Contributed by Dr. David Weinstein – Nephrologist, Belleville, ON
I wanted to share my experiences with other physicians and offices about some tools for my Electronic Medical Record in Ontario. I have been a physician in Ontario since 2015 and have been in practice since 2002. I work in both my local hospital and my private practice. My EMR and associated tools are so important for making my practice and life more efficient. It is really amazing some of the things I can do.
In the office, I seamlessly pull labs from OLIS (eHealth Ontario’s Ontario Laboratories Information System) into my EMR. I no longer need my office to call around for blood work. I have access to the data quicker and can work more efficiently. My referring doctors know not to send me blood work. This speeds up the flow through my office and saves me on monthly faxing costs.
In the office I no longer call pharmacies looking for medication lists. I can just pull recent prescriptions electronically and now I know I have accurate medication lists.
I can access records from other hospitals including blood work, radiology reports and images and dictated reports using the ConnectingOntario ClinicalViewer. It makes it so much easier to reconcile patients from other sites back into the office and make sure I have a complete picture of what is going on with my patients.
I can access hospital reports in my EMR as soon as they are finalized because my EMR is connected to HRM (OntarioMD’s Health Report Manager). I do not have to wait for anyone to mail or fax them to me anymore. In fact, I have asked my local hospital to stop sending me paper copies of EVERYTHING.
From my smartphone, or form any hospital computer, I can easily access my EMR and review patient history, medication, prior labs and notes to streamline hospital care.
As a e-Consult consultant, I can help out other physicians through the Ontario eConsult Program, but I also can challenge myself based on the difficult questions I am being asked.
I encourage all Ontario physicians to incorporate the various digital health tools into your office practice. You will work more efficiently and your patients will be happier. Contact OntarioMD at email@example.com to connect your EMR to the services I mention above as well as additional services to help you use your EMR more effectively.
It’s well known that poverty is a major determinant of health, and that one’s social and economic environments play a large role in whether a person becomes physically or mentally ill. However, little has been done in a practical way to identify and assist at-risk members of society at the primary care level.
Now, however, a project has been launched to turn things around. Initially, a two-month pilot project was conducted in 2018 that gave primary care providers a computerized tool to identify patients who are at risk of living in poverty, and who could use the support of community resources.
The project was conducted at primary care clinics in four Ontario cities – London, Sudbury, Cambridge and Toronto – under the leadership of the Toronto-based Centre for Effective practice (CEP), a not-for-profit organization which started at the University of Toronto’s Department of Family and Community Medicine to create and disseminate evidence-based improvements in primary care.
“My office screened 700 patients for poverty, and 100 were identified,” said Dr. Mario Elia, a London-based family physician and one of the pilot site leads.
Overall, 4,517 patients were screened at the four sites, and 12 percent were found to be at risk of poverty.
Of these, 30 percent were provided with customized resources and referrals to community supports at the same visit.
Dr. Elia and Claire Stapon, a manager at the CEP, spoke about the poverty screening project at a session for physicians at OntarioMD’s EMR Every Step Conference, held in Toronto in September.
Stapon said that 20 percent of Ontario families live in poverty – about 1.57 million persons. At the same time, she noted that 50 percent of a population’s health is determined by social and economic environment, according to recent studies.
Indeed, all of the following have been strongly correlated with a person’s environment: diabetes, asthma, arthritis, cancer, COPD and mental illness.
“Often, doctors don’t have the resources, and we struggle with how to help patients living in poverty,” said Dr. Elia.
The computerized intervention devised through the Centre for Effective Practice has been identified as a step in the right direction.
The tool was developed in partnership with CognisantMD, which produces Ocean software, a system that helps automate information gathering as patients arrive at a clinic. Also involved is 211Ontario, a free helpline and online database of Ontario’s community and social services.
The Centre for Effective Practice has been producing other tools used in clinics; the one created for this project has been optimized to screen for patients struggling financially.
