I will respond to Dr Blair’s original letter from the June issue (“EMRs and specialists” BCMJ 2009;51: 190) and Dr Hwang’s response concurrently.
Through an extensive requirements definition and evaluation process involving over 40 physicians, a breadth of choice of electronic medical record systems has been established for selection and reimbursement through the PITO program. Many specialists, including neurologists, pediatricians, ophthalmologists, rheumatologists, obstetricians, cardiologists, and general surgeons across the province are already using these EMRs. I would encourage physicians considering an EMR to fully evaluate all options, PITO-qualified or not.
The PITO team of physicians and staff continues to refine the program and identify opportunities to not only ensure that the EMRs meet the needs of physicians, but, moreover, to address the challenges and opportunities outlined in the May BCMJ article “Specialists and EMR Adoption” (2009;51:154).
While more than 95% of the needs are common across specialties, and in fact the same as those of GPs, PITO is further addressing the remaining 5% that vary between the broad categories of primarily consultation-based subspecialties of internal medicine, surgical specialties, ophthalmology, psychiatry, and pediatrics. Usually these differences relate little to the EMR functionality itself but more to remote access, specialty-specific forms, and interfaces with hospitals.
The PITO program has been in extensive consultation with specialists representing each specialty and major subspecialty to review and confirm specialist requirements both in general and any specific uniqueness by specialty.
While it is not possible to directly seek the feedback of every specialist in the province, representative input has certainly been sought and acted upon, and representatives of PITO and the Society of Specialist Physicians and Surgeons continue to meet to review the input and address opportunities to enhance both EMR and IT support for specialists, including areas not mentioned by Drs Hwang and Blair such as electronic referral, remote access from hospitals, and electronic delivery of diagnostic and other reports from hospitals and private labs.
PITO Program Director
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