Alberta Health Virtual Care Action Plan

July 2022

On this page

• Introduction
• Overview of virtual care action plan
• Virtual care initiatives
  • Establish an eHealth strategy that includes virtual care
  • Expand MyHealth Records Patient Portal information and capabilities
  • Develop secure messaging and collaboration services for Alberta
  • Develop a privacy and security framework for virtual care
• Funding support
• Expected results
• Alignment with federal, provincial and territorial priority areas

Introduction

Virtual care technology allows patients and healthcare providers to interact with each other remotely and is becoming increasingly important in today's world, especially during the COVID-19 pandemic. Used effectively, virtual care can help expand patient access to healthcare services, enhance clinical decision-making, improve provider workflow and information exchange, and reduce the cost of duplicative efforts in healthcare delivery.

Alberta has a good foundation in place for virtual care in the form of the Telehealth program at Alberta Health Services (AHS), the digital health infrastructure that supports Alberta Netcare, the provincial Electronic Health Record (EHR), and MyHealth Records (MHR), the provincial personal health records portal.

Overview of virtual care action plan

Alberta has created a virtual care action plan to leverage this groundwork and move the province to the next level. The Action Plan identifies four priority initiatives to improve remote health service delivery. They include:

1. Establishment of an eHealth strategy that includes virtual care;
2. Expansion of MyHealth Records Patient Portal information and capabilities;
3. Development of secure messaging and collaboration services for Alberta; and
4. Development of a privacy and security framework for virtual care.

These initiatives collectively address the shared federal/provincial/territorial (FPT) principles of prioritizing user experience, emphasizing data security and privacy, facilitating interoperability and data integration, and enabling cross-jurisdictional solutions to accommodate patient flow.

Virtual care initiatives

1. Establish an eHealth strategy that includes virtual care

The aim of this initiative is to develop an eHealth Strategy to guide the implementation of digital health services in Alberta, including virtual care services.

The eHealth Strategy will:

• Empower Albertans to participate as a member of their care team, and manage their health needs using digital tools and virtual care services;
• Increase access to healthcare services for every Albertan, especially individuals with disabilities and those living in rural or remote locations, including Indigenous communities;
• Improve interoperability between Alberta's digital health infrastructure and systems; and
• Facilitate more efficient, convenient, high-quality, and cost-effective healthcare delivery.

The eHealth Strategy is developed in consultation with key stakeholder groups across Alberta including healthcare providers, professional colleges and associations, Indigenous organizations, and Canada Health Infoway to help inform the future patient-centered virtual care model. Stakeholder consultation activities are conducted via one-on-one interviews and workshops.

2. Expand MyHealth Records Patient Portal information and capabilities

The aim of this initiative is to expand the capacity of MHR to support virtual care. MHR will allow Albertans to view key information from their integrated Netcare record and add additional content. It empowers Albertans to manage their own care and improve their health outcomes. The expansion of MHR includes several projects occurring concurrently to provide continuous benefits to all Albertans.

The MHR expansion will:

• Increase the amount of clinical and diagnostic information available to provide patients with a more comprehensive view of their health information, including COVID-19 test results;
• Increase access to digital health tools and information to empower patients to manage their healthcare needs;
• Improve user experience by adding more features and increasing ease of use;
• Provide parents and guardians with access to the health records of minor children and dependent adults to appropriately collaborate with care teams; and
• Begin to modernize and streamline the flow of data from Alberta Health and Alberta Health Services repositories to MHR to reduce duplication of services, and improve system stability and performance.

3. Develop secure messaging and collaboration services for Alberta

The aim of this initiative is to develop a secure and auditable email-like messaging capability coupled with document sharing to support patient-to-provider and provider-to-provider communications and collaboration. Secure messaging offers a convenient and cost-effective channel for care delivery and information exchange between Alberta's patients and healthcare providers. To achieve this, Alberta will implement a secure message exchange and electronic document workflow service that connects point-of-care clinical systems to each other, and with provincial EHR systems and MHR.

The secure messaging and collaboration service will:

• Empower patients to communicate with members of their care team through MHR, improving access to patients residing in rural or remote regions, or with complex health issues, mobility issues, and those facing the challenges caused by COVID-19;
• Increase care team connectivity and collaboration, providing opportunities for more efficient service delivery for providers to work together electronically; and
• Expand partnerships and communication pathways with British Columbia, Saskatchewan, Northwest Territories, and Yukon in support of cross-jurisdictional patient care.

Alberta and Canada Health Infoway will work together to consider possible pan-Canadian standards for secure messaging that could facilitate inter-provincial communication and information exchange.

4. Develop a privacy and security framework for virtual care

In an increasingly digital healthcare system, the safety and privacy of Albertans' personal health information is a top priority. Advancing virtual care will require a strong privacy and security framework to protect personal communications and the movement of health data across the province, and between Alberta and other provinces and territories.

