The promised benefits of electronic medical records are no longer a futuristic vision. They are here, and health experts say the full potential of EMRs and EHRs are just beginning to be explored.
With the PS Suite EMR system developed by MD Physician Services, for example, many physicians now have ready access to their patients’ health information, wherever they are.
In Ontario, “critical mass has been achieved in the province’s primary care system,” reports Dr. Darren Larsen, Ontario MD’s senior peer physician. “In two to three years, as physicians collect data, we will be able to make some powerful improvements to population-based health delivery and service.”
EMR adoption has already improved efficiencies and quality of care. When a medication is prescribed, for example, the EMR system flags potential interactions with other medications, as well as side-effects and risks associated with co-existing conditions.
Physicians also have mobile access to EMR, enabling them to connect to patient records wherever they are. “If I’m on a house call, at the hospital, or at home and on-call, I have all the information I need at my fingertips, all the time. That leads to better decision-making and more effective patient advice,” says Dr. Larsen, a PS Suite EMR client.
PS Suite EMR has the potential to improve patient education and compliance. “I use my computer to show my patients graphs of where they’ve been and where they’re likely going,” he notes. “For example, I can point out that someone has had a high number of urinary infections over a period of time, to show that we need to investigate the cause.”
For the millions of Canadians living with chronic health conditions, EMRs enable more proactive health management. If a patient with diabetes has not had an eye examination in the past year, the system will alert the physician, so the patient can be notified. “Much of chronic care – for diabetes, asthma, cancer, thyroid disease, COPD and scores of other disorders – requires looking forward, using the data from the past. EMR allows that. Once you build a system of reminders, a lot of the process becomes almost automatic,” Dr. Larsen says.
In Peterborough, Ontario, Dr. Nick Vanderkamp has used PS Suite EMR in his practice for about four years. “It’s helpful in measuring the benefit of lifestyle interventions and medication.”
On a macro level, he says, search capability makes it possible to measure quality of care. “As a community, we’re working to improve overall health outcomes, particularly for chronic disease management. With EMR, we can search records to see how many people in our practice are meeting the outcome measures we’re looking for. It’s an exciting new direction.”
In multi-physician clinics, legibility of records, lost records and record retrieval were formerly challenging issues, says Dr. Neeraj Sanjeev Bector of Edmonton.
“With PS Suite EMR, nothing falls through the cracks. Whether it’s our staff or a physician dealing with an issue or patient request, everything is dealt with in the system electronically and can be reviewed after, if necessary, in the audit log.”
Dr. Neeraj Sanjeev Bector
Dr. Neeraj Sanjeev Bector, Edmonton— photo supplied
Visual representation of lab results are much more powerful in motivating patients than “having a bunch of numbers thrown at them,” he says. “They can actually see the effect that medications or other interventions are making on their care in a simplified graphic.”
In Alberta, NetCare is a provincial repository for lab information, diagnostic imaging, hospital discharge summaries and emergency records. “It provides timely access, and I can retrieve data that other physicians have generated,” says Dr. Bector. “We’re not duplicating lab tests or imaging, potentially re-exposing patients to radiation or generating extra cost.”
For patients, EMR can mean better care and greater peace of mind. Mary Jane McQueen, who is the primary caregiver for her 86-year-old mother, says, “When my mom has serious health issues, I’m able to stay in contact with Dr. Larsen by e-mail. As he has access to her electronic health records wherever he is at the time, we’ve been able to get ahead of the game in terms of treatment, rather than get to the point where we’d have to go to emergency.”
While Ms. McQueen’s mother has had a number of long stints in the hospital, thanks in part to EMRs and her daughter’s ongoing communication with Dr. Larsen, she is still able to live at home most of the time with her daughter and son-in-law.
Being in regular contact with the family practitioner also made a big difference when her mother was in the hospital receiving acute care, says Ms. McQueen. “It made me feel like we had a support team.”
All physicians quoted in this article use PS Suite EMR and are clients of MD Physician Services Software. PS Suite EMR is a leading EMR solution, which also offers a fully integrated mydoctor.ca Health Portal, developed exclusively for Canadian physicians.
For more information, please call the Hotline at 1-800-361-9151, e-mail practice.hotline@cma.ca, or visit md.cma.ca/EMR.
IMPROVEMENTS
Initiatives aim to improve care and better manage health care costs
In an age of health care cutbacks and harried practitioners, a sign in Dr. Davidicus Wong’s medical office in Burnaby, B.C., sends an unusual message. The sign asks patients to reveal their “complete lists” of medical problems at the start of each visit, “so that each can be addressed thoroughly” by the family physician and his staff.
It’s a philosophy of quality that Dr. Wong both practices and teaches as the Family Practice Champion of the province’s Practice Support Program.
Set up by the B.C. Medical Association (BCMA) and the BC Ministry of Health under the General Practice Services Committee (GPSC), the program helps family doctors and their offices enhance both their efficiency and the level of care they provide. It includes financial incentives, strategies and training modules in areas ranging from chronic disease management to better scheduling, sessions that Dr. Wong helps to deliver.
“I tell my colleagues to ‘embrace the list,’” he says, explaining that some doctors limit patients to one medical problem per visit, to keep appointments short. But it can actually be more efficient for the doctor to know all aspects of their conditions, because it can help uncover related issues and plan overall care, says Dr. Wong, who has been practising for 20 years. “It’s a new way of listening.”
Such quality initiatives are intended to improve the health of the population, enhance the patient experience and reduce or at least control the cost of health care.
“We are on the right track,” says Dr. Nasir Jetha, the president of the BCMA, adding that the GPSC is having a beneficial effect on processes and outcomes in the province. “The patient is getting the best care possible, the physicians have the right tools, and it’s a benefit to the health care system in terms of savings.”
Dr. Jetha, who has been practising as a pediatrician in Vancouver for 27 years, says that “managing change can be challenging” for doctors. “But we can’t throw our hands up in the air when we see there are ways by which we can deliver better care and better quality.”
There are more to come in B.C., Dr. Wong says, such as additional training modules focused on areas such as palliative care and youth mental health.
“There’s many, many layers to improving quality,” he explains. For example, he is the Medical Lead and Chair of the Burnaby Division of Family Practice, set up under the GPSC, sort of “a new doctor’s lounge” where a community’s family physicians have a voice to improve the health of their patients, he says. “We’re no longer working in isolation.”
The divisions, as well as the training modules and other strategies, spell “the renaissance of family practice,” he says. “We’re closing the care gap between what patients need and what they get.”
