Nearly 40% of B.C.’s 6,000 physicians are using electronic medical records (EMRs) three years after the provincial government launched an incentive program to encourage EMR adoption.
The province’s health-care system is one of the national leaders in adopting EMRs, but that adoption is only the start of a push by government, health-care professionals and the private sector to increase the use of information technologies (IT) in health care.
And as B.C.’s Physician Information Technology Office (PITO) noted in a July announcement, ensuring that EMRs are used effectively once they are adopted by physicians is a whole different battle.
PITO was setup by the B.C. government and the BC Medical Association in 2006 in order to standardize and encourage B.C. adoption of EMRs – which replace doctors’ paper files with a more secure electronic filing that, if used right, can improve physician access to clinical information and reduce paperwork and duplicate testing.
The $107.8 million program reimburses up to 70% of costs required for physicians to set up an EMR system.
EMR adoption is the first priority in province’s eHealth program, which was launched in 2005 in order to guide the integration of IT into the health-care system.
Other components of eHealth include the Public Health Information Project, which is in early stages but aims to help B.C. hospitals in managing vaccine distribution and potential outbreaks; and Telehealth, which enables health professionals to treat patients over long distances.
The latter system is being used in more than 100 B.C. communities.
Since 2005, $185 million in government funding has gone toward developing the provincial eHealth program, with the large majority of that going toward EMR adoption.
Last year, $37.2 million of capital funding went toward the eHealth program.
In an email, the Ministry of Health Services said that B.C. is third among provinces in terms of EMR adoption.
“We recognize the value of new and emerging technologies and the potential that they hold for the health-care sector,” said the ministry. ”But with mounting pressures on health budgets we have to be prudent and invest in established technologies.”
That’s where the private sector sees an opportunity: a number of technology companies in B.C. are capitalizing on health care’s increase adoption.
Kelowna’s QHR Software Inc. (TSX-V:QHR), which is one of five vendors selected by the provincial government to supply EMRs, has grown its revenue in its EMR division from $1.6 million in the first six months of 2009 to $4.7 million in the first six months of this year; 3,500 doctors across Canada are using its EMR software.
Al Hildebrandt, QHR’s president and CEO, noted that while incentive programs help, EMR adoption has to be driven by physicians.
“If a doctor can actually be more efficient in how they do their work, if a doctor can record information more automatically, they will have a better and more organized business,” said Hildebrandt.
While doctors and GPs are adopting EMRs, adoption among specialists in B.C. has been slow.
As a result, PITO re-jigged its incentive program in July: rather than requiring specialists to adopt a particular EMR package, PITO is allowing specialists to define the level of adoption they require, with funding incremental to the level of adoption.
Hildebrandt noted that QHR is trying to encourage doctors and specialists alike to use EMR technology to its full capabilities.
“They haven’t really used it as an educational tool,” he said.
“If all they’re doing is inputting information on the patient and not using it as a research tool, it will [improve their patient care] but it will not be as [effective] as it could be.”
The B.C. government has also recognized the need to educate physicians on the use of EMRs.
This fall, it’s launching pilot projects across the province to train physicians on how EMR can help with prescribing medicine and managing chronic diseases, mental health care and office workflows.
A white paper released this month by the Ivey Centre for Health Innovation and Leadership and sponsored by Telus Corp. (TSX:T), called on individual citizens, health-care practitioners, health regions, and the province to partner together to adopt health IT.
“If B.C.’s health-care system is to remain sustainable in the face of enormous challenges on the near horizon, we must embrace the information technologies that other sectors of the economy have successfully used to enhance efficiency and improve service,” said the Ivey Centre’s chair Kellie Leitch.
The paper called for B.C., among other things, to develop leadership capacity through education programs targeting current and future leaders in the health system; and to support and disseminate research that establishes the evidence base for health IT systems.
Telus has seen the potential for health IT to improve both health care and the company’s own bottom line.
It has invested $800 million into research and development of health-care-related technologies in the last three years.
Much of that has gone into the development of Health Space, an Internet portal that vlooks and functions much like a social network through which consumers can manage their health-care data and costs and communicate with health-care professionals.
The portal remains in pilot stage with a test group of Telus employees, but could potentially be the centrepiece of Telus’ burgeoning health-care business – which generated $400 million in revenue last year.
Much of that was generated from managing and storing EHRs and other health-care records in its datacentres.
“Health has always been an industry lagging in IT,” said François Côté, president of Telus’ Health Solutions business.
Côté pointed to Ottawa Hospital as a leader in the adoption of health-care IT.
Hospital staff members conduct patient rounds toting iPad tablets on which each patient’s EMR is stored and managed.
“I think we’re seeing a perfect conjunction,” said Côté, “There’s good motivation for governments to [encourage the use of health IT], and there’s clear demand from consumers to have it – either with or without the participation of the health-care system.”