With the ease of online banking comes this Canadian first: patients perusing their X-rays, checking laboratory test results and discreetly obtaining a second medical opinion - all from the comforts of their home computers.
Ontario's Privacy Commissioner even keeps her electronic health record, called MyChart, on a memory stick, a device the size of a pack of gum that neatly tucks into a pants pocket.
"Given that I travel extensively, it's very important to have access to my [medical] records at a moment's notice," said Ann Cavoukian, who has undergone neurosurgery three times.
Although MyChart is available only to patients at Sunnybrook Health Sciences Centre in Toronto, other Canadian hospitals are coming out with their own versions of the paperless health record.
"By 2010, the goal is to have half of the population with an electronic health record," said Richard Alvarez, president and chief executive officer of Canada Health Infoway, an independent, federally funded agency that works with provinces and territories to invest in electronic health-record projects, typically by funding half the cost. By 2016, he wants every Canadian to have one.
The reality today, however, is far different: Only 9 per cent of Canadians have an electronic health record.
Convenience might seem an obvious first benefit, but those who tout electronic health records say the advantages extend far beyond that. By having quick access to medication histories, laboratory test results and images, doctors can provide the right treatment quickly, especially when it comes to dangerous drug interactions.
"Isn't it ironic that I can pay my hydro bill online from Australia," said Dan Strasbourg, Canada Health Infoway's director of corporate communications, "yet if I present at a Toronto ER unconscious, the physician can't even access my medical history housed at my physician's office a few blocks away?"
Although that is the case today, the rapid funding of electronic health records shows they are coming online.
As of Dec. 31, there were 245 projects under way in Canadian hospitals, other health-care facilities, pharmacies and laboratories, with an investment value of $1.332-billion, according to Canada Health Infoway, which funds the vast majority of electronic health-record initiatives in the country. That compares to 53 projects valued at $125-million in the 2004-2005 fiscal year.
Across Canada, many of the efforts begin with hospitals selecting patients who use the health-care system frequently.
In Edmonton, Capital Health is to launch a system this year in which medical appointments can be made online and reminders about checkups are provided. It will start by focusing on those with chronic diseases, such as diabetes, and on new mothers, who need to book regular appointments for their infants.
In British Columbia, electronic health records of patients who attend any one of a dozen hospitals at Vancouver Coastal Health and Providence Health Care are available to doctors at the touch of a keystroke. Although the records aren't available to patients, they do give physicians handy access to prescriptions, laboratory test results and, later this year, diagnostic imaging reports such as X-rays and CT scans.
Next month, Grand River Hospital in Kitchener, Ont., plans to launch an electronic health record where patients with chronic kidney disease can obtain laboratory results, including monthly blood work.
And at the University Health Network, which includes Toronto General, Toronto Western and Princess Margaret hospitals, patients diagnosed with breast cancer can view test results such as blood work. This spring, those with chronic kidney disease will have access to lab results.
"What we're also trying to do then is be pro-active in presenting the information in a way that does not create more anxiety and more questions," said Lydia Lee, chief information officer for shared information management services at the University Health Network.
If there's one thing that people involved in electronic health records agree on, it is that the home computer should not be the first source of a devastating diagnosis.
