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Group Health Centre Medical Records Clerk Christina Aquino - Soriano moves files on the second floor of the Medical Records Warehouse in Sault Ste. Marie Ontario. The old paper charts of Group Health Centre are kept in a secure, storage warehouse and rarely accessed.

At the Group Health Centre in Sault Ste. Marie, Ont., paper records are a quaint relic, stored away for historical purposes. The pioneering clinic has had electronic medical records since 1997.

"When we started out we had paper charts and we longed for something more legible, more complete and more accessible, so computerization seemed like the way to go," said Lewis O'Brien, a family physician with the Algoma District Medical Group at the GHC.

But, quickly, he said, "we realized this was going to change patient care, change it for the better."

Being only a mouse-click away from medical charts, test results, diagnostic images and prescription drug information saves time, reduces waste and duplication, and improves safety, he says.

"It allows you to deliver patient-centred care," Dr. O'Brien said.

Unlike patients of the GHC clinic, most Canadians still do not have electronic medical records. But if the Soo can do it, why can't every clinic, physician and hospital?

"That's a good question," said Richard Alvarez, president and CEO of Canada Health Infoway. "I would say it's not technology or money that's lacking but a culture of collaboration. Once you have that - like they do in Sault Ste. Marie - anything is possible."

Currently about half of Canadians have their health information stored in some electronic form, but that statistic overstates progress.

The real challenge is to link disparate systems so that every Canadian has a single electronic health record that stays with them for life and that is accessible (appropriately, of course) to all health professionals.

A point of definition: An electronic medical record is a file that exists in one location; an electronic health record exists when all the components are linked.

In Canada right now, about 50 per cent of citizens have an electronic medical record - meaning information stored in electronic form - but only 17 per cent have an electronic health record - one that contains all their essential health information.

According to Canada Infoway, there are electronic medical records in about 37 per cent of physician's offices, 65 per cent of hospitals and nearly 100 per cent of pharmacies.

Expanding those numbers is relatively easy but it's not cheap. Over the past seven years, more than $3-billion has been invested in electronic health records and twice as much again is probably required to complete the task.

Physicians have been slowest on the uptake: Some balk at the cost, while others are set in their paper ways.

The provinces have responded with incentive programs to speed the switch to electronic records. Some jurisdictions buy computers and software outright for physicians, while others require them to have electronic records to claim incentive payments for screening like Pap tests.

The final piece of the puzzle, the connections to get at the records, is the most complex. Because there are a multitude of systems around the country (and often within hospitals), it can be a challenge to get them speaking the same language.

There are also concerns over privacy: ensuring that electronic health records are only accessible to appropriate health professionals. This is done with passwords and varying levels of system access.

But, ultimately, Dr. O'Brien says, electronic records are far more safe and secure than paper records.

Mr. Alvarez, for his part, says patients are increasingly demanding electronic health records because they know they improve their care. He is also confident that electronic health records will soon be the norm.

"Is the job done? Absolutely not," he said. "But this is going to happen. We're past the tipping point."