Progress made: Information technology in physician's offices

In 2000, Canada Health Infoway was created with the mission of having an interoperable electronic health record (EHR) in place across 50% of Canada (by population) by the end of 2009. Its initial funding was $500 million, which was later increased to $1.1 billion to achieve this goal. Physicians and other health care providers were excited that the federal government had finally recognized the benefits of having comprehensive electronic pa tient medical records available to them. However, it soon became evident that the money designated for Infoway would not be adequate to completely achieve this and that it was not in Infoway’s mandate to provide any funding for physicians’ offices. Consequently, at present, the pan-Canadian EHR is not able to include all the information physicians generate daily in our offices, private laboratories, and diagnostic imaging facilities. It stands to be a vast electronic highway with only a few vehicles on it—critical information would be missing.

However, there are areas where Infoway has achieved major success. Digital diagnostic imaging (PACS-type systems) are now in place, or soon will be, across large areas of Canada. These systems provide superior images as well as access and availability on an as-needed basis. Provider and client registries, while not very glamorous, are necessary for uniquely identifying patients and health care providers and allow the EHR to function. Infoway is investing in telemedicine and other electronic technologies that are helping to build the framework we need. But the information that physicians output daily is still missing.

Last year, Dr Burak wrote in these pages about the lack of IT investment in our offices and unfavorably compared us to Alberta. The Alberta government had realized the benefits of making such investments and was actively promoting and funding up take of IT by physicians.

One year later, it is gratifying to see, as our most recent negotiations indicate, that the government of BC understands these problems and aims to rectify them by placing a priority on getting physicians electronically connected. If the agreement is ratified, those of us who choose EHR will have a secure, high-speed, broadband phy sician network available. Funding will be provided for a portion of the hardware and software required to introduce EMR into our offices. We will be able to generate a core data set of essential information that will be available to other physicians, when needed, to help provide comprehensive care to our patients. We will have access to PharmaNet and be able to e-prescribe—potentially preventing dispensing errors due to poor handwriting, adverse reactions, misuse of prescriptions, etc. Lab and X-ray re sults will be available to all who treat our patients, avoiding duplication. Clinical practice guidelines will be available at point of care, chronic disease flowsheets will automatically help us provide optimum care for patients with complex problems, and, importantly, we will have achieved all of this while remaining the custodians of our patients’ information. To ensure the best interests of patients and physicians, we will need to be present at every committee where important de cisions about implementation and funding of IT will be discussed.

The benefits this program can provide to our patients ultimately mean benefits for the provincial government through the savings that will be made throughout the health care system.

Everybody wins—our patients, the government, and physicians.

Exciting times are ahead!

—Michael Golbey, MD
BCMA President