Giiwednong Health Link, as an e-Health requires multidisciplinary teams with a broad range of skill sets from health care, administration, and technology fields.  The GHL has brought together individuals from the 14 stakeholder communities in a highly collaborative team environment that represents 4 functional area of the initiative: Information Technology, Privacy and Security, Evaluation and End Users.    

The value of working together was realized when at a GHL general meeting in Sault Ste. Marie, that brought together all the GHL stakeholders that included the  working groups. It was decided that we should try to use the infrastructure that has been put in place in a demonstration project. Penny Carpenter from KNet, who also sits on the IT Working Group offered to assist in co-ordinating video conference, based H1N1 workshops with interested parties using the existing broadband network and video conferencing equipment already in place.  Through KNet, working in concert with Keewaytinook Okimakanak Telemedicine (KOTM) and North Western Ontario Infection Control H1N1 workshops were co-ordinated with  Serpent River, Batchewana, Noojmowin Teg Health Centre in AOK and M’Chigeeng Health Centre.   

Issues arose at the in M’Chigeeng Health Centre that would prevent transmission of the signal.  Technical problems with specialized network gear were preventing a successful network connection to the Health Centre. M’Chigeeng IT support  ,Wesley McGraw contacted fellow IT working group member in Wikwemikong, Rudy Mandamin. Rudy was trained, through KNet,  to support the same network gear that M’Chigeeng was using.  Together Wesley and Rudy were able to troubleshoot the M’Chigeeng Health centre network connection and light up the video conferencing unit with a robust signal.  The workshop proceeded as scheduled! 

A key success factor in this development of broadband networking in First Nations has been  to have local IT support at the community level to keep the infrastructure up and running.   The Information Technology Working Group has a good cross section of individuals with, several of the group whom are IT professionals.  The group has been working towards developing a service management model to provide support for proposed GHL infrastructure.  

The members of the working group naturally evolved into a support team, simply through the sharing of knowledge and best practices.  Ancillary benefits and synergies are already being realized simply through bringing people together.      

The End User Working Group will be responsible for the user experience of any solution being proposed.  This will encompass functional requirements,  non-functional requirements, health subject matter input and testing plans.  This group is critical in both the solution design and ultimately its implementation.

•       Objectives – Functional

o   Type of data stored

o   Access lists

        §  Data and application access

        §  Roles based

                 ·         Definitions 

                 ·         Access

      §  Audit requirements

o   Reports

o   Areas of coverage

o   Application Scope

o   Interaction with foreign database sources

o   Chartingo   Information record

o   Client identification

o   Document management

o   Integration to faxing and email

o   User access§  Client§  Health care provider§  Health care administration§  Funding partners•       Research •      

Non-Functional requirements

o    Data retention

o    Audit logging

o    Response time

o    Hosting model

o    Document storage and retrieval

o    Backup and recovery

o    Database administration

o    Security requirements

o    Number of active user

o    24/7 access

o    Mean time between failure

o    Maintenance windows

o    Technology refresh

o    Remote access  

  The GHL project will be adopting project evaluation throughout the process.  This working group will act as advisors and mentors for the entire project team.  The group will provide recommentations on metrics, inputs, outputs, outcomes, goals and reports back to the project team as it relates to the project evaluation methodologies. 

Objectives     

o  To provide leadership in project monitoring and coordination

o   To provide advice and subject matter expertise for the ongoing evaluation process and to the Project Secretariat and Project Steering Committee;

o   To provide a direct link to the community, getting community input, communicating information about the evaluation back to the communities and serve as a resource person with respect to the GHL Project’s evaluation;

o   To provide guidance to the resources, internal or external, responsible for the evaluation activities;

o   To review and comment on the evaluation approach, methodologies and tools and possibly reviewing the draft and final report;

o   To identify important issues and concerns relevant to the GHL Project’s evaluation of First Nation Communities interests and to communicate them to the Steering Committee; 

This working group will be the lead for the privacy and security concerns of all the stakeholders.  It will be incumbent on this working group to increase their privacy and security awareness and capacity.  All solutions being proposed will need to use the privacy framework as the baseline for their discussions.  The working group will provide recommendations and oversight for all privacy and security members. 

