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Record-keeping to leap out of Stone Age

ROD MICKLEBURGH

From Tuesday's Globe and Mail

Latest comment posted at 11:24 AM EDT 17/04/07

British Columbia to launch electronic patient files ...Read the full article

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  1. Sonia Brock from Toronto, Canada writes: My doctor's office is moving to computerized record keeping. The effect so far is that the doctor spends a lot more time staring at the computer screen than she does looking at me when I visit. A skilled doctor she is not computer literate and this changeover is the cause of considerable stress to her.
    In time I suppose it will get better but it is a tough transition for both of us.
  2. Billiam Smith from Montreal, Canada writes: Way to bring health care administration into the mid-twentieth century, boys. In no other profession is there such thing as a skilled worker who isn't computer literate; why should it be any different for doctors?
  3. Vincent Clement from Windsor, Canada writes: I don't understand why we don't have health cards with smart chips that would store a patients medical information plus, say, a record of the the last 6 visits to doctors, medications recently prescribed, and so on.
  4. albert v from canada, Canada writes:

    When pigs fly!
  5. Avandoc W from Canada writes: I'm a physician in BC, and I think this is great news. North America is behind Europe and Australia in this realm, so this is overdue. I work in a hospital, and I find it very frustrating not to have access to a patient's treatment records from other institutions. This will be money well spent, and I agree that it will reduce redundant procedures and tests. I do foresee, however, some difficulty getting independent medical practitioners to use this technology in their offices. I hope the province develops a plan to make that easy and inexpensive.
  6. Adebisi TheGamer from Canada writes: Ontario should go this route. It already finances Northern Ontario doctors to purchase a laptop every 2 years.

    And computerized record keeping is a good idea in that it would allow hospitals and specialists ready access to your file.

    As for the skills needed, they are minimal and easily learned, really. There are plenty of doctor's offices that simply speak to their computer to have it bring up your file, create a new file, and to add to your file.

    However, I predict, once this system goes live it will be hacked in 10...9...8...
  7. The Loyal Canadian Workfarce from Canada writes: Ha! Ha! As Sonia Brock says, computerized health records will make it easier for the physician to ignore his or her patient
    s, especially the older ones with unsightly diseases that actually require care. How will this help reduce the number of 'medical errors', which know stands at 70,000 a year in hospital? What's desperately needed is help for the patients to access a doctor's records, especially a surgeon, to reduce the number of deaths from medical errors in hospital, which now stands at more than 23,000 per year.
    In the US patients do have access to such records and the number of medical errors in hospital are proportionately lower, 'only' 1.2 million and 90,000.
    There is a campaign now under way in Ontario to follow suit, giving patients access to a surgeon's success-failure records, malpractice cases and past reprimands for incompetent or unethical practice.
    Doctors Inc. in Canada are routinely prescribing unneeded medications, especially in the psychiatric field. Surgeons are performing unneccesary or non-consensual surgery. Fast surgery can be more deadly than fast food. Physicians are so independent and hard to get, they've become arrogant beyond arrogance and are getting away with egregious practices.
  8. Paul who is from Canada writes: .
    Sun Microsystems (B.C.) Inc.?

    Never heard of it.
  9. D Burgess from Vancouver, Canada writes: Once developed, it should take the Campbell govt. about 6 months to sell the administration and ownership of the whole system out to American interests. Our medical insurance records are already under the purview of the Patriot act; our medical history is next.....
  10. Cryin Outloud from Canada writes: If the Campbell government is doing it one can be guaranteed big US corporations will be the beneficiaries. Campbell is doing everything he can to incorporate and sell BC's assets to Corporate USA. He has also decided that paying people for their kidneys and parts of their liver is not only good business in China, hey, lets do that here in BC! This kind of technology will help with the new eorgan purchases around the globe! He's likely doing it for personal reasons as he certainly is heartless and his liver probably needs an upgrade.

