By: Kathy Tudor, Director, Marketing and Communications, OntarioMD
A major digital health transformation is underway in Southeastern Ontario. Six hospital organizations and thirty-three health care sites have joined together to create Lumeo, a shared regional health information system (HIS) designed to improve the flow of information and support more coordinated patient care between the hospitals and sites.
Lumeo is connecting people and care teams from Brockville General Hospital, Kingston Health Sciences Centre, Lennox & Addington County General Hospital, Perth, and Smiths Falls District Hospital, Providence Care, and Quinte Health. The goal is better, faster patient information sharing, enhanced care quality, and fewer redundancies.
As part of this digital transformation, Lumeo collaborated with OntarioMD on how to optimize Health Report Manager (HRM®) to reduce report volumes and improve delivery of critical patient information to family physicians and nurse practitioners. HRM is the system used by hospitals to send patient reports to community-based primary care clinicians.
The Wicked Problem
For years, clinicians in the region have dealt with faxes, inconsistent formatting, duplicate reports, and missing documentation. While the transition to a fully electronic HIS improved access to information, the digitization and automatic distribution of additional report types also led to a significant increase in HRM report volume.
As Dr. Siddhartha Srivastava, Regional Chief Medical Information Officer (CMIO), explains, it is “a wicked problem”—complex and interconnected, with shifting requirements across multiple interest holders and no single quick fix.
“Good solutions to wicked problems require systems thinking with an iterative continuous improvement mindset and intense collaboration and dialogue across hospitals and community practices,” he says. “We have spent time building relationships with community practices and have made good progress in our report delivery problems.”
OntarioMD convened an HRM Task Force to address the issues at the hospital and EMR ends of the delivery process leading to several recommendations. Lumeo then worked closely with OntarioMD, local Ontario Health Teams, and primary care clinicians to develop an action plan. This collaboration led to clearer rules for determining which notes should be distributed, as well as standardized naming conventions and reducing unnecessary or duplicate reports.
Solutions = Technology + People + Partnerships
Within the first month, Lumeo eliminated more than 5,000 duplicate clinical notes with an average reduction of 236 duplicate notes per day across the region as well as:
- 96% reduction in duplicate Emergency Department notes
- 97% reduction in duplicate Discharge Summaries
- 36 note types removed from external distribution in first seven months
The Lumeo team and its partners understood that technology alone would not drive lasting change. Their transformation combined system reconfiguration, workflow redesign, and strong cross-sector collaboration, supported by guidance from the Frontenac, Lennox & Addington Ontario Health Team (OHT), one of the province’s leading OHTs with a well-established Primary Care Network (PCN).
“When you’re moving six health care organizations and 33 sites onto a single digital platform, report distribution isn’t a technical issue, it’s a system issue. It affects hospital workflows, primary care practices, and ultimately, the people we serve,” says Leon Goonaratne, Lumeo’s Regional Vice-President.
“The only way to solve it is together. Our collaboration with primary care leaders, Ontario Health Teams, and OntarioMD has helped us in redesigning how information flows across the region.”
Recognizing the importance of clinician input, Lumeo developed a direct feedback channel with primary care clinicians in the region. This has improved communication around report issues and provided the operations team with valuable insights to investigate and resolve problems more effectively.
Lumeo also introduced a Primary Care Medical Lead, Dr. Daniel Glatt, who has been integrated into Lumeo’s governance structure to provide clinical expertise and to advocate for community clinicians. “A family medicine practice is the patient’s medical home,” says Dr. Glatt. “Effective communication between hospitals and community clinicians is crucial for the patients we serve. By including family medicine in the governance structure, we can continue to build a system that works for all parts of the patient’s health care journey.”
OntarioMD supported report distribution during the migration and partnered with Lumeo on the HRM Optimization Trial which introduced AI-generated report summaries.
Lumeo has since become the first Oracle Health site to deliver pathology results through HRM (reducing fax delivery) to all primary care physicians, referring physicians, and copied physicians, with plans to expand the service to attending, ordering, and consulting physicians.
Looking Ahead: Local Success to Guide Provincial Change
Since Lumeo’s Go-Live, duplicate reports have been reduced substantially, and work is underway to manage other issues, while piloting new projects. The regional team is working on further standardizing note types and addressing complex situations where clinicians practice both within the hospital and in the community.
The work and ongoing partnerships prove what’s possible when hospitals, primary care, OHTs, and OntarioMD work together toward a shared goal: reducing burden for clinicians and improving care for patients. “People and organizations have come together for a shared vision of high-quality care for the people we serve,” says Goonaratne. “I’m really proud of the inclusion of the community in our governance model, as it allows us to hear their perspectives and continuously improve.”