Board gives final approval of system to standardize use of electronic medical records across region

Manitoulin Health Centre

MANITOULIN – The Manitoulin Health Centre (MHC) board of directors has given its final approval to sign member and master service agreements to work with the North East Local Health Integration Network (NELHIN) on the Health Information System (HIS) roadmap. This roadmap has since turned into a plan to integrate 24 hospitals in the Northeast into a one-patient, one-record (ONE) system by standardizing the use of the electronic medical record (EMR) across the region. 

“I provided a briefing note on this and briefing notes from the law firms on the agreement. This agreement is coming back to the board now,” said Tim Vine, vice-president of corporate support services and chief financial officer (CFO) of the MHC at a board meeting last week. “Basically, this is an internal review for all hospital boards’ involvement, and it has been reviewed by the hospitals and the lawyers involved in the process.”

In his memorandum to the board, Mr. Vine explained, “this regional approach is a true digital clinical transformation; it will not only allow improved patient care by allowing greater access to patient electronic medical records across sites, but also improve clinical workflows at each hospital site.”

“At the March 25, 2021, MHC board meeting, the board voted to instruct the CEO to sign the memorandum of understanding (MOU) that committed MHC in principle to continue regional planning work on the ONE HIS project, with more specific details to come in the form of the membership agreement (MA), and master services agreement (MSA). Prior to giving leave to sign, many board members participated in regional MOU board sessions to gain a better understanding of the document and the process,” explained Mr. Vine. “Senior management also kept the board advised of key aspects of the document, including the outline of representation on the board of the new shared services company (NewCo) to be created later.”

“The governance structure contemplated in the MA for the Class A members (of which MHC is one) is based on regional clusters of small hospitals,” continued Mr. Vine. “MHC is included with St. Joseph’s (hospital) Elliot Lake, North Shore Health Network and Espanola Regional (hospital). There will be a single seat on the board of NewCo reserved for a representative from one of these hospitals, elected by the cluster annually and taken from the senior management ranks.”

Along with the other 23 hospitals in the Northeast region, MHC was provided the final draft of the MA and MSA in late December 2021, Mr. Vine explained. Both agreements were drafted by legal counsel from INQ Law, retained by the group of hospitals for that purpose. Further review and refinement was carried out by legal counsel from Timmins and District Hospital and the Sault Area Hospital. These agreements have been vetted by no less than three sets of legal counsel, he pointed out.

“There have been no surprises in the final agreement,” said Mr. Vine who added, “we are comfortable with the recommendation to sign the agreement.”

Mr. Vine pointed out as well, “at this time there are no opportunities to make amendments to the agreement. But leaving it (not signing the agreement), would prejudice us.” 

Board member Barbara Baker said “we would be one of the representatives on the board (from the cluster of four local hospitals the MHC would be a part of). Is it the expectation that, every fourth year, one hospital would have representation (on the overall board) or would it just be the biggest hospital that would provide the representative?” she questioned.

“We’re working on all of that, but that would be something we would be looking at,” said Mr. Vine. “We have a good relationship with all the hospitals involved. We feel, for instance, in the first year maybe someone with more financial background would be the representative. The agreements are set to take effect on February 1, 2022, and require signing by January 31 from all 24 hospitals. As discussed, with the board having reviewed the MOU, the co-CEOs are seeking approval of the MA and MSA and instructions to sign on or before January 31, 2022,” explained Mr. Vine. 

“Are you happy with the cluster of hospitals we are part of?” asked Ms. Baker. 

“Yes, we are, especially with the Espanola Regional Hospital, but we have a really good working relationship with all of them. We’re quite satisfied with the cluster we are part of,” said Mr. Vine.

Dr. Simone Meikleham  asked, “could you speak to what would happen if we do not sign the agreement.”

“Doom and disaster,” quipped Mr. Vine. “Basically, we would have to support our own electronic medical record system on our own, and clinicians would not have the access to medical patient records for those treated at HSN (Health Sciences North); it would severely limit some clinical processes. And it would be financially onerous for us to do this on our own.”

Paula Fields, MHC co-CEO said, “in reading the (agreement) documents, we would be at risk if we didn’t sign. We already agreed to be part of this agreement. And the total cost of the agreement was based on everyone (participating hospitals) signing on. If we don’t sign, we would be putting MHC at risk.”

Mr. Vine said the MHC co-CEOs are looking for a formal motion to be passed by the board. (At that meeting, there were still two acting co-CEOs. Ms. Fields was confirmed to the role of CEO by the MHC board following the regular board meeting.)

MHC board chair Dennis McGregor said, “I read the MOU. The bottom line is there would be a cost saving by signing this agreement with the other hospitals rather than being on our own. I would like to commend both of you (co-CEOs) for all your efforts in getting us to this point.” 

The MHC board passed a motion for the co-CEOs to sign the agreement on behalf of MHC on or before January 31, 2022.”