Medical Post, EMR: The push is on to get connected

Public

I just wanted to alert people to this article in the May 15, 2007 Medical Post. You will probably have to be registered on the new Medical Post web site to see it as direct (public) access has been eliminated, however the link is, "EMR: The push is on to get connected"

EMR: The push is on to get connected
May 15, 2007 | Kylie Taggart

OTTAWA | Canada Health Infoway is working toward having an electronic health record system in place for half of all Canadians by the end of 2010.

This means databases of health information, such as diagnostic imaging results, will be able to be accessed and viewed digitally by a health professional from his or her own computer.

But since getting information technology into physician offices is not part of Infoway’s mandate, when could a pan-Canadian electronic health record be at the fingertips of most doctors?

Infoway, an independent, not-for-profit organization, invests in information technology projects in tandem with regional governments. A strict investment model is followed to ensure each project will be replicable in other regions. It builds infrastructure in nine chosen investment areas, including drug information, diagnostic imaging, laboratory information and public health surveillance. Everything is vetted by provincial and territorial ministries of health.

Can Infoway realize its 2010 goal?

“If we don’t get there we’ll be very, very close,” Infoway executive Shelagh Maloney told IT and health professionals at a conference here recently. “We’re making progress.”

Maloney said electronic health records are available to between 5% and 6% of Canadians right now, although the percentage varies from region to region.

The 2007 federal budget allocates Infoway another $400 million, upping federal support of the organization to $1.6 billion since 2000. Of this $1.6 billion, almost $1.2 billion is currently financing projects. About 230 projects are underway or have been completed, while about 60% are in the implementation phase, Dr. Sarah Muttitt, Infoway’s vice-president of innovation and adoption, told the Medical Post.

Yet, it seems a bit like Infoway is filming television programs before most people have a television set.

Bill Pascal, the Canadian Medical Association’s chief technology officer, said the push for a pan-Canadian electronic health record is like any large IT project, where the return on the investment won’t happen until all the pieces are in place. And some of those pieces are physicians who practise in the community and outside of heavily connected acute care centres.

“If you don’t have the physicians in the community connected to those systems, they’re of little or no value,” Pascal noted during an interview last month at CMA House here.

The CMA is lobbying the federal government to put a further $1 billion into Infoway targeted at helping physicians automate their offices. The plan is for physicians to contribute half the investment and get a rebate once their office is automated. The result would be a 75% share of federal money, with the rest paid by physicians.

“Our estimate is, along with Infoway, we probably need to put just under $2 billion on the physician front alone to help physicians across the country get automated,” Pascal said.

All provinces and territories have plans to help physicians automate—the problem is funding.

Even with all the money in the world, Pascal doesn’t expect Infoway’s 2010 goal to be achieved. The process of getting offices automated will take at least seven years from when the clock really starts, he added. The sooner money is available the better.

In the meantime, the CMA and Infoway are collecting case studies of physician offices that have successfully automated. They plan to publish them in upcoming issues of Future Practice, a CMA publication.

Both organizations are also pushing to develop software standards to be used in physician offices to encourage record sharing (see the Medical Post, Nov. 3, 2006).

The CMA is also working on policy papers on privacy and data stewardship issues to help provinces work through some of the sticky questions surrounding electronic health records. Infoway has set up a physician advisory board and hired four senior medical advisers to ensure systems being put in place are helpful to, and accepted by, physicians.

Infoway is also working with universities to make electronic health records part of the medical school and nursing curriculum, Dr. Muttitt explained.

The benefits of Infoway’s work is also being evaluated and documented. A study of diagnostic imaging projects in regions of Ontario and British Columbia, for example, showed digital access of diagnostic imaging improved efficiencies for radiologists, reduced turn-around time for reports and reduced patient transfers related to diagnostic imaging services. Further results showed a reduction in duplicate testing, Dr. Muttitt said.

Pascal is optimistic more physicians in Canada will soon have their offices automated and connected to databases that will be part of a pan-Canadian electronic health record system.

“I see the right mindset. I see the willingness to work together that was not there before. I see an understanding that was not there before,” he said.