Lauren MacDougall, Nova Scotia Health Authority
The continued growth of the digitalization of health care information is critical to the delivery of high value care. In August 2019, Nova Scotia became the first province in Canada to successfully connect a Laboratory Information System (LIS) to the Panorama Public Health Information System.
Panorama is a digital health solution or integrated electronic health record that is used across Canada to manage communicable diseases, outbreaks, immunizations and vaccine inventory. According to Canada Health Infoway, Panorama modules are now live in provinces covering 75 per cent of the Canadian population and several jurisdictions are now in the planning stages.*
Between 2017 and 2018, Nova Scotia implemented Panorama’s three modules: Vaccine Inventory; Immunization and Investigation and Outbreak Management. The implementation of these three modules provides a central repository for data to support and inform public health programming and policy related to immunization and communicable disease management. Nova Scotia is the first province in Canada to implement all three modules within such a limited time.
The connection of lab results to Panorama is the latest expansion of the system in Nova Scotia. “The Panorama project has been a significant amount of work for many individuals from the Pathology Informatics team and Public Health. Those that were involved deserve a lot of credit for their hard work,” says Dr. David Haldane, Clinical Director, Provincial Public Health Laboratory Network of Nova Scotia.
Nova Scotia is home to nearly one million residents, with nearly half of the population located within the capital of Halifax and surrounding areas. The new interface is connected to one of the province’s three laboratory information systems – Cerner Millennium – which is located in Halifax and includes the primary microbiology reference laboratory for the province. The development of the connection between the second LIS – MEDITECH Client Server – which serves areas outside of Halifax is underway and it is anticipated that this work will be completed in early 2020. The third LIS supports the IWK Health Centre, the Maritime’s children’s hospital in Halifax; however, this is not in scope at this time.
To support communicable disease case management and surveillance, the Department of Pathology and Laboratory Medicine at Nova Scotia Health Authority (NSHA) is required by law to report instances of diseases, infections and other organisms to Public Health that could pose a risk to the population. Historically this information was reported by phone, fax or a daily data download from the LIS that required a level of manual management by Public Health. The new LIS interface has automated this process, improving efficiency and accuracy.
In addition to the LIS, Panorama is also currently interfaced with Nova Scotia’s Client and Provider Registries which uniquely identify patients and demographic information. Panorama is also connected to the Nova Scotia School Information System to support the Public Health School Immunization Program. Integration with Nightingale Electronic Medical Record exists today and work is underway to integrate with the two replacement EMRs.
The availability of lab results via Panorama is fundamental for designated public health officials to efficiently identify and effectively manage outbreaks for the protection and health of all Nova Scotians in the community and in health care facilities. Officials can make decisions more quickly as the result of better access to more complete data. This contributes to Nova Scotia’s digital health plan, supporting a modern, integrated health system and demonstrating Nova Scotia Health Authority’s innovation value and the Government of Nova Scotia’s support for innovation.
*Source: Panorama: Safeguarding the Health of Canadians. Canada Health Infoway.