Relying on IT for technical support of the Connected Health Record
IT is playing a key role in connectivity, user authentication and cyber-security
This year, the curtain goes up on The Connected Health Record Revue, an all-star production that’s expected to dazzle audiences, wow the critics and play for an open‑ended run in CIUSSS West-Central Montreal.
All eyes will be on the leading player, the Connected Health Record (CHR), whose charismatic power will enable staff to use a single digital platform to gain quick, easy access to complete, integrated and updated information about the users of health care and social services at all CIUSSS sites.
Since health information will be much more readily available to staff, workflows will be more efficient, resulting in a greater level of safety and a higher quality of care, as well as more time for personal contact between clinicians and users.
Naturally, with this kind of show-stopping performance, the CHR will be entitled to a deep bow.
A multiplicity of details
However, star power isn’t everything. For this production to really succeed, the work of many more professionals will have to come into play.
For the CHR to really shine—that is, to be ready for immediate, worry-free use by staff—the Department of Information Technology (IT) has to make sure that, among other things, all of the necessary links and connections are in place, the login process is working smoothly and securely, access is granted to the right people, and the technical infrastructure is functioning as required.
In addition, the project has the backing of the visionary mind-set of the CIUSSS’s Board of Directors, as well as the contribution of clinicians who have significant expertise in IT‑related matters.
IT by the numbers
- Total digital applications of all types now used in CIUSSS West-Central Montreal: At least 140
- Servers needed to support those applications: More than 1,200
- Total employees on the IT team: 110
- Number of IT staff dedicated to cyber-security: 12
- Workstations (CIUSSS-wide): More than 10,000
- Phones: Over 10,000
- Accounts managed: At least 13,000
Working together, they are “translating” the needs of clinicians and healthcare users into solutions the CHR will deliver.
To be clear: IT isn’t developing any of the code or software for the CHR. That’s the task of Harris Healthcare, a partner that’s working closely with the Digital Health team—bolstered by IT’s in-depth familiarity with the CIUSSS’s needs—to design the features that clinicians will use.
But after Harris and Digital Health have done their part, the CHR will need a substantial support system—a responsibility that, to a considerable degree, falls to IT.
Tackling a mega-project
Thus, it’s no surprise that the CHR has acquired a reputation as the largest, most ambitious and most complex project the CIUSSS has ever undertaken, says Jennifer Boudreault, who serves as liaison between IT and the Digital Health team.
She explains that launching the CHR is a major challenge, simply by virtue of the fact that it’s breaking new ground as Quebec’s …
- first fully developed electronic health record that covers all CIUSSS directorates
- first cloud-based application of this magnitude
- first use of email to handle authentication and to grant access to various applications
Once the CHR is fully functional, its upkeep will be somewhat easier than what is needed to support the complex array of applications that are currently in use, says Jacques Laporte, the CIUSSS’s Chief Information Officer.
For starters, he explains, one of the key objectives in introducing the CHR is to retire many of the CIUSSS’s older applications. With them out of the way, IT will be able to concentrate primarily on supporting the CHR.
This will allow clinicians to benefit from working on a single platform, instead of having to log into a different application for each of their many tasks.
Another major difference is the fact that the CHR will be based in the cloud. At the moment, Mr. Laporte says, the CIUSSS’s 140 applications are located on 1,200 servers at the JGH—a labour-intensive responsibility for IT.
Much of this burden will gradually be lifted, once the CHR is phased in and increasing numbers of staff begin working in the cloud.
More about the Connected Health Record
Interested in reading about the CHR in more detail? The following JGH News articles explore the major improvements that the CHR will bring to the safety of users and the daily routines of staff.
- Part 1 of a question-and-answer session about the CHR with Dr. Justin Cross, Chief Digital Health Officer for CIUSSS West-Central Montreal.
- Part 2 of the interview with Dr. Cross.
- The role of Elliott Silverman, Associate Director of Digital Health, in developing the CHR.
- How Mike Shulha collaborates with clinical practitioners and staff.
- Protecting the confidentiality of users’ health information
For staff, the launch of a cloud-based system will also mark the inauguration of an era of mobility. If, for example, a healthcare professional is at an out-of-town conference and needs to be consulted about a specific patient, instant access to the patient’s fully updated medical file will be possible on any form of technology that uses a browser—cellphone, laptop, desktop or tablet.
Supporting the “application ecosystem”
Once this streamlined, cloud-based system is functioning, there will still be plenty for IT to do. Since a number of non‑CHR applications will continue to be used, IT will have to ensure that they and the CHR can all communicate with one another, forming what Mr. Laporte calls “an application ecosystem.”
He says IT will also have to ensure that the CIUSSS complies with the directives of the Ministry of Health and Social Services with respect to cyber-security, connectivity with the cloud, and the authentication of staff who want to log onto the CHR.
As well, IT must ensure that cellphone coverage is improved at the JGH by increasing the number of service providers; all CIUSSS sites have the proper digital equipment and access to the necessary applications; and the internet is available to all staff who need it.
Given this significant degree of innovation on a provincial scale, Mr. Laporte stays in regular touch with the Ministry of Health to ensure that the CHR complies with the government’s requirements for cyber-security and connectivity to the cloud.
The need for utterly dependable cyber-security became evident when the CIUSSS became the target of a cyber-attack in the fall of 2020. Fortunately, Mr. Laporte says, no data was lost, no ransom was paid and no CIUSSS files were encrypted by the intruder.
“Were we lucky?” he asks. “Maybe. Were we good? Yes! We managed the crisis in the right way by working with experts in the Ministry who later told us we did exactly what needed to be done.
“What we learned was, if we implement a system in the cloud, we have to make sure it’s as secure as it can possibly be, because in the cloud, you’re not in control of everything in the same way as when you use your own servers.”
Does this make the development and implementation of the CHR a daunting prospect? Certainly, replies Mr. Laporte, “but I also have no doubt it will be worth every minute we spend on it. Just you wait and see—it’ll be great!”