After more than 20 years as a family physician, Michelle Greiver questions why Canadians can access their bank accounts 24 hours a day, seven days a week, but when they go to the hospital after hours, their medical records are unavailable.
She is among the minority of the nation's doctors who are trying to do something about the health care system's archaic processes, which by one estimate are causing as many as 24,000 unnecessary deaths each year.
Last year, she began collecting and storing patient data on computers. This year she sold her filing cabinets and expects to discard the last paper chart in her Toronto office.
Already, every one of her patients in for a check-up receives a printout of their medical profile. It's especially useful for the elderly with chronic conditions who are taking many pills, and she tells patients to take the information with them if they have to go to the hospital.
"I don't think Canadians should accept anything less," she says.
Unfortunately, most are forced to. In Canada and abroad the medical industry is years behind most other industries in embracing information technology.
In the financial sector, for example, companies allocate somewhere between 6 and 10 per cent of their spending for IT. In Canadian health care the figure is less than 2 per cent.
As a result, more than 90 per cent of physician visits in Canada involve paper and most prescriptions are handwritten, according to Canada Health Infoway, a group comprising the 14 federal, provincial and territorial deputy health ministers that provides guidelines and standards for IT adoption.
Even those doctors that have gone electronic cannot send prescriptions to pharmacies over computers, or connect into the networks of local hospitals, which themselves don't link to other hospitals.
Switching to electronic patient records is considered merely the first step in the massive undertaking of moving the medical establishment into the 21st century.
Electronic medical records could provide a historic account of all a patient's medical information. A central database for drug information could include patient reaction data, which doctors could scour for patterns with analytical software. Another type of software exists to analyze medical images for abnormalities. Wireless systems could be set up to monitor patients in hospitals and remotely at home. Computerized order entry systems exist to allow doctors to enter procedures and tests straight into a computer, improving both accuracy and efficiency.
Proponents of the technology say it would save thousands of lives and billions of dollars annually.
"Today we have documented evidence that because physicians at times just don't have the right information, we have between 9,000 to 24,000 deaths -- a lot of that caused through adverse drug interaction," says Richard Alvarez, president and chief executive officer of Canada Health Infoway. "Sadly enough, a lot of that is preventable."
Big IT companies remain frustrated by the many obstacles unique to the medical sector, including the difficulty in establishing standards. But they are intensifying their sales efforts, hiring medical experts and even banding together to exert pressure for reform.
Dushan Batrovic, an analyst with Canaccord Capital Inc., says a number of factors are "converging to establish health care as perhaps the single biggest market opportunity for technology companies today."
The strongest drivers are in the U.S., where runaway health insurance premiums are motivating large employers to take matters into their own hands. Last month for example, five of the nation's biggest corporations, including Wal-Mart Stores Inc., announced plans to give their employees electronic records.
The fundamental building blocks have already reached the mass market, he says. They include high-speed networks, Intranets and wireless information systems. Better still, today's technology is sophisticated enough to be adopted by the health care industry off-the-shelf, he says.
"The tipping point is approaching," he says.
There is a host of improvements that IT companies can offer the health care industry today, Mr. Batrovic says.
