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If you attended OntarioMD’s Ottawa EMR: Every Step Conference this past June, you know about the amazing discussion and insights shared by our keynote panel on the challenges and opportunities of patient access to electronic medical information. We’ve invited our Ottawa panelists to continue the conversation over the coming weeks here on OntarioMD’s blog, to discuss the question “What will a successful digital health transition look like to you?”

Join us at our Toronto EMR: Every Step Conference on September 26  for more great education and networking around how to build an effective patient-centred health care system driven by digital health technology.

Julie Drury, Former Chair, Ontario Minister’s Patient and Family Advisory Council

In our current health care landscape, patients are their own care coordinators, information gatherers and information disseminators. That is a reality that is unlikely to change as patients become increasingly supported to be partners in their care, are encouraged toward self-care and self-management, and are engaged in shared decision making.

These are all good things.

However, we are no longer a ‘paper-based’ society, and there are high levels of inefficiency, poor communication and issues of patient safety in the absence of digital solutions. Patients must submit applications for requests to access their health information (and pay for it). They create binders of their own personal health information, and they are forced to use technology such as CD images to access and share information.

We are increasingly a digital society. We bank, pay bills, make appointments (other than medical), update our health cards, licenses and pet registration, all online. Digital health is slowly evolving through the application of EMRs in clinicians’ offices, EHRs in hospitals, and the establishment of patient portals. We are discussing electronic referrals and electronic consultations. Virtual care via secure email and video-medical technology is slowly emerging. However, this transition to electronic information is being hampered by outdated privacy legislation that limits information exchange, clinicians who do not want patients to have unfettered access to their information, and patient portals/EHRs that are not interoperable.

In some instances, solutions to these issues are on the horizon. But from the patient perspective, these solutions seem to be focused around organizational and provider needs, while the needs and expectations of patients is secondary.

For a digital health care system transition to be effective for all system participants, patients must be part of the conversation.

Selina Brudnicki, Program Lead, Digital Patient Experience, University Health Network

As Ontario Health Teams move toward a connected health care system centred on patients and their families and caregivers, a successful digital health transition must enable seamless flow of information for patients, authorized care providers and family/caregivers that make up their circle of care. Flow of information includes electronic access to data and analytics; virtual, real-time or asynchronous communication; and the ability to facilitate other types of interactions. This supports safe transitions and activates patients to gain the skills and confidence they need to participate in their own care. Patient activation leads to better health outcomes and care experiences.

One of the basic digital needs of patients is online access to their complete health record information, including test results, reports and clinic/doctor notes, so they can communicate effectively with their care team to make safe, timely and informed decisions. Transparency helps patients feel more engaged, and engaged patients are “more likely to adhere to treatment plans and medications, follow through on screening and prevention protocols, detect and prevent errors, and adopt more effective management strategies for chronic illnesses.” 

Unfortunately, barriers to patient access exist such as health professionals’ fear of increased workload, telephone calls and duration of appointments. Despite these concerns, that fear has been unfounded. There is a perception that patients and society may expect more of physicians and care teams in the future. EMR vendors could help reduce fears and potential burnout caused by excessive time, effort and frustration associated with electronic documentation. Observing and understanding the needs and challenges of providers, patients and family/caregivers could improve their EMR products and result in efficiencies and better experiences.

Seamless flow of information requires health data to flow privately and securely between information systems or applications when authorized to do so. Interoperability standards already exist and we must advocate that these services be readily available for the purpose of health information exchange, integration and retrieval of data. With recent advances in technology and innovation, it will be important for patients to gain visibility and transparency into all their health data, wherever it lives, and be able to control, authorize and monitor secondary use by third-party companies or organizations.

Ontario Health Teams (OHTs) hold the promise of organizing and delivering care that is more connected to patients in their local communities. Health systems and health data have lived in fragmented silos for far too long, and we must be careful that we do not create new types of silos. We must find better ways to collaborate, share knowledge and expertise across OHTs and disciplines, and think beyond ‘health care’ toward larger goals of ‘health.’ Bringing together patients, family/caregivers, care providers (including solo primary and community care practitioners), privacy/policymakers, government, technical and innovator subject matter experts would help leverage and scale investments and find sustainable solutions toward a connected health system.