In the pilot, staff and clinicians at the four clinics were first given education about the topic and training on use of the tool. Dr. Elia said it wasn’t difficult to implement at his clinic, as the office had already been using Ocean questionnaires to gather patient information.
All patients over the age of 18 were given tablet computers, on which the form to screen for poverty would pop-up. Questions included such examples as, “Do you ever have difficulty making ends meet at the end of the month?” and “Have you filed your taxes?”
Not only does the tool effectively identify at-risk populations, importantly, it also provides physicians with sets of local supports and resources for patients.
Low income patients who haven’t filed their taxes – because they fear they might have to pay – are often entitled to tax refunds. The tool shows doctors how to connect their patients with the right resources in order to file their returns and receive these refunds.
Other social supports are also available, making it much easier for physicians and their staff to help patients in need.
The Ocean tool integrates with EMRs and can automatically create reminders on follow-up visits to inquire about different issues.
After the pilot project ended, each of the sites had the option to stop using the tool. However, they all wanted to continue using it, Stapon said.
Now the Centre for Effective Practice wants to spread the resources to other primary care practices in Ontario. They have created a modified version of the tool for TELUS PS suite physician systems, to start. Eventually they’d like to make the tool available for all EMRs in Canada. Those who are interested in more information can visit http://cep.health/poverty.
Contributed by Dr. Steven Klassen, Family Physician, Thunder Bay, ON and OntarioMD Peer Leader
Recently, I accepted a 70 year old man into my family practice. He presented to our first encounter with nothing but his spouse to aid his recall. I had prior hints of his complex history but it soon became evident that neither of the pair had the memory or detail that would have been nice for this intake interview.
One of the tools I have come to cherish in such encounters is OLIS. Subtly integrated within my EMR, in a matter of a couple of clicks I am in the position to query the database for the patient in front of me. On verbal consent from this septuagenarian, I launched digital minions to fetch the last ten years of his labs. Moments later another click of a button allows me to download the retrieved treasure trove into my EMR. Less than a minute later I am pointing to a graph generated by my EMR of his hemoglobin and asking him, “ What happened to you at this dramatic dip in February 2016.?” Visibly impressed, he recalls, “Oh that is when I had my stroke and was given clot busters”. In just minutes, I was able to get a better picture of trends and perspectives that improved my ability to care for this patient without having to send him for duplicate lab tests.
Later, my questions about his diabetes were met with firm denial, yet his previous family doctor had already ordered a Hb A1c in 2015 which was reported at 6.7%. A picture of denial was emerging. The graph of his LDL cholesterol shows the classic swings of someone at one time started on a statin who later stops it only to be started again. In this case, the statin had evidently been stopped approximately a year before his stroke but promptly restarted in February 2017 fitting perfect with my lab graph. My patient and his wife look at me like I have psychic powers. I smile and thank my EMR and OLIS for the good start we were off to.
Dr. Steven Klassen, Family Physician, Thunder Bay, ON and OntarioMD Peer Leader
The 2017 Canadian Guidelines for Opioids for Chronic Non-Cancer Pain emphasized the importance of safely minimizing the dose of opioids that patients are being prescribed. The guidelines made it important for me as a primary care provider to reassess my population of patients on opioids and ensure that I was doing my best to implement the new recommendations accordingly. This presented a formidable challenge and led to the realization that it would be very useful to have an EMR tool to support this process.
In response, the East Wellington Family Health Team (FHT), the Guelph FHT, the eHealth Centre of Excellence (eCE), and TELUS Health partnered to create an Opioid EMR Toolbar (Figure 1) using content informed by the Guidelines and work done by the Centre for Effective Practice (CEP).
Figure 1. Opiod EMR Toolbar
The toolbar provided a practical and effective way to implement the new guidelines into my practice through the following capabilities:
The figure below illustrates the steps I took in using the toolbar to implement the new guidelines.
Figure 2. Steps used to systematically manage my population of patients on opioids.