  Ø  Privacy

• To ensure that the requirements coming out of the working group are input, captured and reflected in the overall project plans and budget  

• To identify important issues and concerns of First Nations Communities interests with regard to Privacy Legislation and resultant policies and procedures, and to assist with their resolution – both within the Working Group, and at the overall project level. 

• To provide recommendations and subject matter expertise as it relates to Privacy & Security to the Project Steering Committee for approval and implementation. 

• To review and comment on planned project activities from the perspective of their impact on Privacy Policy and procedures. 

• To ensure that we establish a dialogue with all relevant stakeholders, agencies and ministries to appraise them of our objectives and plans.

• To ensure that Privacy Contacts Have the level of education and awareness within 3 months to be able to respond to Level 1 questions for the public.

•  Privacy as it relates to staff – part of personnel policy. 

•  Privacy as it relates to business of the operations and business interactions  

Ø  Security 

•  Access control

•   Application security

•  Business continuity and disaster recovery planning

•   Cryptography

•    Information security and risk management

•   Legal, regulations, compliance and investigations

•   Operations security

•   Physical (environmental) security

•   Security architecture and design

•   Telecommunications and network security

The Technology Working Group will be responsible for the underpinnings of any solution provided.  They will look at all potential solutions for their implications to existing technology blueprints.  The support model for existing health centres along with any proposed solutions will be one of the critical outcomes of the working group.

Key strategic area

Ø     Infrastructure Development (Network, Hardware and Software compatibility)  

Objectives

Ø     Activities

§        Community Capacity development

§        Circuit development

§        Wide Area Network (WAN) Development

§        Service Mgmt Development (IT Support/ Help Desk)  

Ø     RFP process associated to the design and implementation of:

§    Network

§    Hardware

§    Software solution selected by end user working group 

Ø     Develop a framework and monitor the functional requirements of the system

Ø     Development and implementation of that hardware, software, and ICT capacity development associated to an integrated WAN and management model to collect, store, and manage health data that complies with the needs of the health organizations

§    Data collection (Asset Mapping/ E-Readiness)

Ø     Software compatibility

Ø     RFP process (Hardware, software, data centre, network, security)

Ø     Training (Health care end users)

The key health organizations have been involved in a formalized process to develop this Health Information Management project since mid-August 2006. Considerable time, effort and resources, been expended towards developing this joint. Direct and indirect expenses have been incurred through the hiring of consultants and in-kind contributions of the directors and support staff. The complexity and challenges of bringing together a project that involves 14 First Nation communities is challenging, much less keeping it viable despite the lack of discretionary dollars and strained internal resources, is simply unprecedented.

The direction of this project is consistent with the MHLTCs LHINs NE Tactical Blue Print Phase 1 & 2 which provides the context for strategic ICT development in Northern Ontario. This regional initiative for First Nations is timely in First Nations involved in this focused implementation are at the cusp of development that coincides with LHINs NE implementation of strategic ICTs for health.

Phase 1: Research & Design

Phase One involves the completion of a comprehensive needs assessment which would examine the ICT infrastructure and data and information needs of the 14 participating communities. In addition, communications and consultation with all stakeholders, communities and partners would be carried out in order to solidify the partnership of the five (5) participating health authorities.

The NSTC health services target an on-reserve population of approximately 5,200 people and an urban population in Sault Ste. Marie of approximately 5,000 people. N’Mninoeyaa Community Health Access Centre which was established in 1995 is modeled after provincially funded Community Health Centres which provide primary health care to those who face barriers to access. It is one of 10 Aboriginal Health Access Centres funded by the provincial Aboriginal Healing and Wellness Strategy.