The health care system is constantly changing and at present, health information technology solutions are at the heart of a major shift in Canada. The use of an electronic medical record (EMR) is no longer a new concept; it has made its mark on our health care system and is now an essential part of the day to day life of clinicians. Advanced EMR platforms have led to improved care and facilitated the shift from an acute care focus to a patient-centric model. Now that many of the technology systems are in place there are steps our health care leaders should be taking to make the most of their EMR investments.
A fundamental goal of health care system reform is to have a fully integrated and connected system. Continuity of information across settings is a critical component to support that goal and forms the basis of most e-Health strategic plans in Canada. Two out of five Canadians have at least one chronic disease and this issue comes at a cost of $68 billion a year in health care spending. The need for easily accessible complete information including an up-to-date care plan, problem list and medication list wherever the patient is seen is key to improving the management of any chronic condition. When empowered with such complete patient information, health care professionals are able to avoid duplication of services, improve patient safety and control costs while at the same time ensuring patients receive the best evidence-based coordinated care.
Health care practitioners across all points of care such as acute, community, long-term and palliative care all need to be able to access accurate, trustworthy, complete patient information seamlessly. When we consider where we’re headed in the EMR arena, integration and care coordination could be the most valuable operational areas for the Canadian health care system.
Achieving provincial EHR success
In some provinces, such as Alberta, Saskatchewan, New Brunswick and Newfoundland and Labrador, province-wide EHR solutions are currently implemented to connect software such as EMRs, lab and radiology systems and patient portals. With that said there are still a few provinces that have yet to take steps in this direction. The hesitation likely stems from a number of challenges.
For one, physicians across Canada have different backgrounds and varying levels of experience with complex technology, and not everyone is on board with the aims and objectives of using EMRs or EHRs. To change this mindset, the value of the technology derived by other clinicians in similar settings must be articulated.
Second, to reduce the initial technical and cost barriers to EMR adoption, there are simple technology solutions such as the web-based EMR “lite” that integrates and leverages existing provincial EHR captured information. This approach offers most of the functionality of a traditional EMR system and requires minimal technology input by the provider.
There are two essential components that need to be in place in order to derive the best value from a provincial EHR as well as from the individually owned EMR systems. These two essential components are an integration engine (to assemble the data from across multiple systems) and a clinical portal to provide a web-based view of all that data.
An integration engine should “just work,” meaning that it is a piece of technology that operates in the background to reliably pull data from systems and transfer it to other systems with minimum fuss. It should be quick to install, fast to configure and simple to deploy. It needs to understand the wide variety and nature of clinical data, and understand how to transfer clinical data across systems deployed across a province. With the volume of disparate information that health care facilities deal with on a daily basis, an integration engine is one of the fastest, easiest and most valuable ways to streamline health care processes and integrate communities.
The clinical portal should act as an open, universal platform that can provide all types of patient information in one place. A good clinical portal should also be able to provide single-view access to all pertinent information whether that information is stored or retained solely in another system like a radiology PACS system.
As we move toward creating a more patient-centric environment where patients are more involved in their care, the right technology needs to be in place. A patient portal that leverages the same views available to clinicians in the provider portal ensures clear communication between all members of the care team including the patient.
The ROI of an EMR
EMRs have become an integral part of healthcare today because they meet the needs of clinicians for improved quality and efficiency in care delivery. However, many EMRs are functioning as stand-alone systems meaning they are not yet delivering to clinicians the maximum benefit they could provide if their EMRs are connected with the rest of the health care system. Using an EMR and an integration engine allows the connection of key components of the care process like e-referrals, medication reconciliation, lab reports, clinical pathways, disease management and so much more. Achieving real-time connectivity from any system to any system, streamlines processes, reduces operational costs, and increases network reliability and visibility.
So, when you ask yourself the question “My EMR is in place – now what?” the answers are clear – integration and care coordination. Canadian health care jurisdictions are well on the way to full deployment of provincial EHRs, so healthcare practitioners should strongly endorse the strategy in their local regions and push for full implementation as soon as practically possible.
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