    So much of what was wonderful about this country has been globalized into an e-care e-less e-society. Where are the caregivers that actually used their instincts and better judgement with patients? Now we have technicians for physicians who cannot do anything without looking at some computer printout or screen. If this is the way we are going, I'm looking forward to the day I can purchase a home e-doctor and forget about the flesh and bones ones.
  11. Ian Pregitzer from Edmonton, Canada writes: My doc has been using Apple technology for well over a year and I have already seen the benefit from the patient side of the laptop he brings into the exam room when I see him. I don't know what the software is but it surely works well for him.

    He is better informed of my record and has everything he needs at his fingertips. Tests, prescriptions and referrals are handled much more efficiently and I think his productivity has increased. He says that his time on administration such as billing is reduced. This means I get better attention from a more knowleadgeable professional.

    I look forward to Alberta's electronic patient record being implemented across the province's health care system.
  12. Johny doe Jr from Canada writes: Another BAAAD article!
    -when is going to be ready?????
    -How much is going to cost?
    -How about the other provinces?
  13. Timothy Nessus from Somewhere, Canada writes: Good initiative HOWEVER:

    1 - WHAT kind of reassurance will we get to make sure the system does NOT fall on foregein hands (US anybody???)

    2 - WHAT kind of reassurances will we get to make sure OUR DATA does not fall in COMMERCIAL hands??
  14. Bernard Samson from Calgary, Canada writes: One issue not yet touched on is, whose data is it anyway? When I approached the Alberta program over a year ago about getting online access to MY OWN DATA via my health care number and a self-assigned password (no different than online banking) I was snootily informed that the data did not belong to me (it was just ABOUT me); it belonged to my doctor and the health profession. They were the owners of the data. So just go and sit down and be quiet.
  15. Dwight Jones from Vancouver, Canada writes: The doctors will be slow to comply, and the CMA will protect them. They are unprofessional and unconcerned if their outdated practices do indeed 'do harm'.
  16. Ian Pregitzer from Edmonton, Canada writes: Timothy Nessus - it's the Health Information Act in Alberta. I don't know about other provinces.
  17. Ian Pregitzer from Edmonton, Canada writes: Bernard Samson - sorry to add to your woes but you are not the owner of your banking data either. It belongs to your bank. You may own the money (personally I own the debt!) but the bank owns the information.

    Isn't life a b***h.
  18. Let me tell You How It Is from Seattle, Washington, United States writes: Canada must have a high rate of psychiatric problems and mental illness as can be seen from the posts above.

    The paranoid conspiratorial theorists come out of the wood work and claim that a medical record system is somehow linked to the US, the Patriot Act and the CIA.

    Other symptoms of paranoia include the recurrent thoughts of being scrutinized by the US Government. These people need to make appointments with their Psychiatrists and get counselling for these intrusive recurrent paranoid anti-US thoughts.

    It should be a new DSMIV-R diagnosis located only in Canada although other people in countries like North Korea and Cuba experience it as well

    Love from Seattle
  19. Kenneth Murphy from Toronto, Canada writes: Let me tell you how it is,

    Actually our resource industry has had a series of booms thanks to the extraction of tin for our tin foil hats and lead for shielding of CIA spy rays not to mention gold to ready ourselves for the imminent implosion of the 'fractional banking' system due to Iraq - its true - it has a 5 minute video on youtube and a wiki entry!

