It is Not the Technology! It is the Adoption and Adoption is Workflow!

Written by OntarioMD Physician Peer Leader, Dr. Keith Thompson

Jan 25th, 2020, my son and I are seated in Union Station waiting to return home and the CBC announced the first COVID-19 case in the GTA. We both watched the T.V. in the waiting area captivated as the paramedics in hazmat suits loaded the patient into the ambulance. A frantic call from my wife ensued to ask if we have been anywhere in the city that put us at risk. The world as we knew it was about to change, and by March 2020, my family medical practice, solo fee for service, was soon feeling the near terminal effects of reduced patient encounters and revenues. How might my practice continue, would it survive? Thanks to OntarioMD I quickly learned the solutions available and virtual care was to become my hero.

My journey into the world of all things virtual constituted a battle by a “29 years in practice physician” determined not to die a death from paper/fax and lack of integration. This journey taught me that virtual care is not about technology or a platform, but is about adoption of a technology that fits with clinical and office workflows.

I was fortunate to be one of the first individual users for OntarioMD to experience eConsult integrated into an EMR. While I had been an earlier user of eConsult, the platform required opening the OTN hub then create a PDF to download from the EMR to then upload into the eConsult fields. This was a classic example of stifling workflows and while eConsult may have been more economical to get an answer for my patient management query, the workflow was a hindrance, and my usage of the platform quickly fell off the chart. With the eConsult fully integrated to a single sign-on in my EMR, simply click and add to the consult note, items from the patient chart such as encounter notes, lab reports, CPP summary and medication lists. A few clicks to add, type the query and hit send! The time spent waiting for appointments, let alone acknowledgement of a referral, has been reduced to merely days or sometimes even hours. The reduction of wait times for patients and the frequent reduced need for face-to-face visits with a specialist contribute to reduced indirect costs for patients. The improved ease of access and use for the eConsult EMR integrated platform means improved workflows, which means improved adoption thus increased patient benefits. Truly a win-win situation!

OntarioMD has been advocating for digital health tools for Ontario physicians for many years. Experiencing the success story for eConsult EMR integration firsthand, I can deeply appreciate the importance of their work and future integrations. The design of novel technologies to support providers in Ontario, and the future planning around population health, make it imperative that our digital health ecosystems not only integrate for seamless communications, but allow for workflows that will aid rather than hinder adoption. The support offered through OntarioMD programs is aligned with the need to improve physicians’ workflows as our reliance on digital systems expands. I would encourage physicians to reach out to OntarioMD, engage with Peer Leaders, and share your journey with them as you pivot to virtual care. COVID-19 may decrease in significance, but virtual care is here to stay. Let OntarioMD help you with workflows and adoptions that make sense for the way you practice.

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Dr. Thompson is a London-based Family Physician, a graduate of UWO Schulich School of Medicine in 1987, completing his CCFP in 1989 and awarded Fellowship Canadian College Family Practice in 2005. He is Adjunct Community Based Faculty Research Eligible Clinical Professor with the Dept. Family Medicine. He is active in his solo practice serving ~ 2800 patients. He recently became interested in the innovation technologies relevant to Primary Care. Dr. Thompson would describe his encounters with Innovations as an “experience that has rekindled his passion for Family Medicine and Patient-Centered Care.” He was one of the initial Canadian Physicians hired to consult with the Teladoc/BestDoctors Canada start-up team in February of 2018. He is CMO for iTelemed, a nonprofit company innovating in virtual care programs within the public-funded Health systems in Ontario. He maintains an active networking relationship with numerous Health technology startups but also with numerous Industry leaders in Virtual care. He is currently involved in 2 research surveys on Virtual care in Primary care settings with UWO Dept. Family Medicine. He is a current member of the Primary Care Digital Health working group for the Western Ontario OHT. He is Member C.D.Howe Institute external reviews for Virtual care and member Dig Health Canada. He is a recent member of the Association for Corporate Growth Toronto Chapter and Digital Health Canada.  

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