Physician Information Technology Office

A group of innovative BC physicians supported through the Physician In­formation Technology Office (PITO) has developed communities of practice (COPs), leading groups of their colleagues who have joined together in the selection, implementation, and use of common electronic medical record (EMR) systems to enhance pa­tient care in a local area or specialty.

General practitioners and specialists across the province have formed 14 COPs so far, engaging in various areas of interest including:

Ending the 2009 calendar year, the second full year of implementation, it seems an appropriate time to provide an update on progress and status.

There are now over 2000 physicians enrolled in the PITO program—slightly over the target for this point—25% of whom have completed implementation. The implementation rate was over 50 physicians per month over the summer months and 70 to 80 per month in September and October, and is projected to be well over 100 per month starting in November.

In the May issue (BCMJ 2009; 51:154) we explored the broad electronic medical record (EMR) requirements of specialists, noting that it is typical that 95% of the functionality is the same between EMRs for all specialties. However, the primary benefits and emphasis of various aspects of the EMR shift depending on the specialties and subspecialties along continuums, as illustrated in the Figure.

The paperless physician’s office sounds great on paper (and it can be), but when the real world intrudes, extraordinary efforts can save the day.

When it came time to open their own practice in Langley in 2003, Drs Leo and Flora Wong, both family physicians, wanted to use electronic medical records exclusively. Designing their paperless office, they made provisions for network wiring but not for chart storage. It seemed that the Wongs had side-stepped the time-consuming transition from paper to electronic.

Until recently adoption of electronic medical records (EMRs) by specialist physicians has been highly variable—avid interest in a few cases, but certainly not uptake on a broad scale. Why has EMR adoption not been higher?

Over the last year PITO has been undertaking an in-depth analysis of specialist adoption of EMRs. We have observed a consistent “value equation.” If all of the following four variables are in place, the environment becomes favorable for specialists to adopt EMRs: