What is IPS and Patient Summary?
The IPS (International Patient Summary) is an electronic health record extract containing essential healthcare information about a subject of care. It represents a minimal and non-exhaustive set of clinically relevant standardized patient data, specialty-agnostic, condition-independent, but readily usable by all clinicians for unscheduled (cross-border) patient care. While focused on unscheduled cross border care, it also provides generic and potentially reusable solutions for global application beyond a particular region or country.
The Patient Summary - Canada (PS-CA) standardized profiles (or specification) leverage the principles of the IPS and (currently) its datasets to provide a core patient summary that supports the provision of effective, high quality patient care within the Canadian context. Developed in collaboration with jurisdictions and their clinicians, PS-CA outlines the critical high priority data clinicians want, the data standards (data language) all systems need to speak to exchange the data and standardized methods to exchange the data, such as CA:FeX (Canadian FHIR exchange).
What problems do they solve?
Even in the age of digital health, system incompatibilities across the spectrum and a lack of data integration and portability at points of care mean that data is often “locked” in an individual system. This causes several issues:
- Unless visiting their own family physician (where the bulk of primary data resides), most other healthcare episodes typically lack access to data, raising the risk of unintended side effects or adverse reactions and reducing quality of care unintentionally
- Patient satisfaction suffers as expectations are not met due to extended waiting times for diagnosis, when information is either missing or inaccessible and at times inaccurate
- Inefficiencies in care provision due to time required to locate information for clinicians already feeling burn-out
- Inability for funders to receive reliable business intelligence to support the most effective funding decisions
When data language, common data elements and exchange methods are aligned and technical components are available, information can be shared quickly, efficiently, and easily whether within a region, a province, a country or international setting.
Prioritizing Patient Summary
Patient summary is a container that includes the most relevant health data domains that capture and consolidate patient information across various health care settings. Over 200M transactions occur using these domains, across Primary and Acute care settings alone, through EMR point of service systems; representing the highest contributions to patients’ medical summaries. Solving for the exchange of patient summaries is key to resolving some of the challenges above.
Infoway has a history of collaboration with jurisdictions in supporting foundational and pivotal transformation. Whether the move from paper to electronic records, in-person visits to virtual visits and, standardization of data using internationally recognized standards (common data language for systems), we see the next critical transition to be the unlocking of patient data. The pandemic has further outlined the need to consider patient health data not just from a local or even national perspective, but also from a global perspective.
Many jurisdictions have also recognized this and made patient summary a priority and as we have always done, we will continue to support and align with jurisdictions in meeting their goals and advancing the Canadian healthcare landscape.
Infoway’s Role:
Recognizing that healthcare delivery in Canada has several specializations that are the same content but use a different data language, Infoway is:
- Collaborating with jurisdictions and key stakeholders to consolidate the requirements
- Assessing the existing content to define and standardize the common elements across all jurisdictions to outline the base foundational profile for all
- Reviewing jurisdictional profiles to ensure alignment to the common profile
- Aligning the core profiles against internationally recognized standards, including the IPS
- Providing technical and data standards (data language) leadership and expertise
- Representing Canada in the international community focused on data standards and interoperability such as GDHP and its members, IHE International and its affiliates, we bring the Canadian context to advance international specifications and advocate for changes based on stakeholder feedback
- Educating vendors about the new profiles and how to implement them and lastly,
- Testing and scoring vendor implementations on their alignment to the published pan-Canadian specifications
What tangible benefits we can expect?
PS-CA is a stepping-stone towards the future. It allows access to the most critical patient data now, while allowing the room to build out modern, “just in time”, secure and access-controlled ecosystems that respect patient privacy while allowing citizens to participate in the delivery of their own care. Common standards for Patient Summary including the way in which it’s exchanged, can realize multiple benefits to different stakeholders, including the ability for a single longitudinal patient record.
Stakeholder | Benefits |
Patient | Improved patient experience due to more efficient and comprehensive data sharing between providers leading to improved health outcomes. Having the ability to access and share their own personal health information. |
Health Care Funders | Reduction in costs and time to implement patient summary and interoperability solutions due to availability of reusable data content and technical profiles that reflect 80+% of the common requirements. Availability of more reliable automated reporting to better target health care spending according to need. |
Jurisdictions | Reduction in implementation burden due to centralized expertise in niche interoperability areas and reusable profile components, which also reduces resource demands. Ability to reuse data content and technical profiles that reflect 80+% of the common requirements which will decrease implementation timelines. Promotes better scalability and enhancements for patient summary solutions with minimal effort into the future where vendors can incorporate new elements without jurisdictional oversight. |
Vendors | Ability to reuse significant number of standardized components to implement across all jurisdictions with minimal variability. Reduction in implementation time. Coordinated approach for all jurisdictions reduces complexity and resource requirements. Alignment to global standards also supports international vendors who will no longer need to specialize their solutions specifically for Canada. |
Clinicians/ Health Care Providers | Enhanced communication between health providers: Bridged silos within the health system (e.g. between acute, primary and specialist care, long term care) to enable more effective coordination and transitions of care, in addition to improved support for clinical decision-making. The ability to communicate between different solutions, and/or different jurisdiction also facilitates cross-jurisdictional patient flows. Improved provider experience and increased satisfaction: More accessible and better-organized patient information leads to significant time savings, freeing time to spend with patients. Reduced administrative burden, improved workflow efficiencies and more targeted, effective use of practice hours helps prevent clinician burnout and facilitate clinician work-life balance. Improved data quality and currency: Clear, consistent records of past tests and results enable more focused investigations and testing, with reduced redundant/duplicative tests. Patient safety is improved through the availability of more timely, accurate information about the patient’s medical history, potentially preventing harm, delayed care or inappropriate treatments. Supports the provision of virtual care: Providers delivering care through different modalities/solutions can access the same health information about a patient. Consistent access to information and better communication also facilitates encounters with unfamiliar providers at the point of care (i.e. a provider delivering care on a telehealth platform to a patient without a regular primary care provider). Better health outcomes: Consistent access to health information aids decision-making for clinicians and patients and supports proactive health management. Better coordination and transitions of care help to increase patient safety by improving timeliness of care, reducing duplicative testing and preventing instances of contraindicated medications and/or treatments. More effective care is received more quickly, across health care settings. |
Projected Annual Benefits:
The projected annual benefits at 50% adoption are:
- Safe & improved transitions of care.
- Health System = $490M in improved ambulatory interactions, effective use of ED, in-patient services and a reduction in duplicate lab/DI tests.
- Canadians = $448M in saved patient time.
- Clinicians = $328M in saved clinician time.