Virtually Priceless Thoughts

In my work at VIHA over the spring we have drafted a series of Clinical Information Architecture Principles to support the ongoing development of the Clinical Information Systems at Vancouver Island Health Authority. We developed seven interrelated, draft principles. These are meant to be draft as we expect that future experience leads to hardening and enhancing these principles, but they are in use now as we begin the next stage of work on electronic clinical documentation in VIHA.

As VIHA’s IM/IT strategy for the next 3 years is being approved and disseminated and these principles have made the rounds throughout VIHA, I thought that it would be an opportune time to start sharing these 7 principles here. Over the next few weeks, I’ll endeavor to share the essence of each principle, with some additional commentary as needed to provide context to each one. The seven principles are:

1. One Person, One Record: VIHA will create a Virtual, Electronic “Individual Health Record” for each person.
2. Clinical Information is Designed Centrally and adopted by all regional clinical systems
3. Capture and Use of Patient Information is Designed to Support Care Delivery across the region: first for points of care, then for points of reflection.
4. Core Patient Information will be stored and maintained in Cerner so that advanced EHR features can be properly supported in VIHA.
5. Documentation will be constructed from standardized building blocks or “patterns” that are interactive and support decision-making.
6. Approved vocabularies will be consistently adopted wherever appropriate in all regional Clinical Systems.
7. Across VIHA Regional Clinical Information Systems, clinical information must have a defined Source of Truth, be up to date, and consistently available.

Time will tell how achievable these are, particularly in light of economic times, but these will serve as guide posts for decisions we need to make over the next three years. They will be modified, based on what we learn as an organization going forward, and may split into sub groups of principles that drive more detail level decision making as well.

Finally, a public tip of my hat to Glen McCallum. He’s worked closely with me on these and shaped them drastically for the better. We would not have completed these without him. Thank you.