Integration

Telus and EMR vendors launch PHR pilots

By Rosie Lombardi

Many doctors believe that better frontline communications with patients, combined with electronic communication between clinics and hospitals, can improve health outcomes. To collect test this notion, Telus Health Solutions is running three pilot projects with EMR vendors Wolf Medical, QHR Technologies and KinLogix Medical. The telecom company is on a mission to prove its patient health record (PHR) platform on Telus Health Space can be used as the key communications conduit to improve healthcare.

“We’re convinced that we need to find a way to that last mile, to get the patients involved in managing their own health,” says Helene Chartier (pictured), head of marketing and strategy at Telus Health Solutions. “Doctors we’re working with are asking us to find ways that allow them to communicate better with their patients, so they’ll be in a better position to manage their health.”

Chartier says Telus has partnerships with three major EMR vendors to test the ways in which its technology can be used to improve healthcare. “For us, the critical part is to make sure we have leading EMR players connected to our PHR.”
Telus Health Space is based on HealthVault, Microsoft’s PHR platform, for which Telus has an exclusive licensing agreement in Canada, she adds.

The first pilot project launched earlier this year in Quebec was with KinLogix, a dominant EMR player in the province. “There are already 150 clinics using its EMR and we’ve already deployed an integrated version of our PHR with their EMR. Two clinics are using it for 100 patients to push out information to them.”

Chartier says the objective of the pilot is to gain a thorough understanding of the information patients and doctors want or don’t want and the ways in which they could use it in an integrated PHR-EMR system. “We also want to know the motivations from a physician’s standpoint. That’s key, as you have to have physicians on board to effectively promote the solution to patients. Now we’re working on getting into full general availability and pushing it commercially throughout the province with our partner KinLogix.”

Telus is also launching two more pilots next year in western Canada with Wolf and QHR, she adds. “We have partnerships with Wolf Medical in British Columbia, and we’re looking to work with about 500 physicians next April. The third pilot is with QHR, which is a really big player.”

The goals of all three pilots are essentially the same, although some regional tweaks may be needed. “For all three, the point is to show how you can integrate patient and doctor records in a meaningful way. There are only a few hundred patients using Health Space today, but we’re confident that in 2012 we’re going to have a critical mass of patients using it,” says Chartier.

She says Telus plans to bring more EMR vendors, hospitals and laboratories on board in the future. “In the short term, we want to ensure we’re successful with the launches we’ve done.”

Feedback from doctors involved in the pilots is invaluable in developing policies, procedures and workflow changes needed to successfully use PHRs to boost both health outcomes and productivity.

“The way Health Space works, the EMR pushes information to the patient PHR. The doctors make decisions about which information they want to push to the patients, be it immunization, lab results and so on. Then it gets transferred into PHRs so patients can use the information at their end,” says Chartier.

Patients can also add information and push it back to their doctors, for example, patients with diabetes would be able to take glucose level measurements on a regular basis and add that data to their PHRs for their doctors’ review.

“So you’ll have mixed information. But the advantage with Health Space is that you can always see who has been pushing that data into the system. If the source is a hospital, clinic or another entity recognized in the industry, Health Space shows clearly that the information has been pushed by a recognized source versus the patient.”

Chartier says project leaders are getting a lot of questions from doctors about integration with their EMRs and impacts on workflow. Unlike their American counterparts, most Canadian doctors prefer to review most of the information beforehand instead of pushing it directly to PHRs, she adds.

“As we move forward with the pilots, we’re being very careful about incorporating steps that minimize the time consumed by PHR activity by the physician so it’s business as usual.”

Although the traditional approaches – phoning, arranging patient visits to review lab results and so on – are also time-consuming, doctors need to change the way they do things if they’re working with PHRs instead.

“It’s just a matter of working their reviews of information into the integration with their EMRs. That has to be done appropriately and we’re working with doctors to identify how to do that. I think there is a general acknowledgement in the physician community that this is the direction we should be taking.”

The issue of remuneration for PHR-related activity will need to be settled by provinces in the near future, says Chartier. “I think it will vary from province to province, and they’re making decisions about how they want to treat this. We might see a combination – in some regions, there will be remuneration to the physician to push information to PHRs. Others may think it's a role for the private sector, which means the physicians could treat this as non-insured services to the patient.”

Posted December 8, 2011