“Better data can improve health care decision-making and contribute to better quality care.”— Dr. Joshua Tepper, family physician, President and Chief Executive Officer of Health Quality Ontario (source: Infoway)
“Nearly seven in 10 (69 per cent) of Canadian adults said digital health solutions would allow them to take more control over how their health is managed.” (source: Better Together)
So where is our health information?
- In the Electronic Medical Record (EMR) used by any doctor, specialist, or provider that you have had an appointment with.
- Your allied health professionals (your chiropractor, physiotherapist, psychologist etc.) likely have information in their own Electronic Medical Record.
- Any hospital where you have been a patient has your information in a Electronic Health Record (EHR).
- You may track information in your own personal files, health apps, notes.
Currently, in Alberta, a single or unified health record does not exist. There is no way for the hospital to access your medical history from your family doctor.
In Alberta the Electronic Health Record is called Netcare. It does not have all of your health information but it does consolidate some of your information. Netcare includes: medications, laboratory test results, diagnostic images and reports, hospital visits, surgeries, drug alerts, allergies and intolerances, personal demographic information, and immunizations.
There has been discussion about the fact that there are more than 1,300 systems for health records within AHS and no (or little) interoperability = they can’t share information. The Alberta government has committed to address this with a plan to implement a Clinical Information System (CIS).
“The AHS Provincial Clinical Information System (CIS) Program is a collaborative effort between Alberta Health (AH) and AHS staff, clinicians and patients to improve care and safety for Albertans. In the last budget, Alberta government committed $400 million over four years towards a new AHS Provincial CIS.…
The AHS Provincial CIS will support Albertans to take ownership of their health and care by giving them access to their own health information.…
The AHS Provincial CIS will be implemented provincially over a long period of time in order to allow our facilities time to prepare for this transformation. ” (source: AHS)
Patients are the common thread in their health journey, they may have numerous encounters with a variety of health professionals along the way but they are the only consistent piece of the puzzle, why not allow patients to have and control all of their health information?
If I had the choice and decided to take control of my information – to have my own Personal Health Record – what would I want?
- Storage – secure way to save my information, contribute to it, and refer to it when I need to. I want to be able to look back and reflect on what has worked and what hasn’t.
- Secure communication – In order for my care team to really benefit, I would want some way to share my health information with whoever I choose. I may decide to share my information with members of my family, my family doc, my physiotherapist etc.
- The information should reflect how I am doing – what my current state of wellness is, what my biggest issues are.
- When required, I would want to have a clear plan for addressing my health issues. It might be a fitness plan, medications, or a unified care plan that is shared, understood and agreed upon by my entire care team.
One of my biggest concerns with the path that Alberta is currently on is the timeframe. I have heard references to a phased approach to the rollout with patient access to our medication history happening soon. The plan is to complete the project over the next ten years. I immediately wonder what the world will look like ten years from now, and try to remember what technology I was using 10 years ago.
What the world looked like 10 years ago (source: CNET)
- Launch of the iPhone on January 9, 2007
- Netflix streaming was launched in January of 2007
- The Kindle e-reader was launched in November 2007
- Facebook was 3 years old and celebrated hitting 20 million users. FYI – as of December 31, 2016 they have 1.86 billion users with 1.15 billion active daily
- For the first time Americans were sending more texts than making phone calls
- Android platform was announced – Android devices weren’t released until 2008
I recently watched a video that is an interview with Vinod Kholsa about “Investing in Healthcare Moonshots”. Khosla is an entrepreneur, investor and founder of Khosla Ventures, a firm focused on assisting entrepreneurs to build impactful new energy and technology companies. In the interview Kholsa talks about system change:
“… it’s very hard to change any system from the inside. If you look at who changed automobiles, it wasn’t General Motors, it was Tesla and maybe Google with driverless cars. If you look at who changed media, it wasn’t NBC or CBS, it was YouTube and things like that. If you look at who changed space, it wasn’t Lockheed or Boeing, it was SpaceX. If you look at retailing, it wasn’t WalMart, it was Amazon. I can’t think of a single area where innovation came from the inside.”
I believe it is incredibly important for the health system to have a culture that encourages innovative thinking, depends on continuous improvement and embraces and learns from failure but I wonder what the world will look like in 10 years and whether expecting Alberta Health or AHS to lead us there is the best way forward.
I recently saw an announcement about the province’s new eReferral system, which is actually a great step forward in killing the fax. The announcement outlined that notifications to patients of referral status will be enabled as part of the last phase “later in 2018”. This seems a bit ridiculous when we know a tool like ezReferral can do that now, and has actually been functioning and providing this valuable information to patients since it was launched almost 2 years ago. I am always extremely excited to learn about success stories like ezReferral and Brightsquid, especially homegrown ones. The health system in Alberta needs to be excited about, and embrace, the innovation that is happening around them.