BY HEIDI ULRICHSEN

When the Group Health Centre, an ambulatory care centre in Sault Ste. Marie, became one of the first organizations in Ontario to install an electronic medical record system in 1997, physicians and other health-care professionals using it weren’t sure what to think.

Some found that looking at the electronic chart and entering information onto the computer during appointments lessened the personal connection they had with their patients.

“It’s interesting, though, that over the years they’ve found a way to make it work. What they’ve done is incorporate the screen right into the visit,” said Tamara Shewciw, senior manager of information technology at the Group Health Centre.

“If I’m a physician and you’re my patient, I’d be pointing to graphs on how we’ll you’re doing with your health.”

The benefits of the electronic medical record system, which was purchased from Clinidata, have more than made up for the health-care workers’ initial unease, she said.
Every visit to a health-care professional within the centre, whether it’s with a family physician or a nurse, is recorded in the electronic medical record, keeping the entire health care team up to date on patients’ conditions.

An interface with Sault Area Hospital’s electronic medical record system automatically deposits certain information about patients into the Group Health Centre’s files, she said.

The centre’s Health Promotion Initiatives (HPI) program, which is integrated with the electronic medical record, gives physicians a system of easy-to-use templates to follow when assessing and treating patients with chronic conditions.

They have a list of tests to perform and questions to ask. For example, for patients with diabetes, the physician will do things like check their weight and ask about their diet and recent blood sugar levels.

The health of patients with chronic conditions has improved significantly as a result of the HPI program, said Shewciw.

Having an electronic medical record system also allows for studies on the centre’s patient population to be done easily, she said.

“We knew that we wanted to do research so that we could provide better care,” said Shewciw. “Measuring outcomes is so much easier with electronic charts than trying to flip through paper charts and looking for the number of diabetes patients we have, for example.”

The Group Health Centre, established in 1963 with money raised by unions in Sault Ste. Marie, serves 62,000 patients.

The centre itself is run jointly by the Sault Ste. Marie and District Group Health Association, a not-for-profit, charitable organization, and a group of 61 physicians belonging to the Algoma District Medical Group.

The Group Health Association owns the building, equipment and furnishings, and employs 300 “non-physician” staff, including health professionals like nurses, nurse practitioners, audiologists and speech pathologists, as well as administrators.
The electronic medical record system is supported by a large technical department, said Shewciw.

If a health-care professional doesn’t want to spend time filling in t he electronic medical record themselves, they can pick up the phone and dictate what they want to appear in their patient’s chart to the transcription department, she said.

The people working in this department will transcribe this information and send it back for corrections before it is permanently entered into the system.

Paper documents arriving at the Group Health Centre are scanned in the scanning department, converted to an electronic format, and stored in the patient’s file, Shewciw said.

A year ago, the Group Health Centre pushed its electronic medical records to the next level with the launch of EMRxtra.

The Sault’s 23 pharmacies now have access to health information for 300 consenting patients with congestive heart failure and diabetes, letting pharmacists know why physicians are prescribing certain medications and helping them to reduce mistakes.
Shewciw said she hopes EMRxtra will eventually be extended to all patients rostered at the centre.

Canada Health Infoway provided $2 million to finance the project, and the Group Health Centre provided another $1.5 million.

“As we were setting up the EMRxtra project, we looked at what a pharmacist would need to see to help with a patient’s care. We decided on lab results, past surgeries and the care plan of the patients. Our physicians agreed that this makes sense,” she said.
“The pharmacists have actually been calling patients in to review their meds to see if they are on the right ones. A lot of the time they are taking over-the-counter medications that our physicians don’t know about.”

Because of regulations, physicians must still provide paper prescriptions to their patients, but that information is also transmitted electronically to pharmacists, said Shewciw.

The centre has already won two awards for the EMRxtra project - the 2007 Canadian Information Productivity Award, and the Sault Ste. Marie Centre’s Project of the Year Award.

Shewciw herself won the 2007 IT Executive of the Year Award for her contributions to EMRxtra and the electronic medical record system, and Group Health Centre family physician Dr. Lewis O’Brien won the Community-Based Physician Leader/Innovator Award at the 2007 Canada Health Informatics Awards Gala.

Patients participating in EMRxtra also have access to their own medical information and a series of tools to improve their health on an Internet portal on Group Health Centre’s website, called My Health Matters, said Shewciw.

For example, they can learn more about their diagnosis, and keep track of appointments and the medications they are taking, she said.

“We hope to roll it out to the rest of the patient population as soon as possible,” she said.

www.ghc.on.ca