eHealth Ontario back on track

Posted on November 1, 2012 in Health Delivery System

Source: — Authors: – opinion/editorialopinion
October 31, 2012.   Greg Reed

There will be no “big bang” in 2015 when 13 million Ontarians’ electronic health records are all suddenly turned on. It’s happening now, each and every day. More than 9 million Ontarians already have an electronic health record.

Three years ago this month the auditor general of Ontario issued a report highly critical of eHealth Ontario’s progress, spending, and lack of strategy. Since then, a new management team and board of directors have been working to turn around the agency and deliver real progress.

Here’s what we’ve achieved:

• Today two out of three Ontarians have an electronic health record.

• Over 65 per cent of all primary care physicians use those records to provide better care to their patients. Today, more Ontario doctors use electronic health records than in all other provinces combined.

• Physician records are increasingly connected to regional health-care institutions. Each month, more than a quarter-million hospital reports like patient discharge summaries, critical to avoiding expensive hospital readmissions, are sent electronically to clinicians so patients get better care once they are home.

• Electronic records are more comprehensive, providing immediate access to the Ontario laboratory information system, a provincial database containing 60 per cent of community and hospital lab tests.

• Diagnostic images (CT scans, MRIs, mammograms, X-rays) are digital so they can be sent electronically across the province. Brain CT scans of patients suffering head trauma are now transmitted and viewed within minutes by an on-call neurosurgeon who consults with medical staff at any of Ontario’s 97 acute care centres.

• Patient electronic records are consulted by nurses, therapists and other health care providers in various clinical settings.

• In every one of the province’s emergency rooms, the individual drug profiles of Ontario’s seniors are available onscreen to ER staff.

• All 86 of Ontario’s community health centres are installing electronic records so that 600 nurse practitioners and physicians can provide better care to their patients.

How did all this happen?

When we relaunched eHealth Ontario, we focused on three basic ideas:

1) Improve front-line care immediately. Focus on early impact by funding doctors to install electronic medical records software, or “EMRs”, in their clinics and family practices. Then connect those records to nearby hospitals and clinics, and push more patient information into those records from other sources like labs and hospitals.

2) Don’t reinvent the wheel. Take advantage of existing regional systems to connect clinicians with patient information. Fund the expansion of “legacy” patient information systems rather than replacing them with one large, expensive “provincial standard.” As these local systems expand, connect them across Ontario so they are able to share information provincially.

3) It isn’t all government work. With funding from eHealth Ontario, enable health-care providers and the private sector to innovate and provide better solutions through digital technology. Thirteen different Ontario companies build EMRs currently used by clinicians. eHealth Ontario sets the standards they must meet and certifies their use. Through innovation and the competitive forces of the marketplace they are creating improved EMRs that allow physicians to manage a wide range of chronic diseases and process thousands of different lab results from their desktop computers.

There are big “heavy lifting” systems that eHealth Ontario builds directly: databases linking 13 million patient records to 300,000 clinicians, systems authorizing clinician access, and registries keeping patient information private. There are hundreds of large and thousands of small systems in the province containing patient information, and securely connecting them is a complex job. But it doesn’t prevent us from improving front-line care today.

We are making steady progress — continuous improvement that starts with primary care physicians and EMR adoption. We are working with the Ontario Medical Association and a wide array of health-care professionals to implement this transition from paper records and film to the speed and efficiency of the digital world. Just as you might send a text message or photograph from your cellphone, eHealth Ontario is enabling the medical community to transmit critical patient data between health care providers.

What does the future hold? We continue to build on our accomplishments. The number of clinicians using EMRs keeps growing, the information contained in those records continues to expand, and they become connected to more of our care providers. Electronic health records are building a continuous narrative of each of our health care histories.

Every day the work of eHealth Ontario is felt throughout the province. It happens when lab tests are delivered in hours instead of days. When costly air ambulance flights are unnecessary because a CT scan can be sent remotely to an attending neurosurgeon. When an elderly patient’s medication history is at the ER doctor’s fingertips or their hospital discharge summary is sent immediately to their family physician.

eHealth Ontario is working. It’s working for you.

Greg Reed is president and chief executive officer of eHealth Ontario.

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