    Sun Microsystems? Aren't they the company from the movie The Terminator that built the chip?
  20. Richard Hawrelak from Sarnia, Canada writes: For 15 years, we cared lovingly for my mother-in-law. She left B.C. when her husband died to live with us in Ontario. We kept fairly accurate hand written instructions on her medication. She was fortunate to be taken on by our personal doctor. Now, he is a genius, but he is computer illiterate. After 10 years of visits with him and numerous screw-ups on her medication, my wife, also computer illiterate, wrote out her mom's history in MS Word (not exactly rocket science, eh?). We took the print out to our doctor and said, 'There, this has to be better than your chicken scratching.' He was amazed. He said, 'Fantastic, how did you do this?' I kid you not folks.
  21. Byron Heppner from Winnipeg, Canada writes: Well, let's hope they can do it within the time frame and budget that they project (or at least in the same order of magnitude--see file labelled "Gun Registry"). Really, there is no reason this couldn't be quickly and easily implemented. Analytical labs (ie for water treatment, etc) already have all their results available to the customer online. Online banks protect our "sensitive" (does it really matter who knows that I have a negative net worth?:) banking information, and all sorts of e-commerce sites deal with millions of hits a day. At least they are hiring an actual computer company to design the system, rather than creating a government agency to re-invent the wheel.
  22. Byron Heppner from Winnipeg, Canada writes: Oh, and another thing. Boohoo for the computer illiterate doctors. The times, they are a-changing. It is simply their job to keep up with accurate record keeping. If you don't think your doctor is up to dealing with computerized files, tell them. And then go find a new doctor. Yes, it's difficult, but not impossible.
  23. keith stringer from Cincinnati, United States writes: Brian Smith and Dwight Jones, both your posts bash doctors. Doctors in hospitals in Canadian cities have been using computers actively in patient care for decades using the computers and software available in hospitals there. The modernized improvements mentioned in this article will make it easier for clinic X to get the result from laboratory Y or for doctor's office A to get the records from hospital B, apparently by unifying the software while still protecting confidentiality. Why bash doctors over these technical improvements - do you think airline pilots are somehow responsible for easy communication between the Toronto airport tower and the Oshawa airport tower? And Dwight Jones, you bash all doctors with your venomous spit of "Doctors are unprofessional and unconcerned if (they) do harm" (end quote). Do you think that blanket condemnation adds anything useful to this discussion?
  24. Richard Hawrelak from Sarnia, Canada writes: I ran a computer development group at Dow Chemical. We pioneered e-mail and record keeping. The key to running our department was not the super-smart computer guys. The key was to hire a computer science college grad, a low key secretarial science major. She ran our department because she knew how to file, how to enter data, how to back-up files, how to restore. In effect, she ran the department and I took almost all the bows. She did get a permanent job and quite a few good raises thereafter ... my right hand woman. If she reads this, she will know who I am talking about and she will take it as yet another complement of what it takes to run an information system.
  25. Ian Pregitzer from Edmonton, Canada writes: "Let me tell You How It Is from Seattle" - thank you for that wonderful insight into the Canadian psyche - it has contributed zilch to the topic under discussion.

    What's up? No decent Seattle newspapers to contribute to? Or is everyone there as cynical as you?

    There are always opinions different than yours - even in the land of Bush. Doesn't make them wrong or make you right. Try discussing by contributing.
  26. Ian Pregitzer from Edmonton, Canada writes: Byron Heppner writes "Really, there is no reason this couldn't be quickly and easily implemented."

    Have you implemented a system of this complexity across such a wide spectrum of stakeholders Byron? No you haven't - otherwise you would know better than to make such a silly comment. You know not of what you write.
  27. Name Witheld from Vancouver, Canada writes: I fail to see how 'computer illiterate' doctors should prevent this from becoming a reality. I recall how as a student, some grizzled, old dinosaurs in my profession talked about professional secretaries with training in terminology and procedures relevant to the legal, medical or engineering fields who were responsible for 'processing' the data generated by the professionals themselves. Type your own letters, or reports? Bah! let the secretary do it.

    It may be an idea 'past its prime' but I'm sure that whichever doctors choose to remain computer illiterate (and really, there can't be all that many left) can arrange to get the help that they need to use proper record-keeping systems!
  28. Moose Pie from Toronto, Canada writes: Since I have had my records lost on a couple of occassions in lieu of a diagnosis, bring on the electronic record keeping. Now if I can only find a doctor who is taking paitents and doesn't start every meeting with "Are you on a drug plan?"
  29. Rick Drysdale from Sidney, Canada writes: CORRECTION: Andy Canham is the president of Sun Microsystems, which has reached a deal with the B.C. government to establish a province-wide system of health care electronic record-keeping. Incorrect information appeared in the B.C. section of Tuesday's Globe and Mail.