The privacy and security framework will:

• Safeguard communications and information exchange among Alberta's providers and care delivery organizations, along with the patients they serve;
• Support virtual collaboration with providers in other jurisdictions for the purpose of care delivery, particularly Alberta's neighbours - British Columbia, Saskatchewan, Northwest Territories, and Yukon;
• Identify gaps between current privacy frameworks and emerging projects under virtual care; and
• Support patients and providers with guidelines that ensure safe handling of health information.

Alberta will collaborate with Canada Health Infoway and other jurisdictions during the development of the framework to consider alignment of pan-Canadian information exchange policies and practices, where appropriate.

Funding support

The table below summarizes how funding from Health Canada will be allocated to the four initiatives to accelerate progress towards Alberta's virtual care objectives:

Initiative	2020-21 (actuals)	2021-22 (actuals)	2022-23	Total
1. Establish eHealth strategy that includes virtual care	$305,437.00	$369,562.50	N/A	$674,999.50
2. Expand MHR patient portal information and capabilities	$1,158,202.00	$1,487,714.50	$1,907,339.50	$4,553,256.00
3. Develop secure messaging and collaboration services	$2,262,538.00	$4,085,112.75	$3,500,000.00	$9,847,650.00
4. Develop a privacy and security framework for virtual care	$304,644.00	$227,818.75	$300,000.00	$832,462.75
Total	$4,030,821	$6,170,208.50	$5,707,339.50	$15,908,369.00

Funding from Health Canada will be used for each of the virtual care initiatives to support the research and project development necessary to establish comprehensive and thoughtful business plans, engage with stakeholders and vendors, participate in procurement activities, and implement strategies and solutions that will deliver virtual care services to Alberta's patients and providers.

Two million dollars in additional funding will be provided by Canada Health Infoway as part of the federal effort to support virtual care delivery. The funding will be applied to the ‘expand the MHR patient portal information and capabilities initiative’ and specifically to MHR licensing fees. The licensing costs are considerably higher than what Alberta Health had anticipated. There has been a significantly higher number of users who have registered for MHR access than initially forecasted.

Expected results

The table below outlines the progress that is expected to be made on the four priority initiatives by March 31, 2023.

Initiative	Outputs	Target outcome
1. Establish an eHealth strategy that includes virtual care	A Provincial eHealth Strategy that includes virtual care An implementation plan for an enhanced eHealth Governance Model An eHealth Architecture Blueprint An Electronic Medical Record Integration Business Model	A clear strategy for eHealth including virtual care Defined provincial priorities and expected outcomes
2. Expand MHR patient portal information and capabilities	Parent / Guardian access to minor children's health information through MHR Initial changes to support use of the Community Information Integration (CII) infrastructure for transport of data from Alberta Health and Alberta Health Services repositories to MHR for viewing. The first data to flow using this infrastructure is eReferral and Diagnostic Imaging information Expanded patient health information and clinical results posted to MHR	A dedicated pathway to manage parent and guardian MHR access An expanded set of virtual care tools and health information available in MHR for every Albertan An increase in number of Albertans using MHR to manage their healthcare needs
3. Develop secure messaging and collaboration services for Alberta	Provincial standards and protocols for secure messaging and electronic referral Secure messaging exchange service connected to MHR patient portal Electronic referral notification service to patients and providers Integration and user validation services Initial connections to end-point clinical systems for messaging to support provider-to-provider information exchange	Secure messaging and document sharing services that support increased communications and collaboration between patients and members of their care teams Increased virtual communication between patients and providers
4. Develop a privacy and security framework for virtual care	Privacy and security framework for virtual care Implemented provincial privacy and security policies around virtual care Privacy Impact Assessments for virtual care initiatives Communication and training material on virtual care privacy and security for patients and providers	Comprehensive privacy and security measures that enable virtual care while safeguarding patient information

Tracking measures for each target outcome will be identified in the detailed project planning phase for each initiative. Alberta will work with the Canadian Institute for Health Information (CIHI) to develop mutually agreeable pan-Canadian indicators for reporting progress on virtual care implementation. Alberta will provide CIHI with applicable and available data demonstrating the results of its initiatives.

Alignment with federal, provincial and territorial priority areas

The following table summarizes how Alberta's virtual care initiatives align with the five FPT priority areas for virtual care:

FPT priority area	Alberta Virtual Care Initiative
	Establish eHealth strategy	Expand MHR	Secure messaging & collaboration	Privacy and security framework
Secure messaging and information-sharing/file-transfer platforms or supports to enable end-to-end messaging
Secure video-conferencing technology to deliver care to patients remotely
Remote patient monitoring technologies
Patient access to COVID-19 and other lab results
Back-end supports for integration and/or alignment of these new or existing platforms and supports, including needed hardware and tools to meet the first four priorities