During this process, I also found it very helpful to participate in Academic Detailing sessions provided by the CEP. These are one on one sessions in which an expert from the CEP met me at my office and reviewed key topics including:
Non-pharmacological and non-opioid options for the management of patients living with chronic non-cancer pain
Managing opioid therapy for patients living with chronic non-cancer pain
Managing care for patients living with opioid use disorder
The toolbar gave me the information that I needed, when I needed it, provided individualized patient decision support, and saved me a lot of time on documentation. I was able to spend more time with my patients. They felt engaged and well informed.
Within nine months of the adoption of the toolbar I was able to safely taper the dose of opioids for a significant number of my patients and there was a statistically significant reduction in the overall MEQs I prescribed over this time period (p<0.05).
I really hope that others will find similar success in helping their patients manage their pain safely and effectively. The Guidelines have paved the way for us, and the Opioid Toolbar has proven to be an effective vehicle to help get us there.
The Opioid Toolbar is now available to all users of Telus Practice Solutions EMR. The simplified version of the toolbar used for this quality improvement initiative is available through theeHealthCentre of Excellence for PS EMR (Oscar under development). eHealth coaching sessions are also available through the eCE (with Mainpro+ credits) for primary care providers across the Waterloo-Wellington Local Health Integration Network.
The Academic Detailing sessions are free-of-charge and free of commercial interest. Physicians can earn Mainpro+ credits for each AD session. More information and the process of signing up for a session is available on the Centre of Effective Practice website.
Busse, J.W. (2017). The 2017 Canadian guideline for opioids for chronic non-cancer pain. Hamilton, ON: McMaster University.
Need help supporting your patients in managing their pain? Visit the Ontario Pain Management Resources for a coordinated program of tools from partner organizations across the province.
The above editorial describes the author’s desire and need for a single national Electronic Medical Record (EMR) in primary care. He speculates that many of our problems in primary care could be solved by such an instance, from the sharing of records between clinics to research, to specialist access to notes. He cites single health systems in the US and Singapore as examples of how and why this could work. This is an interesting perspective, but one which may be overly simplistic and not shine the light on the whole picture. There has been significant progress and development made in the digital health space in Ontario over the past ten years and this should be recognized and celebrated. This, coupled with a relentless focus on systems integration across the continuum of care, is where we should put our energy.
Although we have much in common as family doctors across the country, we all ask very different things from our EMRs. Practice environments are not the same in inner city urban centres, suburban practices, rurally, in university health clinics or aboriginal care centres. This delivery complexity needs to be appreciated. Nationally over 80% of family doctors already have purchased an EMR that works for them and are using it fulsomely. In Ontario, this is over 85%. Physicians own their systems. They have made significant investments in these … financially, in time spent recording information about their patients, and in blood sweat and tears producing clinically useful data. We should appreciate this effort and use the systems to their maximum. Much has been accomplished and advancing from where we are is a very tenable option.
Switching to one EMR solution that attempts to meet the needs of 43,500 family doctors nationally is an impossible task. And the disruption in care created by “ripping and replacing” would take decades to recover from. Canadian provinces have collectively invested billions of dollars in EMR development, deployment and mature use. We cannot afford as a society or at any level of government to start over again. That said, fundamental health system reform, advances in integrated care models and associated compensation reform should be the driver that defines how integrated digital health platforms can and should be presented at the local, regional, provincial and national level.
Satisfaction ratings with individual EMRs is actually quite high in provincial surveys. Even with multiple EMRs on the market, connectivity is improving year over year (witness Netcare in Alberta, Connecting Ontario and Clinical Connect in ON and Saskatchewan’s eHealth portal). In Ontario, information from virtually every hospital is pushed directly into EMRs within minutes of it being generated via Health Report Manager. Lab results from everywhere can be queried and downloaded through OLIS. Integration with drug and immunization repositories is occurring now. eReferral and eConsult systems are up and running and are becoming more and more integrated into the point of care.
As we evolve into an increasingly cloud-based environment the perceived advantages of a single EMR product or database are no longer compelling. What is most helpful is gaining access to data for clinical, research and system planning purposes. This is less a technical issue than a policy one. Integration and interconnectivity are the key. We are getting closer and closer to this daily, with the advent of single sign on, contextual launching of external digital tools from the EMR, data standards and data movement. The most unpredictable factor is a human one: even when standards exist, having people use them consistently is a challenge. A single EMR does not fix this. Endless dropdown lists and tick boxes do not either. In primary care nothing is more important than the patient narrative. We can never lose this.
Choosing a single EMR vendor has other dangers in creating a monopolistic environment. This makes us vulnerable as a health system and as a profession. Currently, Ontario has certified 11 EMR vendors and 12 EMR products to a set of core requirements that improve constantly over time. This allows progress to occur incrementally on interconnectivity, data portability and system functionality. Having a single vendor control the entire market means that we are at the whim of one company whose business interests may not be aligned with those of clinicians or patients. We lose our collective influence.
Open source software is not the solution to this problem either. Although it has the advantage of being inexpensive and in some cases free, it has the disadvantage of needing as much if not more support as proprietary EMRs do. Most physicians lack the knowledge, skill and desire to program and produce changes in their EMRs themselves. They just want to get down to the work of looking after patients. Multiple different customized instances of an open source EMR do not improve the situation overcurrent state in any way.
It may seem on the surface that having a selection of EMRs nationally is folly. But experience has shown that competition drives change and innovation. We do not disagree that there are aggravations in navigating from an EMR to a viewer or external portals, but this is a solvable problem. The key is to build bridges allowing access to data that is required for a clinician at the point of care. We maintain privacy, confidentiality and security more effectively this way. Data for secondary use can be liberated easily through these structures if we create the right policy and business drivers. All of this comes at far less risk and with a far better user experience for the average doctor. Banks have done it. Retailers have done it. We are doing it.
At OntarioMD we believe in more choice not less. We want to encourage new software products to enter the market to speed up the pace of innovation. Some of these are EMRs, some are apps that make an EMR fly. We want to let doctors be doctors, not computer engineers or data scientists. And ultimately, we think that patients should be the first and last point of approval regarding the secondary use of their personal health data. These are our principles. We strongly believe that the best way to accomplish them is via our current approach to EMR selection, certification and improvement. One EMR system for all is simply not a realistic option.
Since 2004, OntarioMD has supported more than 16,000 Ontario primary care clinicians with the adoption and efficient use of electronic medical records (EMRs) and other digital health technology. From having the lowest rate of adoption among Canadian provinces just eight years ago, the EMR usage rate for Ontario physicians is now one of the highest among all provinces. OntarioMD’s strong industry knowledge, relationships and understanding of the health care goals of both clinician practices and the province are keys to our success.
We assist clinicians directly with their digital health needs by certifying EMRs, connecting clinician practices to provincial digital health services, developing solutions to connect these services to EMRs, and help practices adapt their workflows through hands-on change management support from OntarioMD Peer Leaders and our EMR Practice Enhancement Program, as well as at various OntarioMD events.
The digital health space is evolving rapidly as health care needs change, and potential solutions are regularly introduced. However, not all digital health services are effective solutions for clinician needs or for health care system challenges. With this in mind, we constantly test and measure the success of our innovations and support programs with end users. We also collaborate with system partners on assessment and evaluation activities, with the end goal of continuing to build an integrated, effective, patient-centred system aided by technology. The following are just a few examples of how we measure success.
Health Report Manager (HRM)
Health Report Manager (HRM) enables clinicians using an OntarioMD-certified EMR to securely receive patient reports electronically from participating sending facilities including hospitals and specialty clinics. Clinicians connected to HRM automatically get text-based medical reports such as discharge summaries and transcribed diagnostic imaging reports sent to patients’ charts within the EMR. More than 9,000 physicians receive reports through HRM from over 160 hospital sites and more than 200 specialty clinics locations – and the numbers of connected clinicians and sending facilities goes up each month.
