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I can't help wondering why doctors in my area still use paper-based systems; in spite of well-documented/discussed efficiencies afforded by an Electronic Medical Record (EMR) system, available subsidies from the OntarioMD organization etc., the status quo is being maintained.

Instead of adopting a critical stance, I've decided to try and place my feet in their shoes, so to speak, via a fictional character called “Dr. J”, so here goes...

At this time, Dr. J is envisioning three “must-haves” before any further EMR systems consideration, namely:

• Connection to every hospital in Ontario (explicitly for her LHIN) and implicitly for others 
• Software as a Service (SaaS)-based EMR application
• Reorganization of the way patient data is managed in Ontario

This article will serve to discuss the hospital connection functionality issue with a couple of example incidents, and deal with the others in future articles.

Note that Dr. J has just read the Telus health space Personal Health Record (PHR) announcement with excitement  – this is exactly what she would love to offer; after all, there's nothing better than partnering with educated patients!

In our first example, Dr. J has an elderly patient who visited her emergency department late one Friday evening –  after an examination, she was told things were fine.
However, hospital staff needed her medical history to ensure the best available care was being administered, but because Dr. J's office was closed, the examining doctor thought it prudent to admit her for the weekend.
Dr. J could have potentially waited upwards of 10 d ays before learning of this incident, had the patient not decided on an immediate visit!

Secondly, another patient was visiting family in a different LHIN and whilst helping with some home renovations, a splinter lodged itself under his thumbnail; this soon required a visit to the nearest emergency department where the patient was asked the following by the triage nurse:

• Who is your doctor?
• Do you wish information regarding this visit be sent to Dr. J?

The patient questioned as to why pertinent information is not available via a swipe of his health card, and why would he want to hide the visit?

To reduce the potential inefficiencies of the above examples, Dr. J would love to see the day when:

• There's no differentiation between patient data inside or outside of a hospital
• The above is available to every primary care provider in the LHIN, 24/7
• There's a vehicle to share patient data between LHINs
• Based on such a repository, she could recommend PHR systems (such as Telus health space) to all her patients

Indeed, a recent announcement re hospital-physician data transfer, has shown that this day is fast appro aching.

Next time we'll hear from Dr. J on the type of EMR applications she 'd love to see made available for healthcare providers.