PAN-BC update Feb 07 by csgirla


									Incredibly, almost 9 months have passed since the PAN-BC inaugural
meeting in May 2006. Some of you attended that meeting and will be aware
that a PAN-BC Steering committee was selected to lead this initiative. The
members of this committee are: Mark Ansermino, BCCH Anesthesiology;
Larry Dallen, Victoria Anesthesiology (Chair); Darcy Goodwin, KTM
Division, BC Ministry of Health; Chris Hall, IT Consultant, VCHA; Don
Henkelman, CIO, PSHA; Richard Merchant, RCH Anesthesiology & BCAS
Safety Director.

There may be some of you who are hearing about PAN-BC for the first
time. If you read this missive and the attached Minutes of the December
meeting of the PAN-BC Steering Committee, you should be up to speed.

We have a vision - and now a vision statement for PAN-BC: To develop an
integrated electronic anesthesia record that informs clinical decision-
making across the province for improved patient safety and efficiency.

The PAN-BC Steering Committee has been very active behind the scenes
ever since the May meeting. There was a lull in the summer but during that
period it was recognized that finding seed-money for our project would be
problematic because PAN-BC does not fit comfortably into anyone's
mandate. PAN-BC needed a sponsoring organization so in September the
BCAS Executive was approached. I am pleased to report that the BCAS
has become an enthusiastic supporter of the PAN-BC project and
contributed the first $10,000 to help get things started. Very soon thereafter
commitments of $5000 each were received from 5 Anesthesia
Departments - Royal Columbian, BC Children's, St Paul's, Victoria and
Vancouver General. This amount of money from anesthesiologists is
sufficient to get started and for that the Steering Committee is exceedingly

Our first priority is to get PAN-BC's case presented to those who have the
authority and the resources to fund a project of this scale. Since
December, we have been working with The Howe Group, a public service
consulting firm, that is helping develop a Strategic Plan. This strategic plan
articulates the vision, goals and rationale supporting PAN-BC and provides
a framework for how to accomplish these goals. The PAN-BC Strategic
Plan will be completed by mid March 2007 and made available to you.

Immediately thereafter, it is anticipated that work will begin on a Business
Case for PAN-BC. This document will be much more detailed, expanding
upon the Strategic Plan including: a review of the current state-of-the-art in
anesthesia information management; a full inventory of anesthesia IT
requirements for BC; and all the financial, logistical and management
details of implementing this project. Completion of the Business Case for
PAN-BC will likely take the remainder of 2007. During this phase, input
from all of you will be needed.

I would like to outline the Information Technology (IT) hierarchy in Canada
and B.C. so that you have a better understanding of where PAN-BC fits into
the health care IT world.

Canada Health Infoway is a federal government organization that exists
to facilitate the development of key health care IT technologies that can be
utilized by all jurisdictions across the country. CHI is interested in
standardization, registries, interoperability, networks etc. - projects that can
serve as templates for similar initiatives elsewhere - all with the goal of
reinforcing the development of an electronic health record (EHR) for all
Canadians. Members of the CHI Board of Dirctors from B.C. are Mr. Ron
Danderfer (see below) and Dr. Michael Golby, a Kelowna GP and past
president of the BCMA. PAN-BC is the first project of its kind in Canada
and could be the template upon which a national anesthesia information
network is built. CHI should be interested.

The Division of Knowledge Management & Technology (KMT)
supervises IT activities for the B.C. Ministry of Health. Ron Danderfer is the
Assistant Deputy Minister (ADM) responsible for KMT. He is also a
member of the board of directors for Canada Health Infoway, the eHealth
Steering Committee and PITO (see below) - obviously a key IT player. KMT
supervise several important committees within the Health Ministry and the
Health Authorities. Darcy Goodwin is Director of the Project Management
Office, Corporate Management and Operations Branch, KMT division.
Darcy is currently acting Executive Director of the KMT division reporting
directly to Ron Danderfer (ADM). Darcy is also a member of our PAN-BC
Steering Committee.

