The Commonwealth Fund asked 6,000 primary care doctors in seven industrialized countries about their use of information technologies (IT) to support primary care. Canada did not fare well. In fact, only 23 percent of Canadian doctors said they use electronic medical records (EMRs), compared with overwhelming majorities of doctors in the Netherlands (98%), New Zealand (92%), the U.K. (89%), and Australia (79%).
Right now, few of Canada’s family physicians are able to electronically order tests and prescriptions, access patient test results and hospital records on-line, or share health records electronically with other clinicians outside their practice. Canada has the lowest usage of computerized alerts on dangerous drug interactions and automated reminders for follow-up or preventive care. Other countries moved to address this sooner and we’re clearly lagging behind.
A staggering 68 percent of specialists receive no patient information for referred patients on their first visit. Patients with chronic illness regularly visit emergency rooms in hospitals that have no record of their medications or medical history. In addition, the lack of an integrated electronic health record significantly impedes the capacity of physicians to work in integrated multi-disciplinary teams. Unproductive appointments, repeat tests, unnecessary hospitalizations and uncoordinated care – the cycle of inefficiency ripples through the system, impacting access to services and wait times. Much worse, anywhere between 9,000 and 24,000 Canadians die each year from health system errors, much of it caused by preventable adverse drug events.
We must strengthen our commitment and accelerate the pace of implementation if we are to play catch-up with other countries who commenced their investment some 15 years ago.
This is the clear message from our healthcare community – from the Patient Safety Institute to the Canadian Medical Association to countless clinical bodies and hospital associations – and now reinforced in the Commonwealth Fund study. Echoing this sentiment, the Health Council of Canada recently stated that if we don’t modernize the management of patient information, all other activities for health care renewal will stall. Given that one of our key renewal efforts underway today is to improve wait-times and patient access to timely care, we clearly need to accelerate our efforts to tackle this national priority.
In addition to finishing what Infoway and its partners have started, our renewed commitment must provide a secure, comprehensive electronic health record for every Canadian, introduce electronic records in physician offices and computerized prescribing in hospitals. Our approach must also empower patients (and in particular, chronic-care patients) by giving them the tools to promote self-care and to access wait-times information on-line.
It is estimated that a one-time investment of about $300 per Canadian will be needed to fully implement the necessary systems. This investment will provide estimated savings and benefits to Canada’s health care system of approximately $6 billion each year once fully implemented. However, in terms of the lives that can be saved, the service improvements that will be delivered and patient empowerment, the benefits are priceless.
This material taken from an editorial commentary by:
Brian Postl, MD was Canada’s Federal Advisor on Wait Times and CEO of the Winnipeg Regional Health Authority. He is also a member of the Board of Directors at Canada Health Infoway.
Richard Alvarez is the CEO of Canada Health Infoway, a not-for-profit corporation responsible for accelerating the introduction of electronic health record systems to all Canadians.
