We would like to start by indicating that while many of us in different sectors of the economy are used to dealing with electronic records and digital systems, we were amazed to learn that for our health system, there is no universal electronic medical health record for patients in Alberta. While there are bits and pieces being used, they do not and are not expected to talk to each other, and in fact, there are a significant number of doctors that rely on paper records in their practices, for one reason or another. The billing side however, is digital and universal as required by the province.
On Thursday and Friday of last week we attended a symposium hosted by Canada Health Infoway. Infoway aims to improve the health of Canadians by working with partners to accelerate the development, adoption and effective use of digital health innovations across Canada.
The Infoway team had invited Dr. Flemons to speak on the Continuity of Care report and he suggested we tag along to represent a patient’s family’s perspective.
The room was filled with individuals from the Canada’s healthcare sector who have contributed to the conversation about Electronic Medical Records (EMR). It was apparent that EMR systems significantly benefit doctors, patients and the system as a whole.
What EMRs could have meant for Greg
Note: the doctors are numbered the same as they are in Greg’s Journey
e-Referrals and Continuity of Care
There were several breakdowns during Greg’s journey through the system that could have been highlighted and ultimately avoided if there was an EMR system with e-Referral in place.
- When Greg was first referred to a specialist by Doctor #1 the referral was not responded to for 94 days, and Doctor #1 was unaware this happened. Doctor #1 assumed that Greg had an appointment with the specialist and because he hadn’t heard there was nothing to be concerned about.
- Greg went for a CT scan that was ordered by Doctor #2, the CT Scan occurred 19 days after the urgent request and when Greg hadn’t heard from Doctor #2’s office 7 days after the scan he called and learned that Doctor #2 had left the practice.
- Doctor #6 (who had taken Greg’s file from Doctor #2) reviewed the CT scan results with Greg and then referred Greg to a specialist at the Southern Alberta Institute for Urology (Doctor #7). After 7 days without hearing from Doctor #7 Greg called back to Doctor #6’s office who then told Greg he should call Doctor #7’s office directly. When Greg placed that call he got a message stating the Doctor was out of the office for an extended period and would not be back for a couple more weeks. Greg then called Doctor #6’s office back and they then submitted another referral to a different Urologist.
EMR systems that include e-Referral capabilities allow doctors to track their patients appointments and to follow-up if necessary.
While e-referrals would work for Greg’s doctors (and therefore Greg indirectly) a system that could be accessed by Greg himself (a patient portal) would have given him the ability to track progress and advocate for himself.
Recommendation 1 of the HQCA Continuity of Patient Care Study describes how a patient portal can allow patients to view:
- “When the key steps in the referral, appointment time, and report generation process for specialist consultation, special diagnostic imaging studies, and procedures have been successfully completed and notifications when they have not.
- Appropriate contact information for patients when they detect a problem with the special health service, referral, appointment booking, or followup procedures.
- Lab results, DI reports, pathology reports, procedure findings, hospital discharge summaries, other diagnostic information (e.g., EKG, echocardiograms, pulmonary function tests).”
Other benefits of EMRs
In addition to the benefits that could have impacted Greg’s journey the Canada Health Infoway symposium exposed us to examples of other components of EMRs that have proven to be valuable. We plan on breaking down the benefits and sharing with you real success stories that prove the value of EMR systems in the coming weeks.