    Is it just me or is it really prophetic that the announcement of this was screwed up?
  30. Rick Drysdale from Sidney, Canada writes: Moose Pie from Toronto
    Maybe you need your hearing checked. My doc keeps asking me if I'm on drugs.
  31. Alannah Bjur from Seattle, United States writes: As a clinical informatics and patient centered technologies major at the University of Washington I see this initiative as something that will cause a number of growing pains for all involved but at the end of the day be one of the most effective things to hit BC Health in a long time. For anyone who has the opportunity to check out the Puget Sound Group Health Cooperative website http://www.ghc.org/ you can sample how stream lined care can be made when you can access everything online. We live in a world where technology is a given and soon it will be a necessity. Canada is in a unique position for the implementation of this technology. The publicly funded health care system allows for a comprehensive data base that can be accessed by a multitude of care practitioners to allow for collaborative care in the best sense possible.
    For those who are worried about the states involvement... I think it is a mut point... they're too busy trying to figure out what to do with themselves. Remember there is no universal health care in the states... a large scale project like this is unimaginable south of the border.
    Be proud of Canada taking the initiative to stand out as a leader with this type of initiative.
  32. Bernard Samson from Calgary, Canada writes: Ian Pregitzer - me again. Maybe you missed my point, I was not interested in taking my data and running away with it. I just wanted the same sort of access to it, as a bank customer has to his account information. How many of the other posts here have made the point about correcting or supplementing lost , missing, or faulty information.

    I well remember being examined years ago by a young intern under the tutelage of an older doctor. She detected and disclosed to me that I had a heart murmur. I raised the matter in my next visit with my regular doctor. His response? "Well, I didn't think you needed to know."!!!

    I no longer patronize that person. My records at his office were a thick sheaf of handwritten paper notes. I GUARANTEE none of that information will ever be computerized. So what becomes of that data? Lost forever unless I can lay some sort of claim to it.
  33. Ian Pregitzer from Edmonton, Canada writes: Extract from CTV news today for those who have concerns about the enforcement of health information laws:

    S***** M*****, who worked at a doctor's office in Calgary and accessed the records of her lover's wife 17 times, was fined $10,000 last week for illegally obtaining health records.

    http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20070417/healthprivacy070417/20070417?hub=Health
  34. Diane Schweik from EDMONTON, Canada writes: Is there any real evidence,apart from the claims of the vendors,that all this computerisatioin is cost effective ? The NHS in the UK has been bogged down in an increasingly expensive scheme to try to computerise the scheduling of all appointments throughout the country.It has been going on for several years and it is now estimated that the final cost maybe of the order of CDN$40 billion with no end in sight.Meanwhile the system is almost bankrupt and it is possible that doctors and nurses will be laid off,but not IT staff. A recent study in (?) Phoenix AZ comparing the offices of two similar ophthalmology practices showed that the traditional paper record office was more efficient than the new "paperless" one.
  35. Ian Pregitzer from Edmonton, Canada writes: Diane Schweik writes: "the traditional paper record office was more efficient than the new "paperless" one. "

    That is not suprrising Diane - but when the client goes to many, many "offices" (hospitals, clinics, GP, laboratories, dentists, opthamologists, etc. etc. - the list is huge) over a long period of time the records become very large and need sharing.

    Your choice - either give the records to the client to carry around (the smart card that Albertans rejected about 12 years ago) or build a system to let custodians share (as Alberta Health is now doing).

    Paper records?? Surely not in 2007. Also don't forget that lots of the health records are now computer images and hence environmentally unsuitable for a paper-based system.

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