In 2017, we asked Deloitte to conduct a survey-based benefits evaluation of HRM that was supplemented by an OntarioMD-led study where practice advisors studied workflow variations and conducted timing assessments. Findings from Deloitte and OntarioMD found that HRM saves an average of 33 minutes per clinician per day by not having to manually handle paper reports. HRM also reduces hospital expenses on printing and postage, as well as labour related to reports that would otherwise need to be faxed to clinicians. The Deloitte report estimated that HRM avoids an average of $15 million a year in costs to the Ontario health care system.
EMR Practice Enhancement Program (EPEP)
EPEP was launched in 2016 to help clinicians and their staff unlock the full potential of their EMR and realize benefits for their practice and patients. Using a hands-on, evidence-based approach, the EPEP team has helped over 500 clinicians and their staff improve EMR data quality and practice workflows and tap into their EMR to proactively monitor and treat patients.
EPEP works with evidence-based tools developed by OntarioMD: the EMR Maturity Model (EMM) and EMR Progress Assessment tool (EPA). These tools assess maturity on a six-point scale (0-5) across three functional areas: Practice Management, Information Management, and Diagnosis and Treatment Support. During EPEP engagements, advisors conduct baseline assessments of a clinician’s EMR maturity and EMR data quality in several priority measures, such as smoking status, cancer screening adherence, and immunizations. They then reassess at regular intervals during and after an EPEP engagement. Our results of these assessments have revealed that data quality measures show improvement after six months. More importantly, most improvements are sustained or even further improved upon at 12 months.
EMR Quality Dashboard
OntarioMD has recognized the need for busy clinicians to quickly and easily visualize their entire patient roster based on their EMR-based patient data. Working with TELUS Health, OSCAR EMR and various industry partners, we developed an EMR Quality Dashboard. The proof of concept initiative is currently in phase 2 with approximately 500 participating clinicians. The Dashboard:
provides clinicians with real-time access to EMR data in a user-friendly visual manner, using widely-recognized primary care indicators from Health Quality Ontario, the Canadian Institute for Health Information and the Association of Family Health Teams of Ontario;
provides the ability to drill down to patient-level data for each indicator, enabling clinicians to take immediate proactive steps to improve patient care;
helps clinicians standardize their data entry to improve the quality of patient data in their EMR;
allows clinicians to trend and compare their indicator metrics with other physicians using the Dashboard;
would scale provincially to all Ontario physicians using an OntarioMD-certified EMR, and
is easily expanded as practice needs and clinical indicators evolve.
Phase 1 of the proof of concept involved approximately 100 physicians. We conducted a benefits evaluation at the end of that phase, which found that over 75% of participating physicians recognized the Dashboard’s value in identifying target patients and generating actionable patient lists. In addition, 80% said the change management support they received from OntarioMD while using the Dashboard was effective in addressing their questions and concerns and optimizing their use of the technology. Following the end of phase 2 in December 2018, we will conduct a more in-depth analysis of participating clinicians to further demonstrate the clinical impact of Dashboard on participating practices.
In each of these cases, our focus on measuring the success of our initiatives has helped us refine and expand our offerings, and integrate them with OntarioMD’s robust change management and support services. Find out more about HRM, EPEP, Dashboard and our other programs and services at www.ontariomd.ca or by contacting us at firstname.lastname@example.org.
OntarioMD is excited to partner with the Quality Improvement Practical Experience Program (QIPEP) at Queen’s University. Our two organizations share a passion for quality improvement in health care and a commitment to developing future health care leaders.
QIPEP aligns with OntarioMD’s EMR Practice Enhancement Program (EPEP) in seeking to enhance the quality improvement competencies of EMR users and students who will shape the future of health care increasingly enabled by digital health services.
