Electronic health records
eHealth Ontario develops
By Catherine Krever
TORONTO – Every
time you see your doctor or nurse practitioner, visit a hospital or lab,
your visit is recorded on a form. And although many providers use
electronic forms, sharing between facilities is fraught with challenges
because more often than not, each form is unique and the information is
eHealth Ontario’s standards team – through its Clinical Document
Specification (CDS) initiative – is committed to changing this.
“We are currently developing the standards-based CDS to allow clinical
documents to be shared electronically between hospitals, physicians,
Community Care Access Centres (CCACs) and other health care providers,”
says Grant Gillis, Director, eHealth Standards.
“The project involves two frequently exchanged forms – assessment and
consults reports,” said Gillis. “We already have a specification to
support discharge summaries and we have built upon this previous work
for the CDS.”
Available as an initial draft since November 2010, the CDS offers a
number of unique attributes in comparison to other specifications.
First, it is based on an overarching clinical document architecture that
can incorporate additional document types, as well as allowing for the
accommodation of subcomponents (i.e., the ability to run queries on
patient demographics, allergies etc.).
The CDS is based on an international document standard adapted for
pan-Canadian use and is suited to meet Ontario health-sector business
requirements. It also provides a framework for vendors responsible for
implementing clinical document repositories by providing guidance on
exchanging clinical documents.
“Patients benefit if their comprehensive, accurate and secure health
information is in the hands of their healthcare providers at the point
of care,” adds Greg A. Reed (pictured), President and CEO of eHealth Ontario.
“Patient forms play a critical role in this, so it’s important that they
follow a consistent standard across the system. The CDS initiative
brings greater consistency to the collection and exchange of patient
Beyond the ultimate benefits to patients, the CDS is a valuable tool
that will help healthcare providers do their important work, while also
improving efficiencies. It will enable the digitization of paper-based
processes – such as assessments and consults – which will advance access
and quality of care provided. It will also contribute to a digital
history of a patient’s care that can be traced and queried from multiple
points of care.
To date, the CDS has undergone six reviews including two public reviews
– open to providers and provider organizations across Ontario and across
the country – two vendor reviews tailored to implementers, and also
technical and business reviews, each with representatives from across
the health sector.
CDS has generated significant interest in the ehealth community.
“I have had the opportunity to lead, facilitate and/or participate in a
number of public review and ballot processes in the establishment of
health informatics standards over the past 10-plus years,” says Michael
van Campen, CDS project facilitator. “The level of participation and
interest in the CDS rivals and indeed exceeds levels in many
pan-Canadian and international standards efforts. Kudos to eHealth
Ontario’s ability to develop relevant and timely specifications for
Ontario’s ehealth stakeholders.”
The Public Review Period, which allowed for wide review of the draft
CDS, closed on January 28, 2011.
During that period, the eHealth Ontario standards team received
interest, feedback and requests for the specification from across the
province as well as from other jurisdictions in North America and
Some 100 comments and observations on the draft CDS were received from a
variety of major vendors, hospitals and other healthcare organizations
during this period. Their input ranged from suggestions for technical
adjustments to the clinical information model to meet specific
requirements, to the addition of more detailed guidance on the
February 28, 2011 marks the Interim Release of the CDS. It will include
feedback received throughout the Public Review Period. The Interim
Release will be made available at
Please visit this website for further news and developments.
Public Reviews Fast Facts:
• 35 healthcare organizations participated in the business review.
• The technical review involved 26 individuals from healthcare
organizations, informatics associations as well as government, agencies
and LHIN representatives.
• The public and vendor reviews brought well over an additional 200
healthcare and IT professionals to the table.
• The CDS received over 120 downloads within the first two weeks of
Posted February 10, 2011