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Electronic Medical Records in Ontario: significant value now — enhanced patient data and functional

by Rick Tytus, MD – OntarioMD

Republished with permission from OntarioMD

Electronic medical records are becoming an essential tool for the medical practice. More than 70% of Ontario Family Physicians have either adopted an EMR, or are in the process of doing so.

There are many features that an EMR offers today. Family physicians and specialists using the latest Spec 4.1 version of a funding-eligible EMR are able to write and renew prescriptions, receive results for lab tests they have ordered from the three major community labs (CML HealthCare Inc., Gamma Dynacare Medical Laboratories, and LifeLabs LP) and see any Ontario Laboratories Information System (OLIS) lab test results for their patients. Hospital reporting solutions are being rolled out throughout the province, which enable physicians to receive patient hospital reports electronically into their EMRs.

Physicians with EMRs will be well positioned to easily take advantage of the new eHealth initiatives outlined in the 2012 Physician Services Agreement. These initiatives will modernize the delivery of health care and enable faster, electronic exchange of information between primary care physicians and specialists through virtual connections, including e-consultations, and by enabling patients to communicate with all their physician providers more easily.

Prescriptions can be generated on an EMR, along with adverse event checking, however, the prescription must still be printed out. This will change as work is being done to develop e-prescribing for EMRs so that the prescription can be delivered electronically to the patient’s pharmacy. The physician’s EMR would be informed when the patient picks up the prescription.

EMRs are also a key component in the government’s Health Links initiative. Health Links will integrate the delivery of co-ordinated care services across the continuum of care for patients with complex conditions, who make up 5% of the population, but consume 66% of health services. Health Links will bring together hospitals, specialists, community care access centres (CCACs), and primary care practitioners around a common agenda centred on these patients to increase access, quality, efficiency, safety and patient satisfaction. Health Links will reduce duplication and streamline transitions in care between all providers to improve patient outcomes.

Primary care physicians and specialists across the province are integral to the success of the regional Health Links. The OMA and OntarioMD are working with physicians to contribute to the development of this integrated care model for complex patients. EMRs facilitate the identification and management of complex patients, and the hospital reporting solutions enable quick, electronic delivery of patient hospital reports to the primary care physician’s EMR.

EMRs not only connect the dots in an ever expanding eHealth network, they also help physicians complete and manage their Quality Improvement Plans (QIPs). QIPs are now mandatory for family health teams, and voluntary for other patient enrolled model physicians. Physicians can search and query their EMR system to retrieve the data that will form the basis of each QIP.

EMRs are aggregating and sharing patient information to inform clinical decision-making and meet reporting requirements. They have come a long way in the past eight years. They began as simple recording tools for patient encounters, but are now connecting to the other sources of patient information and to useful care tools. This is what physicians have always wanted: to supplement the information collected during patient encounters with the patient’s hospital reports, labs, diagnostic images and more. Decisions will be based on evidence, and overall quality will improve. This is better for patients, providers, and the system as a whole.

The use of EMRs has proliferated over the past eight years to the point where the majority of primary care physicians are using them. The transition may seem daunting at first, but once a practice gets going with an EMR, they build confidence and comfort from seeing positive outcomes and a real return on their investment in time and resources. As more quality patient data is added and more functionality is built into the EMR, it will be hard to imagine practising without it.

Dr. Rick Tytus, a family physician practising in Hamilton, has been using an EMR for approximately 15 years. Dr. Tytus serves as Chair, Board of OntarioMD, and is a member of the OMA Board of Directors.

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