Synapse network for MDs integrates with electronic medical records

BRAMPTON, ONT. – Synapse, a system that enables healthcare professionals to easily communicate with each other via Facebook-like technology, is currently being used by about 1,000 physicians across Ontario, plus another 3,000 nurses, pharmacists and allied healthcare professionals.

Those numbers have been steadily rising since the system was launched in 2012, and will likely get a boost in the months ahead, as the company developing Synapse is now integrating it with a variety of electronic medical record solutions.

At the moment, it integrates with Oscar, the ‘open systems’ EMR that was originally created by doctors and university researchers in Hamilton, Ont. Soon, it will also mesh with other popular EMRs in Canada, thanks to funding from Canada Health Infoway. The plan is to make use of ThoughtWire technology to build a seamless integration layer on top of other EMRs.

“It’s a $1 million project, with a major contribution from Infoway,” said Dr. Sanjeev Goel, the family physician in Brampton, Ont., who has been leading the effort. Dr. Goel employs a team of software engineers and programmers who created Synapse and are now refining it, and adding a suite of related programs.

As its foundation technology, Synapse makes use of Microsoft Yammer, a computerized communications system that has been called ‘Facebook for business.’ In addition to computers, it runs on iPhones and Android smartphones, enabling anywhere, anytime communication.

While there are other Facebook-like systems available for doctors in Canada and the United States, the comparative advantage held by Synapse is that it integrates with EMRs, while most others don’t. That means physicians can not only communicate with each other, but they can also access and update their patient records, wherever they may be.

Doctors can make electronic referrals to specialists, and they can automatically inform patients about the status of the referral by email or text.

They can also send prescriptions directly to pharmacies, eliminating the problem of lost scripts.

An important new component is called iDash, a dashboard that provides doctors with a host of information and metrics about their patients and their own performance.

It can analyze charts, going back three years, to provide information about patients with diabetes, cancer, and other diseases. It can offer reminders to order tests for these patients – such as A1C screening, LDL and eye exams for those with diabetes, and Pap tests and breast exams for women. It then scores the doctor, showing him or her how well he or she is performing when it comes to ordering the suggested tests and exams.

Results are flagged with points and colours – red, yellow and green. “We’re gamifying performance, to make it fun,” said Dr. Goel. “But there are also financial incentives and rewards, as physicians receive bonuses [from the government] for reaching targets for various tests.”

In the end, this leads to better care for patients, as they’re receiving the screening and tests they need to detect problems as early as possible.

The scoring system is effective, said Dr. Goel, as many physicians aren’t aware they need to do more screening.

“When you ask doctors, most will say they’re providing excellent care,” said Dr. Goel. “But if you knew the numbers, you might feel differently.”

He noted that, “I thought I was doing fine with diabetic eye exams. It wasn’t until I saw the numbers that I realized I needed improvement.” The iDash enabled Dr. Goel to track his own performance, and to improve in certain areas.

He said iDash will soon be rolled out to an additional 200 sites in Ontario, as his company, Health Quality Innovation Collaborative (HQIC), recently became an authorized provider of the Oscar EMR. iDash is an add-on to Oscar, and physicians must pay a license fee. But Dr. Goel said most have been happy to do it, once they’ve tried using the system.

Not only does iDash provide performance analytics, but it also offers a patient appointment reminder system, using emails and SMS phone messages, which have proven to be highly effective in preventing patients from missing appointments.

Once they see the whole package they’re being offered, doctors tend to welcome it and don’t mind paying the fee, Dr. Goel said.

Patients can also tap into part of the system, called miDash, to make appointments, and view portions of their electronic records. Test results are displayed in way that patients can understand, using easy-to-read graphs.

Patients can upload their own information for tracking purposes – this includes weight, blood pressure. “We give them devices that allow them to measure and upload the data,” said Dr. Goel.

Dr. Goel is testing e-Visit technology supplied by Medeo, a B.C.-based firm. It allows doctors and patients to see each other and to converse using computers and webcams.

Physicians are funded for e-Visits in British Columbia, but remuneration is not yet available in Ontario or other provinces. Dr. Goel predicts that it’s just a matter of time before this happens. Meanwhile, he is starting to deploy the ‘e-chat’ technology, simply to make it easier for his patients to obtain the medical attention they need.

“If we’re not accommodating patients, we need to change the way we do medicine,” said Dr. Goel. “We’ve got to be more efficient, and one way of doing this by using more e-Visits.”