In this blog post, Janet Song shares her perspective on how quality improvement will help practices, the impact of digital health, and more.
Why did you decide to join QIPEP?
My interest in Ontario’s healthcare system began with my frustration as a patient. It was a month of being ill in my second year of university where I was travelling from clinic to clinic, in a desperate search for a diagnosis. It was through hours in different waiting rooms, multiple retellings of the same medical history, and dealing with the inability to eat solid food, when a doctor finally decided to do a specific blood test for H.Pylori, when I finally discovered my illness.
Throughout this month-long journey, I became tired of complaining about everything wrong about my experience, and instead, I found the motivation find a way to improve the quality of our health care system.
It was through following the Queen’s Institute for Healthcare Improvement’s Facebook page where I found the opportunity to receive hands-on experience to do research in healthcare quality and improvement at a healthcare institution.
As a fourth-year commerce student who is interested in experience in healthcare management, I am extremely excited that experience will enable me to do work that can directly support the improvement of hospital operations to better improve the lives of patients. My project is in the cardiology unit at KHSC which involves working with hospital workers in assessing sources of delay for cardiac order entries for doctors to order care actions for nurses on their patients.
Why do you think Quality Improvement is important to your future practice?
Quality Improvement (QI) is important for my future practice because of my interest in utilizing my management degree to socially impacting the lives of those, and healthcare management is definitely a place where I can positively make a difference in someone else’s life.
I want to learn how to manage certain components of this complicated system, and it begins with starting in a small component of the healthcare sector and learning how to improve the quality of it. It is through the process of the Planning, Doing, Studying, and Acting (PDSA) model in my work. This process will sharpen my research, planning and implementation capacities to not only practice healthcare management in the future but also better manage a complicated system to positively impact the lives of others in other fields as well.
Additionally, as an Ontarian, I deeply care about the future of this fragile system, and I want to be part of improving the system.
In 2017, Ontario was recorded as having the shortest waiting times on average in the country at 15.4 weeks, which is under Canada’s average of 21.5 weeks.
However, digging deeper into this information, the Government of Ontario continues to balance $312 billion ($122,919 per Ontarian) where the cost of healthcare is almost 40%, pushing out resources for other social services to maintain this expense and also paying for interest— which half of the education expenses.
The major question lies, how sustainable is our healthcare system? How much longer can an insurmountable amount of debt be maintained in Ontario?
What do you think of digital health? Where do you think it’s going?
The greatest demand comes from the area of the greatest need; the increasing senior population.
Ontario has a senior population that is aged 65 and over is projected to almost double from 2.4 million, or 16.7 percent of the population, in 2017 to 4.6 million, or 24.8 percent, by 2041. This population is living longer lives, the model of the emphasis of healthcare services in hospitals, the highest healthcare expense, transformed into a home care model.
How can Canada prepare for this great demand?
It begins with redefining care to support these seniors through homecare and digitizing the experience to efficiently distribute resources, minimize costs, and still deliver quality care. Consumer digital health tools increasingly will focus on chronic disease management.
Incredible organizations are taking great steps towards improving this complicated system such as SE Futures, the innovation arm of the home care provider Saint Elizabeth. They focus on priorities such as new senior living communities, patient experiences in-home (home self-screening), homecare experience, caregiver experience (chatbot support), and more.
Physician practices can choose multiple digital health services to help them care for their patients effectively and efficiently. They’ve seen the ads, they’ve talked to colleagues who already use them, but simply don’t know who to contact or what’s involved to get the process started. OntarioMD has a solution that respects clinicians’ valuable time. In one visit, OntarioMD can describe the benefits of each digital health service, get the onboarding process started and help get you trained on using each service. We call this approach the Digital Health Services Bundle. Much like bundling your cable, Internet and phone services, there’s a current bundle of digital health services available to clinicians that give you access to provincial digital health services that contain information about your patients. This streamlined approach is convenient for clinicians and saves time. Instead of multiple organizations knocking on your door, OntarioMD, because of our experience over the last decade in working with physician practices, is their chosen partner to roll out their digital health services across Ontario. OntarioMD is currently rolling out a bundle of services to clinicians on behalf of eHealth Ontario, Toronto Central LHN, the Northern and Eastern LHINs, University Health Network and the Ontario Telemedicine Network.
