For happier patients, go electronic

TheGlobeandMail.com – Opinions/Editorial – Patients’ demands always seem to outpace what Canada’s overstretched health-care systems can provide. Spending scarce resources on electronic health records makes it easier to bridge that gap.
Published on Thursday, Jul. 01, 2010.  Last updated on Friday, Jul. 02, 2010.

Patients’ demands always seem to outpace what Canada’s overstretched health-care systems can provide. A concerted push to spend scarce resources on electronic health records will make it easier to bridge that gap.

Some evidence for this comes from a new study by the Commonwealth Fund that ranks seven Western health-care systems. The U.S. is the undisputed laggard, spending the most and faring the worst. But Canada was in second-last place overall, ranking second-last in efficiency and last in quality of care.

Such a low ranking should not be seen with undue alarm. The study is explicitly subjective, based on 27,000 interviews. And Canada is ranked second to Australia on the most important outcome: whether the people the system serves lead long, healthy and productive lives.

The weaknesses that are evident, though, are often connected to a lack of electronic health records.

Take New Zealand. In that country, 92 per cent said patients received computerized reminders for preventive or follow-up care. In Canada? 10 per cent.

Such alerts can make care safer, and in Britain, 93 per cent said that doctors routinely received alerts on potential problems with drug doses or interactions. In Canada? 20 per cent.

In Germany, the Netherlands and Britain, over half of primary care practices say that patients can easily see a doctor within a day if they ask (in part because their electronic systems allow them to prioritize patients). In Canada? 17 per cent.

So Canada’s waiting list problem is, in part, a resource allocation problem exacerbated by poor records. A lack of electronic records comes at a real, hidden cost.

With decentralization of care and advances in genetics, the case for electronic records will get stronger. Robert Bell, CEO of Toronto’s University Health Network, says that “in the next 10 years, complexity is going to change health care so that it is fundamentally a practice of information management.”

Political efforts to institute electronic systems are fraught. In Ontario, an expenses scandal made “eHealth” a pejorative term. Some new systems were unnecessarily built from scratch; Dr. Bell points to the need to network existing systems, a cheaper solution with more immediate benefits.

More fundamentally, a customer service mentality may both improve health and address the political obstacles to better health-care systems. Patients will still be patients. But if they are regarded with more respect, empowered with information about their own care, and treated by professionals armed with good information, their care will be better. And electronic health records are a path to that outcome.

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