The eHealth Steering Committee is where decisions are made about
what IT projects and types of IT projects will be supported by the Health
Ministry. It has representation from the health authorities, Health Ministry
and some clinicians. The eHealth Committee is co-chaired by Ron
Danderfer. Physician members of this committee are Dr. Jonathan Burns,
ERP from Abbotsford, Dr. Kendall Ho, ERP from Vancouver, and Dr. Mark
Schonfeld, Executive Director, BCMA.

CIO Council is a congregation of all the Health Region's Chief Information
Officers that meets monthly. These are the people who manage IT at the
Health Region level. Most of the CIO's attended the PAN-BC inaugural
meeting and all of the CIO's are now well aware of PAN-BC as are key
players up to, but not yet including, the Canada Health Infoway Board of
Directors, with the exception of Mr. Danderfer. Don Henkelman, CIO for
Provincial Services Health Authority (PSHA) is an influential member of the
CIO Council and Don is a member of our PAN-BC Steering Committee.

Health Authority IT Strategic Planning committees manage IT at the
health region level.

Professional Information Technology Office (PITO). This is a
committee of the BCMA that was convened to manage money that was
negotiated by the BCMA and earmarked for use in offsetting the costs of
acquiring information technology by physicians so that they can contribute
to the EHR. Unfortunately, it appears that PITO funding is available only to
office-based physicians, the assumption being that the IT needs of hospital
based physicians will be met by hospitals. Anesthesiologists working in
private surgical facilities should be entitled to apply for IT funding from
PITO. There is a lot of money in PITO - perhaps $100 million.

All these IT groups have their priorities delineated for the next 3 to 5 years
and herein lies a problem for PAN-BC. It has been made clear to us that
the IT priorities in BC at this juncture are to build infrastructure (Registries,
Indexes, Networks, Protocols, Standards etc.) rather than build clinical
information systems. Although PAN-BCʼs profile is improving, our project is
not yet on the IT radar so our challenge is to change this situation.

Whether or not PAN-BC receives funding will be determined by one or
perhaps several of these committees. When attention turns to clinical
information systems, PAN-BC intends to be at the front of the line with all of
our ducks in order.

The shared health record, registries, interoperability, patient safety and
economies of scale in procurement are all hot button issues in medical IT.
PAN-BC addresses aspects of all of these issues.
Patient safety is a high priority item with the Health Ministry and I have met
with Paula Bond the ADM responsible for patient safety, innovation and
integration who has expressed interest in PAN-BC. On January 25, 2007, I
met with Dr. Doug Cochrane, Chairman of the B.C. Patient Safety Task
Force (PSTF) and Dr. Tom Dorran, Executive Director for Patient Safety,
Innovation and Integration to introduce PAN-BC. Subsequently I made a
presentation to the full PSTF committee and asked for their support. The
goals of the PSTF and PAN-BC are closely aligned so support from this
group is anticipated as this project evolves.

At some point in the next few months you will be contacted by someone
from the PAN-BC Steering Committee or by Christine Vanderbeek or
Wynona Church from Howe Group soliciting information about anesthesia
in your institution and your input into PAN-BC.

There is almost enough information to justify a PAN-BC website, so this will
be up and running within the next few months with a view to it becoming a
focus for PAN-BC information and communication.

As this project moves along, we will be looking for anesthesiologists in
every department to represent PAN-BC. We need evangelists so if you
know someone with a passion for this stuff, please let me know. If you have
the ear of any of the people mentioned in this notice, or others with
influence in medical IT circles, please bring PAN-BC to their attention and
let them know that you and your department are firmly behind this initiative.
The more they hear about PAN-BC, and the more widespread the support,
the more likely our project will be considered when this important decision
is made.

This notice has been circulated to at least one anesthesiologist or
anesthetists in every anesthetizing location that is listed on the BCAS
website. If there is anyone who is not included in this circulation list and
should be, please let me know.


Larry Dallen MD


PAN-BC Steering Committee

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