Previously, we posted the first of three priorities that we shared with Deputy Premier and Health Minister Hoffman, Priority #1 Vision & Culture, today we highlight Priority #2: Establishment of a Universal Electronic Medical Record for Albertans.

First, it is important to realize that there is no universal, individual electronic medical record (EMR) for Albertans today. The records relating to your health are likely held across many separate systems, none of them complete. Doctor’s notes, appointments and prescriptions based on your interaction with your family doctor are held there, if you visit a clinic they will take their own record of your visit, hospitals and labs utilize the Netcare system, and if you are referred to a specialist it will likely be yet again another system.

It’s also important to note that many systems which currently exist are electronic, however they are not integrated, if communication does occur across systems it’s most commonly by fax (referrals) or when interacting with the patient by phone or by mail. The vast majority of the current systems are not visible to or accessible by the patient. One common piece of information is you Alberta Health care number, this is prevalent in all, since it is used as the universal ID for billing, however the universality ends there, it does not tie the systems together.

When Greg visited the Emergency Room on May 18th the doctor did not have access to all of the information related to his condition, pre- and post-op surgery and notes, or specific additional information relating to pending appointments or next steps in treatment.

If you are taken to the Emergency Room because you are involved in an accident the doctors there will not have access to the medical history from your family doctor and your family doctor will not necessarily be notified at any point that their patient had been admitted. They will not have access to any current medications you are on, but don’t worry you will be asked for your Alberta Health Care number.

We have been told that there are over 1200 different programs operating in our health system today, most unable to communicate electronically with each other. Netcare includes records from labs and hospitals but it does not include information from primary care doctors, including your family doctor, or specialists. In our Health System, paper records are normal; relying on fax machines is still common.

Electronic Medical Record systems that are in place elsewhere enable patients and their care providers to do the following:

  • Scheduling appointments including referrals from family doctors to specialists or other care providers
  • Secure messaging (providing patients an ability to contact their healthcare providers)
  • Decision support (providing access to trusted sources of health information)
  • Viewing laboratory and diagnostic imaging results
  • Pharmacy information

There are some independent initiatives that others have taken to fill the gap. We highlighted one example in our post on EZ Referral but uptake has been slow. It is hard to understand how something that would save time both for administrators and inform and engage patients would not be highly valued by doctors. We need our doctors to utilize systems that ensure we are informed, that a digital record of our medical history exists and is accessible by other care providers when we need it to be.

Greg carried around a binder of his own medical information. We have heard several people talk about how they have moved from carrying a binder to using a USB stick, and now we have seen examples of apps enabling patients to access and maintain their own records. This is a natural and inevitable evolution. From a patient’s and family’s perspective, we see the value in collecting and maintaining our own records since we cannot rely on a system to do that for us.

Not only has there been significant advances in electronic medical records but rapid growth has occurred in the world of personal health monitoring and recording. More than 40,000 apps exist and the “fitbit phenomenon” seems to be gaining momentum in both the young and older segments of our population.

The Alberta government has been talking about an Electronic Medical Record for 10 years and we are told that even if a decision to plans in motion was made today, it would still be 7+ years and hundreds of millions of dollars to get it in place. A lot will change in technology in 7 years. The health care system needs to be innovative and have the capacity to embrace and adapt to change. Our care providers will continue to be handicapped without an up-to-date system, their ability to collaborate with each other and to coordinate and inform their patients will not be as easy as it should be. The system in Alberta must move away from the fax machines and the isolated systems that are in place today so that as patients we can be the active partners in our care that we must be.

The evolution of how we monitor and record our personal health will outpace and remain well ahead of anything that the provincial or any government attempts to develop itself. Given this, it is our view that the wisest course is to utilize open systems that can adapt and work with the latest apps to integrate all of a patient’s health information. Information should available to any provider who the patient works with in their care. The referral and patient portals are critical. We are not just an ID number to trigger a payment to someone or some facility, we are true partners in our care.

We need the system of recording and sharing our personal health information to be brought into the 21st century.   As patients and families we need to take as much control of our own information as we can. At the same time, Albertans should press the government to make wise decisions. A billion dollar investment in the purchase and implementation of a single proprietary or closed system will not be forward looking, not responsive enough, nor cost effective enough for the patients and citizens of tomorrow.

We all need to be engaged in this priority. Our taxes are paying for it. We need to have a voice in what it will look like and when it will be implemented.

Priority #2 – Establishment of a Universal Electronic Medical Record for Albertans