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Alberta creates task force to improve EMRs

Stephen MandelEDMONTON – After high-profile figures in the political and medical establishment criticized Alberta’s electronic medical record (EMR) systems as fragmented and ineffective, the Health Minister launched a task force earlier this month to investigate how a more unified system could be created.

Stephen Mandel (pictured) has chosen Alberta Health Services administrator Carl Amrhein to lead the task force to look into the business case for a provincial clinical information system and report back early in the New Year, Mandel’s spokesman Steve Buick said.

“This is a group to take a first look at it for the minister and get back to him quickly,” the Edmonton Journal reported. “The thinking is we need a single provincial system.”

The task force will include officials from the Health Quality Council, Alberta Health, AHS and Alberta Innovates – Health.

The auditor general called on the government in a September report to improve the electronic medical record system, noting there are at least 12 different medical record systems being used by Alberta family physicians, and more than 20 percent don’t use electronic records at all.

“We’re still using fax machines to communicate,” Health Quality Council CEO Andrew Neuner told the public accounts committee.

College of Physicians and Surgeons registrar Trevor Theman said the current electronic system is a failure. “We are currently in a state now where it appears there is unanimity that there should be a single system and there has to be interoperability,” he said.

PC MLA Steve Young told the public accounts meeting the province spent $300 million or more on electronic medical records for doctors “and really got nothing more than electronic isolated file systems.”

“Do we realize we need to have data exchange standards before we start adding systems? We need systems to talk,” he said. “It blows my mind.”

Young, who has been asked to serve on the task force, said in an interview Friday the province has spent a significant amount of money with good intentions to bring medical records from paper to the electronic format, but none of the systems talk to each other and share information.

But he believes the various systems can be adapted to enable sharing of medical information between medical providers, health facilities and pharmacists. “We need to have a secure, effective system of systems,” said Young.

Alberta Medical Association president-elect Carl Nohr told the committee an integrated health information system would provide access to a single comprehensive record for every patient that covers all the care received.

“There are different ways a system like that could be built. No matter which way it’s done, it’s going to take time and investment,” he said. “The AMA believes that in the short term we can leverage some of the technology that we have in place today to get some results sooner than later and make use of some of the significant investment that’s already been made.”

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1 Comment responses

  1. Avatar
    December 18, 2014

    It has always been about interoperability. Unfortunately the provinces have focused their certification programs on functional requirements for EMR systems rather than standardized messages and data interoperability. Once a basic level of functional capability was achieved (POSP included), there was no shift to messaging as the core focus of the programs.
    The Danes have had things right for years. They have a single central agency (MedCom) that certifies all of the messages that need to be transmitted between EMR systems and those in the public sector. All of this is achieved with a minimum of fuss and the multiple EMR systems in use. The criticism of the Danish system has been that it is a point-to-point rather than central information exchange system, however it works! True interoperability is not just about communication standards. It is about ensuring consistency in the messages that need to be transmitted such that even after passing through multiple systems, the message can be accurately and consistently interpreted. The problem is not that we have multiple EMR systems. While a single system may be desirable, the challenge associated with ‘rip and replace’ and the destruction of clinical workflows that have been developed within the EMRs over many years of use will ultimately be more destructive than beneficial.

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