CACDI + HALO = Interoperability_Can

[Debra Turnbull]

I realized that my 2 previous posts: CACDI (CIHI) and HALO (Infoway) sounded like pure gibberish... unless you are in the software development world. Allow me to explain...

Up to 2 years ago, each EMR (electronic medical record) software vendor had their own version of a data standard. Add to this, every province and territory would aim to standardize their jurisdictional (provincial) health data. The result - no system can swap data with another. This is the 'silo' effect: across systems and across jurisdictions.

I don't know about you, but I am tired of that pile of sticky notes with all of my Login_IDs and passwords. Doctors also suffer from this - trying to find all the bits & pieces of data to a patient's health record, i.e. 'their story'. It gets worse when pieces are missed. (I attended a presentation where someone described this as 'portal-itis'... yup!)

What CACDI and HALO do, is together, define a National Standard for Health Data exchange. Think of it as the 'rules of engagement' for digital solution developers. In Canada, this is a first. The intent is to have a Canada-wide patient record... for us patients and for our doctors.

This is what true interoperability looks like... the Canadian version.

[Chris Johnston]

@Debra-Turnbull I'm a great believer in data standards Deb - but had a reality check recently when staff in the same hospital using the same EMR all had different notions of why I was there, what surgery was being performed, and what anesthetic approach had been agreed. They all accessed the same EMR, but focused on different portions of it, and often interpreted the same portions of it differently. As a patient I not only had to repeat myself about a dozen times to nurses, anesthetists and others, I had to challenge their perceptions and interpretations, and really firmly hold my ground to get them all on the same page. Now I keep wondering, if that's what happens when they're all accessing the same data on the same system, maybe data standards are just the first brick in the foundation, and we still need to identify a lot more bricks to build a workable solution - but not sure what any of those bricks might be. Lots of work ahead!

[Debra Turnbull]

@Chris-Johnston Good grief Chris! I'm sorry to hear that - but not really surprised. Good thing that you held your ground. There is no accounting for what kind of training the mix of clinicians are getting... and suffering from perspective diversion.

You are correct - this is the first brick.

The goal is to build EMR apps. Not just for clinicians - but for Patients too! This is where I see PAN playing a role - calling @Alies-Maybee .
We have patient representation across the provinces & territories. There is opportunity here. With patient apps, we would have tools to defend ourselves with. Plus, it would be written in their language (I know, wishful thinking).

I have attended many high-tech healthcare presentations. The look on developers' & engineers' faces when they are told about the hoops that they have to jump through - just to have their product recognized - their eyes glaze over. Most are told to market their products in the States first; then come back to Canada. (Nowadays, I have strong feelings about that recommendation...) Now, they have a Canadian starting point.

Will this solve clinician perspective diversion? No.
BUT - it will allow for the development of patient apps that:

• are EMR independent,

• work across the provinces (jurisdictions), and

• give patients their data in which to hold their ground.

BTW - this is a Data Standard plus Framework. I have not had a chance to crack open any documents yet.

[Alies Maybee]

@Chris-Johnston Wow! yes, it seems like there is definitely more "bricks" needed based on your experience. It still would be great to get "brick" one in place, though.