EMR streamlines health care in Elliot Lake

Electronic medical records (EMRs) are revolutionizing the practice of medicine for approximately half of Northern Ontario’s family physicians.

Dr. James Chau, a member of the Elliot Lake Family Health Team, is a good example. A graduate of Queen’s University, Chau completed his family medicine training through the Northeast Family Medicine Program and began using an EMR a few months after he began practising in Elliot Lake eight years ago.

“EMRs have had a significant impact on how data is collected and organized,” said Chau. “It’s so much easier to access the information when you need it, not only during your patient encounter, but also in the hospital, on house calls, or anywhere else. It’s right at your fingertips.”

Chau is able to access the Elliot Lake Family Health Team’s xwave EMR over the Internet from home and even when he’s thousands of miles away on holiday.  He can review lab reports relaxing in an easy chair after dinner, or lounging on a beach.

Having the capability to work anywhere, anytime may not be ideal from the perspective of work-life balance, but when he returns home after a two week absence, there isn’t as much of a backlog to wade through.
Chau finds the EMR useful for writing and keeping track of prescriptions, documenting patient encounters and alerting him to recommended screening procedures.

“The EMR gives you a very clear and precise record of medications prescribed and points out any potential interactions as you’re writing the prescription. If a patient has been on a medication before and had a problem with it, you can document that, and if you forget, it will remind you.”

Once the legalities are worked out, Chau will be able to transmit prescriptions directly to a pharmacy’s computer system, but in the meantime, he is able to fax them from his EMR using a digital signature.

Another advantage of the EMR is having a list of all the screening procedures for a patient based on the patient’s age, gender and health profile.

“During a patient encounter, the EMR will flag that a patient hasn’t had a mammogram or that they’re due for some updated cholesterol lab work, so it’s a very helpful tool to make sure you’re on top of all the preventative health procedures,” said Chau.

Lab reports are transmitted electronically to the EMR and filed in the patient’s record after being reviewed by the physician. The data points can be graphed and correlated to show a patient’s progress over time.

“For patients trying to lose weight,” said Chau, “I’ll pull up the numbers and display them graphically on the screen, so they can see where they were and how they’ve progressed.”

The family health team has started to collect email addresses and is looking at using them as a means of educating patients about smoking cessation, weight loss and other subjects based on their health profiles. Email can also be used to notify diabetics about foot clinics or invite patients to come in for their flu shots, but security and privacy concerns will have to be taken into account as part of any decision to fully embrace this mode of communication.

How and where information is kept in an EMR impacts on the extent to which it can be used for data mining.

“We recently pulled out all of our diabetics, but it took us a while to do that because when we first started using the EMR, we weren’t all putting the information in the same place,” said Pierrette Brown, executive director of the family health team.

Another benefit of EMR technology in an interdisciplinary practice is that patient records are also available to other members of the team, including the dietitian and respiratory therapist.

Of the 13 physicians at the Elliot Lake Family Health Team, only six are using the EMR system. The holdouts are mostly older physicians who aren’t fully computer literate and used to doing things the old-fashioned way. They include Dr. Frederick Young, who is in his early 80s and two other doctors in their 70s.

The family health team is still managing paper charts for the holdouts and employs one administrative person full time to scan reports and documents coming in from the hospital and other sources.

The full benefits of EMR adoption will only be realized when everyone’s on board and hospitals are able to transmit reports electronically to physician offices, but that day will eventually come.

“I prefer using a soft shoe approach instead of a sledge hammer,” said Brown. “We’re into our fourth year and I think we’re doing really, really well.”