues may exist…
…in just the ‘Public’ (HSPs only) Financial and Statistical
available data

10. The Problem:
• How to provide the tools for evidence based decision-making
to 1,100+ organizations each with:
– Volunteer Board of Directors
– CEO/Executive Director, VPs, Dirs, Managers, etc
– Front-line staff (all HC workers are knowledge workers)
most would benefit from access to & understanding of the vast
amounts of data available…
Ranging in budgets form < 500K to $1B, but all with the same
requirement to submit OHRS and meet other reporting
requirements in order to maintain levels or receive new funding.

11. Additional Problems:
• CMH&A’s and CSS’s, others small rural facilities
– Small
– Very small
– Rural, very rural
– Little time for training, admin staff usual also helping clients
– Not accountants, no IT etc
– computers introduced recently
– dial-up
• Need to Maximize Collaboration and Knowledge Sharing for a lot of
users cost effectively, preferably below the RFP threshold/organization
• Shallow Learning curve and easy-to-use

12. The Solution:
Thanks to Dr. Rosling, Trend-Analyzer, Gapminder and Google
• Using light-weight JSON, Flash and HTML 5
• Functional over dial-up, satellite, and cellular
• Final Reports can be re-published on ANY website
– Blogs, share-point, IIS, Apache etc
• Rendering/Visualization is done client-side, using client
resources, no costly resources
• Incorporates Algorithms perfected over 5 years of
OHRS/FSMS Indicator analysis
Data & Technology Solution’s Decision Support System

13. How it Works:
Data & Technology Solution’s Decision Support System
User uploads the same file provided to the MoHLTC to the dtsDSS
• Algorithms dis-assemble, then extract, transform and load the data into a
data repository
– Indicators are calculated, Global & Functional
– Local planning level, size-type, and provincial summaries for calculated
indicators are incorporated
– Functional/Global comparators are added
• Works over dial-up, satellite, and cellular access
• Final Reports can be re-published on ANY website
– Blogs, share-point, IIS, Apache etc
• Rendering/Visualization is done client-side, using client resources, no
costly resources
• Incorporates Algorithms perfected over 5 years of

14. OHRS Reporting Roll-Out

15. Ontario Population Projections by
local health planning region to 2031

16. Ontario Acute Hospitals’ Number of Admissions vs. Average
Length of Stay by Bed Type

17. Health Systems: US, UK, and Canada

18. UK Hospital Statistics Admissions vs. % Admission/ER

19. Includes capability to add video and audio, internet sharing
etc….

20. Summary
• Successful performance management and accountability in
healthcare requires serious tools that can turn large numbers
of indicator data sets into useful information for informed
decision making.
• The dtsDSS, by pre-loading millions of healthcare specific and
related data that may be of interest to health system planners
into a single software-as-a-service business intelligence
system
• Next Steps: ICD-10 (DAD/NACRS), CDS-MH, RAI and any other
standardized submission.

21. Product Thanks

22. Thank you for your support!
Jeremy B. Albisser, BSc AIT
jba@dtsDSS.com, ca.linkedin.com/in/jbaDTS
www.dtsDSS.com