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Wednesday, January 23, 2013

EMR Progress in Canada: A Reaction to the January 2013 Health Care Matters Bulletin 7

Lynne Zucker is Vice President, Clinical Systems Integration, Canada Health Infoway

I just read the recent How do Canadian primary care physicians rate the health system?, an excellent analysis of the 2012 Commonwealth Fund International Health Policy Survey.  This bulletin provides a comprehensive Canadian context for the Commonwealth Fund results, including clear provincial and international comparisons and data trends from previous surveys. I found it easy to read and informative. 

What did I take away?  While the results for Canada are trending in the right direction overall, Canada is not a global leader in many of the primary care areas highlighted in this survey.

The Health Council of Canada rightly identifies adoption of electronic medical record systems (EMR) by primary care physicians as a bright spot, with adoption rates nearly doubling since 2006.  This good news is tempered by the fact that Canada continues to lag many countries in this category and will have to continue to play catch up.

That said, all countries have work to do with regards to ensuring multifunctional EMR capacity.  These systems have capabilities such as order entry management, generating patient information, generating panel information, and routine clinical decision support.  Some countries with very high overall adoption rates, such as Norway (98 per cent) have much lower scores in terms of multifunctional capacity (four per cent).

International comparison of primary care EMR use

© 2012 Commonwealth Fund International Health Policy Survey

In spite of the challenges ahead, I finished reading the bulletin with a sense of optimism. Why?  I can see how many of the initiatives being planned and/or implemented today will result in even stronger results in the next round of this survey.  More provinces are leveraging the available funds from Canada Health Infoway to launch or grow EMR programs for physicians and nurse practitioners.  With the right combination of incentives and support in place, I expect to see the recent significant growth in EMR adoption continue.  Infoway’s investments in peer support programs and clinician education programs will contribute to an increase in the advanced uses of EMRs. This in turn will impact future survey results.   For example, it will increase the number of physicians who can identify patient groups by diagnosis, lab results or appointment reminders.  Our work on EMR interoperability and the priority many jurisdictions are placing on connecting EMRs to hospitals and other parts of the health system will also result in improved survey results in the areas of notification of emergency visits, information from hospital discharge and reports from specialists.

Recognizing our progress to-date and taking up the challenges reflected by these survey results provides a set of opportunities for Canada Health Infoway and the primary care community. What do these results say to you?

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