GTA West DI-r Regional Diagnostic Imaging Repository Presentation Overview • Concept of the DI-r • GTA West Project History • GTA West Project Description • GTA West Project Procurement Strategy • Current Status of the GTA West • Next steps • Questions and Open Discussion Concept of the DI-r – Visual Representation Reference: eHealth MOH 2006 Concept of the DI-r - Challenges • Funding for Modalities, PACS, Archives and Infrastructure • Hospitals and IHFs have different models (both need access to images at point of care) • Unique Patient Identification - EMPI • High capacity, high availability networks not sufficient across the province • Many existing film-less sites lack sufficient resources for full redundancy to provide seamless business continuity • Strong provincial leadership needed, clinical quality guidelines and standards, local and regional governance, collaboration and sharing required, balanced with independence Reference: eHealth MOH 2006 Concept of the DI-r - Challenges • Interoperability of various RIS/PACS solutions • Organizations at different stages of film-less maturity, aggravating persistence of Transportable Media (Films, CDs) • PACS investments often perceived as departmental instead of enterprise • Balancing economies of scale with DI solution performance needs (response) Concept of the DI-r - Rationale • Supports biggest considerations: Clinical needs, Funding, Governance, Flexibility and Performance • Supports patient referral, provider service patterns, existing and new collaboration • Sharing and Clustering where viable, respects hospital and IHF differences • Incorporates existing PACS/RIS investments, solutions and initiatives underway Concept of the DI-r - Rationale • Uses existing data centers • Accommodates geography and network variances • Provide options in the future for consolidating functions Concept of the DI-r - Rationale • Supports patient referral and provider service patterns • Limits local infrastructure burdens, optimizes resources Concept of the DI-r - Rationale • Levers Extensive investments which have been made in departmental and enterprise RIS/PACS – no tear downs • Supports established and new collaborative frameworks (e.g. In Urban/Suburban/Rural and North geo clinical profiles, where resource shortage is acute, region/group collaboration and sharing is extensive) GTA West Project History • The GTA West Diagnostic Imaging (DI) Repository Project is a joint initiative commissioned by a voluntary consortium of 22 hospital corporations that span the central and southern regions of Ontario. The project launched in mid 2007 to undertake a Phase 0/1 Planning Project sponsored by Canada Health Infoway (Infoway). • GTA West represents the last DI-r in Ontario (second last in Canada) and is being sponsored by the Ministry of Health, Canada Health Infoway and the participating Local health Integration Networks. GTA West Project History • GTA West started off with a group of hospitals that are located in the western side of Greater Toronto Area (population ~2.5 Million) • The group expanded beyond the GTA borders to include hospitals and regions that had not yet joined a DI-r GTA West Project Description - Region • LHIN 5 • Headwaters Health Care Centre • William Osler Health Centre • LHIN 6 • The Credit Valley Hospital • Halton Healthcare Services • Trillium Health Centre • LHIN 7 • Baycrest • Bridgepoint Health • Centre for Addiction and Mental Health • The Hospital for Sick Children • Mount Sinai Hospital • The Salvation Army Toronto Grace Health Centre • St. Joseph's Health Centre • The New Women's College Hospital • Toronto Rehab Institute • University Health Network • West Park Healthcare Center • LHIN 8 • Humber River Regional Hospital • LHIN 12 • • Royal Victoria Hospital Orillia Soldiers Memorial Hospital ~ 3 Million DI exams • North Simcoe Hospital Alliance • Muskoka Algonquin Healthcare • Collingwood General & Marine Hospital GTA West Project Description • UHN is acting on behalf of the participating hospitals as their representative with respect to the execution and administration of the agreements with Canada Health Infoway and the eHealth office of the Ontario Ministry of Health and Long term Care • Canada Health Infoway will fund 75% of the eligible costs • The Ministry of Health has agreed to fund the remainder of the costs • There are no operational costs to hospitals for the first 2 years…MOH funded. GTA West Project Description – Project Team GTA West Project Description - Committees Clinical Oversight Committee: – The GTA West Clinical Oversight Committee will be responsible for providing clinical oversight for the planning, development, implementation and operation of a shared digital diagnostic imaging repository (DI-r). – Review, approve and deliver the clinical components of the Current State and Future State Architecture and Clinical Requirements documents; – Review project deliverables as may be requested by the PMO resources from time to time Technical Advisory Committee: – Provides technical oversight for the planning, development, implementation and operation of a shared digital diagnostic imaging repository (DI-r). – Review and recommend the Future State Technical Architecture and Technical Requirements documents – Provide advice to the PMO resources as to the content of the above documents – Review project deliverables as may be requested by the PMO resources from time to time GTA West Project Description - Deliverables Conceptual Detailed # Phase 0/1 Deliverables Phase 0 Phase 1 1.0 Project Management 1.1 SOW/Charter 1.2 Legal Agreement/TPA/Reimbursement Schedule 2.0 Options Evaluation/Future State 2.2 Description Checkpoint Completion 2.3 Gap Analysis Checkpoint Completion 2.4 DI-r - Vendor Information Gathering Process (RFI) Checkpoint Completion 2.5 Vendor Workshops/Discussions Checkpoint Completion 2.6 Refresh Checkpoint Completion 2.7 Test Strategy Checkpoint Completion 3.0 Business Case and Financial Analysis Checkpoint Completion 4.0 Conceptual Privacy and Security Architecture (CPSA) Checkpoint Completion 5.0 Conceptual Privacy Impact Assessment (CPIA) Checkpoint Completion 6.0 Conceptual Threat Risk Assessment (TRA) Checkpoint Completion 7.0 Change Management Checkpoint Completion 8.0 Risk Management Checkpoint Completion 9.0 Integrated Project Plan Checkpoint Completion 10.0 Communications Plan Checkpoint Completion 11.0 Governance Checkpoint Completion 12.0 Preparation of Phase 2 Documents Completion GTA West Project Description – End Goals • To deliver a DI-r capable of accepting PACS data as well as RIS data in native format from multiple institutions and present it through a 3rd party viewer and within the GTA West partners RIS or PACS • To deliver a DI-r that will facilitate the integration of the other DI-r systems in Ontario GTA West Project Procurement Strategy GTA West Project Procurement Strategy • Decided to procure a service and not a solution to ensure that an existing public entity would be able to govern the system with minimal to moderate effort • Built a comprehensive RFP administered by a RFP administrator and controlled by fairness consultants GTA West Project Procurement Strategy • Sections of RFP – **Clinical – Use cases – Technical – **Governance – Privacy and Security – Total Cost – Company profile Current Status of the GTA West • 95% Completed Phase 0/1 – Site surveys – RFP architecture – RFP evaluation – Selection of vendor – Governance group – Contract signing Next Steps • Complete Phase 2 funding exercise for CHI and eHealth Agency • Redo business case • Sign on partners • Build Project team • Initiate project in Sept 2009 – First go-live site late 2010 Questions?