In order to access provincial digital health services, clinicians require a ONE ID provided by eHealth Ontario. Think of it as your proof of identity, like a passport, to log into digital health services. With ONE ID, clinicians do not need to remember multiple user IDs and passwords. It provides one secure single sign-on to access multiple services like the ConnectingOntario ClinicalViewer.
ONE Mail, also from eHealth Ontario, is a secure e-mail service specifically created for health care organizations and professionals. You can send encrypted patient information to 390,000 users in Ontario across 800 organizations. Set-up is easy and there’s 24/7 dedicated support and no need for an on-site mail server.
The ConnectingOntario ClinicalViewer allows you to access and view a patient’s real-time information through secure, web-based portal. You can view your patients’ digital health records that include hospital visits, laboratory results, dispensed medicationss, diagnostic imaging reports and more.
eConsult, managed by the Ontario eConsult Program, is a tool that provides timely access to specialist advice and often eliminates the need to send patients for an in-person specialist visit. Through a private and secure web portal, you can send a specialist a clinical question about your patient and receive advice quickly and securely. This saves you and your patient time and provides quicker access to care and treatment for your patients.
To use any digital health services, you need privacy and security training to fulfill your legal obligations and protect your patient data from privacy breaches. OntarioMD has made it easy, and free, for you to get this kind of training. We offer the OntarioMD Privacy and Security Training Module at OntarioMD.ca. You can do the training whenever you have time, from wherever you can access the Internet. Family physicians also earn two Mainpro+ credits for their time. If you’d like some help to complete it, just ask our staff during the Digital Health Services Bundle visit and they can help you. Once you’ve completed the online training module, you can print a certificate of attestation to prove that you are familiar with the best practices to protect personal health information.
With so many digital health services now available to Ontario clinicians, you may be confused about what’s out there and how the services can help your practice. One email or phone call to OntarioMD will help you make sense of it all and connect you to the tools that are best for your patients and your practice.
Dr. Therese Hodgson, a family physician in the Ottawa area, has found the bundled approach to digital health services valuable and says of some of the services, “The ConnectingOntario Clinical Viewer provides me access to critical information for my patient in an easy and reliable way. This prevents delays in obtaining the information I need to best care for my patients. The OntarioMD Privacy and Security Training Module is a great resource and has helped me educate my staff in our duties as Health Information Custodians to protect personal health information”.
Get connected to digital health services efficiently, in one visit. Contact OntarioMD at email@example.com to talk to one of our staff in your area.
More than 16,000 clinicians use OntarioMD products and services, and over the years our staff both in the field and at our head office have built strong relationships and had thousands of conversations with primary care providers. So, we’re intimately aware of how busy most primary health care practices are. And we know that most of you want to maximize the benefits of the EMR to enhance patient care and make your practice more efficient. If only you had the time and money to devote to learning how to make the technology work for your practice!
You’re likely already using several digital health services like our award-winning Health Report Manager (HRM), or want to start using them. Did you know that OntarioMD also has staff all over the province available to help you better understand and use digital health services? Our staff and Peer Leaders are clinicians, practice managers and EMR experts who understand how you work, understand your challenges, and understand the demands on your time. They can help you achieve your unique practice goals. They will come to your practice, or Skype with you, to work with you one-on-one, give you training tips, show you useful features and tools, analyze your EMR data, all to help you better use your EMR to manage your patients’ health. They can help you learn in as little as one visit or work with you over several sessions, depending on your practice objectives.
