Health care, at its core, is an innovative enterprise whether it’s new developments in the lab or improving patient care services, notes Jeff Doleweerd, the e-Health lead with the North Simcoe Muskoka Local Health Integrated Network. One area it had fallen behind is technology, but that’s quickly changing.
E-health is a concept that marries medicine and technology and it’s changing the way healthcare is being delivered.
One of the most practical ideas is the electronic patient record. “It’s no small feat,” said Doleweerd, “but the benefits are sizable.”
When someone accesses a health-care service, the person’s health information is collected once and is entered into the computer system. It is then accessible to any health-care providers that need it. He uses the example of someone coming into an emergency room with a stroke.
The information can be collected and inputted where it can be accessed by hospital staff, the physiotherapist who works with patient, the nurse who makes home care visits and the pharmacist who dispenses the medicine.
All the elements of care can be inputted in the system including lab results and medications.
“From the patient’s side, you won’t have to repeat the information each time you see a new physician,” explained Doleweerd.
It also cuts down on the chances a mistake is made, said Jean Trimnell, CEO of the local LHIN.
“It’s much safer for the patient.”
With the number of tourist destinations in this area, the electronic files can be particularly valuable if their family physician uses the system. A person coming in to an ER with an injury or illness may not be in a condition to be able to relay his medical information, Doleweerd pointed out.
There also benefits to the healthcare system through time savings. Service providers are already in short supply, he pointed out. “E-health is about enabling the clinician to do what they do best, provide health care.”
There is an Electronic Child Health Network already in place in Ontario. The data bank has been growing steadily since it was implemented a decade ago and it has been shown to improve continuity of care, and improve communication between doctors and specialists across the province as a child’s medical records follow him or her across the province.
Some health care providers are already using electronic health records and while there are benefits, there are also challenges. There are large costs associated with implementing the system, and there is the difficult task of ensuring the existing systems used by the different healthcare services are compatible with each other, she said.
While it’s good to have competition, being able to marry different systems will be necessary to move the system forward. There is a highly competitive vendor community for these types of systems, said Trimnell, “they are aware that we are looking for more commonality or interfacing of systems”
“That’s where LHINs come in,” said Doleweerd. “We can ensure the systems work together.”
Having the medical information of patients available electronically can also be used to better understand diseases and chronic conditions, he added. While, ensuring patient confidentiality is critical, researchers can use the information contained in these records to get a clearer picture of treatments and outcomes for a variety of conditions.
“It will help understand disease better,” he said.
Seniors who belong to the Ontario Drug Benefit plan have an electronic version of their medication history. This can be life saving for someone coming in to the hospital for care who may have memory loss, said Trimnell. By having the information available electronically, it greatly reduces the chance of potential drug complications.
“It’s a beginning point,” said Trimnell, who looks forward to having this service expanded to include all seniors.
Another initiative that is garnering interest from the healthcare community is Telehome; a self-monitoring system for people with chronic conditions. Trimnell would love to have some funding available to run a pilot project here.
“The technology is just exploding.” With Telehome, a patient with a chronic condition is able to monitor his or her vital signs and a healthcare specialist can even access the information remotely.
This ongoing monitoring can keep people healthier, she said, as treatment options can be adjusted to address any changes in a person’s condition.
The patient can also see if the readings are changing and make decisions regarding his own health and decide when it’s time to visit the doctor. “You can likely avoid the emergency room or days in hospital.”
Barrie’s Royal Victoria Hospital is one facility in the area with the ability to access expert advice on the use of clot busting drugs for stroke patients
When a stroke patient shows up in hospital, “there’s a critical decision as whether to use a clot busting drug,” explained Trimnell, and the timing is critical. The province has several stroke neurologists on call 24/7 who are able to provide expert advice after they are sent digital pictures of the patient’s brain. It can mean the difference between having that patient end up in hospital with severe complications or that person going home.
Barrie and Huntsville hospitals have the ability to use the system and the plan is to get the other hospitals on line as well. “We’re looking to expand it to other sites.”
In a similar vein, RVH oncologists can teleconference with other cancer specialists to gather the latest opinions on how to best treat their cancer patients.
This technology can also benefit under-serviced areas, said Trimnell. Healthcare providers often prefer working in urban centres, in large part because of the increased networking and upgrading opportunities that are available to them. This can be done anywhere there is a computer.
“We’re seeing good evidence it works for continuing education,” said Doleweerd. Teleconferencing allows physicians to get together with colleagues and specialists for consultations. “It’s really like the folks are in the room.”
Information isn’t the only thing that can be accessed electronically. Several local hospitals have the ability to transfer digital images including CT scans and X-Rays electronically.
“It’s certainly faster,” said Trimnell, referring to the Pictorial Archive Communication System (PACS). In some cases, the physician may only need to see the scan and this is can eliminate travel for some patients.
As with other systems, different facilities are using different PACSs, but as they look to upgrade, that’s the time to look at how to ensure each can interact with the others, she said.
As technology continues to expand the possibilities of integrating and sharing limited healthcare resources, the province’s 14 LHINs have been charged with facilitating these advances.
“It’s the beginning an electronic health,” said Doleweerd. “It’s not a question should we, but how and when and where.
“The LHINs are charged with putting implementation plan in place.” This includes determining the priorities for this area and their the costs. The most logical place to start is before a new system is brought in, or when an existing system is being upgraded, said Trimnell. One of the key issues is to bring the different healthcare providers together to ensure the various programs are compatible.
While this research will be done locally, the local LHIN will be keeping its eye on where the province wants to go as the Ministry of Health and Long-Term Care has an interest in seeing e-Health provincewide.
“You’ll see a stronger provincial direction ahead with e-Health,” she said.
The federal government is also encouraging the development of compatible e-Health systems across Canada so provinces, including the development of Electronic Health Records that can be shared across the country.
E-Health happening around the world. Denmark reports almost all family physicians are already using electronic records.
Local family health teams and doctors are also looking at electronic patient records, but it is expensive to start up. “We’ll see it phased in,” Trimnell predicted. New physicians will look at getting these electronic patient systems up and running. “For those who have been practicing for years, it’s a little more daunting,” she said, as current files would have to be inputted.
The goal is to improve client self care, helping people stay healthy, and live better with chronic diseases, explained Trimnell. There’s so much opportunity with technology now.
“Technology seems to have a tipping point,” described Trimnell. It seems only a few people embrace new technology when it first arrives, and others wait to see how it is working before buying in.
“You have early adopters. Others watch it before they say, ‘Yes, I see some benefit.’ I’m confident it will reach a point where you don’t see it any other way.”
For more information on some of these initiatives, check out www.health.gov.on.ca/ehealth/initiatives.
Autor(en)/Author(s): Julie Debruin
Quelle/Source: The Collingwood/Wasaga Connection, 12.04.2007
