PEI to create ‘medical neighborhoods’ using new EMR
March 29, 2021
Prince Edward Island recently announced it will invest $8.4 million to provide family doctors throughout the province with the Telus Health Electronic Medical Record (EMR), a project that will result in a common platform for community-based practitioners. As well, Canada Health Infoway is contributing an additional $3 million to the project, largely to establish e-Prescribing between physicians and pharmacists.
“We evaluated several EMRs, and we were impressed with the core capabilities of the Telus system, but also by several additional functions that will be very valuable,” said Dr. Kristy Newson, a general practitioner who is president of the PEI College of Family Physicians. She is also the medical leader of the province’s EMR project.
The additional capabilities she mentioned include embedded video, which has proved so important to clinicians during the COVID-19 pandemic, data analytics for quickly determining patient trends, outliers and physician performance, and secure communications among users.
Not only will the EMR be used by all physicians once they express their interest but the province is also embarking on a unique project that will build medical “homes” and “neighbourhoods” to connect patients and physicians to other allied professionals, such as diabetic care nurses and dieticians.
The patient’s family doctor will become his or her “medical home”, while the network of allied health professionals will make up a “medical neighborhood”. Using the secure electronic medical records, each of the caregivers will have access to the patient’s information, enabling them to better coordinate services.
Moreover, by using the Telus Health EMR, caregivers will have a secure method of quickly communicating with each other – one that is much more effective than the traditional methods of phone and fax.
The EMR will also be integrated with the province’s hospitals, which use their own Cerner electronic health record. By connecting to the Cerner system, physicians and allied professionals will have access to the medical laboratory results of their patients, along with diagnostic imaging test reports, discharge reports and clinical notes.
Other Canadian jurisdictions have started to create groups of clinicians and allied professionals working together, such as the Ontario Health Teams in Ontario. However, Dr. Newson said the teams in Prince Edward Island are likely to be the first in the country to be connected by a common electronic medical record that is also tied into the hospital system.
“It will be the first ‘all-in-one’ network in Canada to combine care-givers, patients and an EMR,” she observed.
She noted that the Telus Health EMR will be rolled out to community physicians in July, initially as pilot projects in a few locations, and then throughout the province during the second half of 2021. The medical neighbourhoods will be established at the same time as the rollout begins, she said.
Dr. Damon Ramsey, the new chief medical informatics officer and vice-president, Collaborative Health at Telus Health, observed that PEI’s project, which creates systems of physicians and other caregivers all collaborating on patient care through an EMR, “could become a model for other provinces.”
Dr. Ramsey recently joined Telus Health after his own company, Input Health, was acquired by the larger corporation.
For his part, Dr. Ramsey created an innovative technology that allowed patients to fill out digital questionnaires before their encounters with doctors, reducing the time needed during the appointment to fill out forms. This, in turns, speeds up the encounter and promotes the efficiency of the practice.
As well, the system can be used by patients to contribute electronic forms after the encounter, to report on their outcomes. In this way, doctors can see how various therapies perform in the “real world”, and they can establish best practices using an evidence-based methodology.
“The self-assessment feature using questionnaires was seen by our doctors as one of the most beneficial aspects of the Telus Health EMR,” said Dr. Newson. “It’s key to gathering data that can be used to improve the quality of care and for planning.”
She added, “It gives us a window on patient care that we haven’t had in the past.”
Dr. Ramsey noted the EMR project, through Canada Health Infoway, will also provide PEI doctors with e-prescribing tools that will improve their communication with pharmacists.
The system will allow them to send prescriptions through their EMR, connecting primary care doctors with pharmacies. And instead of seeing just the prescribed medication, the pharmacist will be able to access the patient’s electronic record and list of medications.
In this way, he or she will be able to check for possible adverse reactions and to conduct a medication reconciliation, if needed.
“We know that medication reconciliation is a complicated problem,” said Dr. Ramsey. “An e-prescribing system helps to make sure that the patient is getting the right medications.”
He noted that pharmacists and doctors can see all the medications that a patient is taking and can determine whether there might be a problem before an accident happens.
As well, by using the same electronic platform, communication between pharmacist and doctor becomes much easier. Instead of communicating by phone or fax, electronic messages can be exchanged.
There are about 240 physicians on PEI who are eligible to acquire the Telus Health EMR (about 160 other doctors work primarily in hospitals, where they use the Cerner health information system).
Dr. Newson said that PEI has trailed other provinces in the use of physician I.T. systems, and that only 30 percent are already using EMRs.
However, she predicts that most will switch to the new system, as it offers so much more connectivity. “Instead of having to go from one system to another for clinical data, for lab information and diagnostic imaging, the Telus Health EMR will integrate it all. It makes sense for them to use it, because it offers one place to go for all information.”
The common platform will also enable fast, secure electronic communication between clinicians – something that isn’t available if a doctor uses a different EMR.
Additionally, the province will be paying for the implementation, so doctors won’t have to pay for it out of their own pockets.
As part of the project, doctors who were using a different EMR will have their data migrated into the new system.
Dr. Newson stressed that adopting an EMR is a major undertaking for physicians, especially if doctors haven’t been using an electronic system.
For this reason, the stakeholders are putting a good deal of effort into change management. “We don’t want to overwhelm our physicians,” she said, noting that support teams will be visiting physician practices to help them – and their staff members – with the transition to working with digital systems.