You can also get EMR and digital health support surrounded by a small group of your peers through OntarioMD’s unique On the Road with OntarioMD regional learning seminars.
On the Road with OntarioMD are free Continuing Medical Education (CME)-accredited interactive evening seminars near you for you and your staff to learn how to get more immediate clinical value from your EMR. Whether you’re a seasoned, active user of all your EMR’s features, or you want to learn how to use it for more than just data entry, these seminars will teach you new skills in a stress-free environment.
On the Road with OntarioMD seminars begin with a presentation on Partnered Efforts for Safer Opioid Prescribing conducted by an OntarioMD Physician Peer Leader or our Chief Medical Officer, Dr. Darren Larsen. You’ll then meet with other Peer Leaders in small breakout groups with other clinicians who use the same EMR as you do. Peer Leaders listen to your challenges and provide their own EMR best practices that you can take back to your own practice and use immediately. The small size of On the Road with OntarioMD seminars give you the opportunity to share and compare your digital health experiences with other clinicians.
All that, plus dinner is included!
On the Road with OntarioMD has visited 14 Ontario cities and more seminars are scheduled.
At OntarioMD, we talk frequently about how we add value to the health care system by helping physicians and stakeholder partners realize digital health’s tremendous potential to improve efficiency, reduce wait times, and improve population health management and patient outcomes. That’s a key focus of our 2017-2020 Strategic Plan, and is interwoven in everything we do.
But what does this mean in practice, exactly? It means that each offering under OntarioMD’s products and services umbrella – whether it’s something developed in-house like Health Report Manager, or a product like eConsult that our head office staff and field teams deploy on behalf of one of our partners – needs to meet these objectives. And it means that the primary care providers that look to OntarioMD as a trusted advisor are confident we’ve done the work needed to ensure the products and services we bring to their practice will help them with patient care and practice efficiency.
Our ongoing work on the EMR Quality Dashboard initiative is a prime example of the rigorous testing and analysis we apply to ensure our offerings aren’t simply digital health tools, but innovations that integrate and add value to the system. We launched a proof of concept in 2015 to demonstrate how user-friendly dashboard tools use real-time EMR data for improved clinical outcomes and practice efficiency. In phase 1 of the proof of concept, we worked with vendor partners TELUS Health and OSCAR EMR, physician advisory board members and other health care sector stakeholders, to develop a framework that would allow clinicians to view their patients’ data measured against a range of widely-accepted health indicators, and to take immediate action by identifying patients in need of follow up.
We’ve since expanded both the number of health indicators incorporated into the dashboard and the number of participating clinicians. Today, more than 400 clinicians from across the province are participating in the proof of concept. Their feedback and experiences will be reflected in a benefits evaluation after phase 2 ends in December. But we already know that by using the dashboard to view their patient population data across indicators for conditions including smoking status, cancer and diabetes, participating clinicians can see and quickly respond to preventive care trends among their population.
They can also easily see where the data in the EMR appears to not match their patient care experience. For example, if the Dashboard shows that smoking status isn’t recorded for most patients, but the clinician knows it is, they can then take action to make sure the information is stored in the right place. An EMR’s potential can only be tapped into if data is being entered effectively.
In recognition of the importance of change management and ongoing support in the adoption of new tools, this initiative has incorporated the expertise of OntarioMD’s EMR Practice Enhancement Program (EPEP) practice advisors. They are deploying the Dashboard to all participating clinicians and supporting them in getting the most out of the tool. The EPEP process involves first analyzing a practice’s workflow and EMR data and then working one-on-one with clinicians to improve their data quality so that the patient information in their EMR can be effectively used for better patient care. When paired with a digital health innovation like Dashboard, that’s a powerful combination that can lead to better patient care for all.
We’re currently working on a business plan for the eventual province-wide availability of the Dashboard that will ensure that clinicians on all EMRs have access to both the tool and, crucially, the data quality support offered by OntarioMD’s EPEP team.