Blog

by Jamie Louie, OntarioMD

Why is digital health so important? Even before the COVID-19 pandemic necessitated the rapid adoption of virtual care, digital health has always played a crucial role in a patient’s health care journey.

In celebration of national Digital Health Week (November 29 to December 5), we’d like to share Leslie’s story, highlighting the impact of digital health on a patient’s road to recovery.

After falling, Leslie, a 78-year-old woman with Type 2 diabetes, goes to the Emergency Department. Throughout her care journey, her family physician, Dr. Tech Savvy, uses a variety of digital health services to allow Leslie to experience seamless health care. Leslie’s story does not suggest that digital health is perfect in Ontario. It illustrates the strides made in digital health that were not possible just a few years ago.

At the ER

Leslie undergoes an x-ray, which reveals no fractures. The ER doctor is concerned about opioid usage or other medications that may have caused the fall and checks ConnectingOntario ClinicalViewer to view her medication history. Leslie also reports becoming increasingly fatigued over the last few days, so the ER doctor administers a COVID-19 swab test as a safety precaution.

Leslie is then discharged and Dr. Savvy is in­formed through an eNotification via Health Report Manager (HRM®) that she had been in the ER and discharged.

Meanwhile at the Physician’s Office

Dr. Savvy has developed a Practice Improvement Plan through participation in the College of Physicians and Surgeons of Ontario Quality Improvement and Quality Assessment program. His goal is to make improvements in his practice to benefit all his patients. He has also requested advice from an OntarioMD (OMD) Peer Lead­er, who recommends Dr. Savvy deploy OMD’s Insights4Care Program to help him identify his high-risk patient population for several chronic diseases.

Through the i4C Advisory Service, Dr. Savvy is advised he could also use the i4C Dash­board to identify diabetic patients in need of care. Dr. Savvy looks at the list of patients. Leslie is one of them. She has been identified as a high-risk patient and her last visit had been more than 12 months ago, with her HbA1C at 8.2.

When Dr. Savvy receives the eNotification in his electronic medical record (EMR) system from HRM informing him Leslie had been in the ER, he is concerned the fall might be due to diabetic nerve damage. He notifies staff to book Leslie for a diabetic follow-up.

Three days later, he also receives an eNotification to check the Ontario Laboratories Information System (OLIS) because Leslie has a positive result for COVID-19. He accesses OLIS from his EMR to view Leslie’s test results and his assistant books an appointment for Leslie’s follow-up visit using his online booking system. To prevent the spread of COVID-19, Leslie’s appointment will be by video. Dr. Savvy’s assistant checked to see if Leslie had the technology to participate in a video visit and was comfortable doing so.

At Leslie’s Physician Appointment

During the video visit with Leslie, Dr. Savvy accesses her patient record in his EMR. He sees that HRM sent Leslie’s COVID-19 vaccination reports four and six months ago, and that she has received two vaccine doses. He also uses EMR tools to access rel­evant data, and ensure her HbA1C, Lipid Profile, Alb, Cr, retinal & foot exam will be monitored and tracked in accordance with best practice guidelines.

Dr. Savvy asks further follow-up questions to monitor her COVID-19 symptoms and any increased risk for complications.

Dr. Savvy checks his EMR for Leslie’s most recent blood test. Leslie mentioned that she went to a walk-in clinic for flu like symptoms a few months ago. She does not remember whether blood sugar was checked at that time. Dr. Savvy did not receive that report, but is able to access it through an OLIS query. The lab record shows the HbA1C level has been 8.4, higher than recorded in her last visit.

Endocrinologist Consult

Concerned that Leslie’s diabetes may not be in control, in addition to her positive COVID-19 result, Dr. Savvy uses eConsult to consult with an endocrinologist to discuss whether the catalyst of Leslie’s fall was due to poor diabetes management or her COVID-19 infection. The endocrinologist suggests a change in medication and close monitoring for severe complications due to COVID-19, as well as diet and lifestyle modifications, particularly while Leslie recovers from COVID-19, and a follow-up every three months. A dietician is recom­mended, giving Leslie greater control over her condition and helping to keep her out of hospital.

Back at Dr. Savvy’s Practice

Dr. Savvy prescribes the new medication and orders new blood work. He books Leslie’s next appointment. His EMR will remind the receptionist to follow up with Leslie if lab results are not received when expected. Dr. Savvy feels confident that they are effectively monitoring Leslie’s condition.

The Impact of Digital Health Care

Digital health care truly makes a difference. It helps make patients’ lives easier, and they can continue to receive the care they need. Just a few short years ago, Leslie would have had to wait days or weeks for follow-up appointments with Dr. Savvy. She would have had to wait months to see a specialist about her diabetes. Digital health tools have made it easier for Leslie’s circle of care to share information about her.

For Dr. Savvy, he is able to make informed decisions for Leslie’s care much sooner. He receives hospital reports electronically and not by mail or fax like he did a few years ago. He can access lab results from his EMR. He can also receive a lot more information about his patients because OMD has integrated provincial digital health repositories like HRM and OLIS with his EMR. Everything is in one place—his EMR. That’s the way he likes it.

Dr. Savvy receives communications regularly from OMD so he knows the patient data that’s coming to his EMR next. He’s looking forward to accessing drug information for all his patients through the integration work OMD is doing to connect OMD-certified EMRs to the provincial Digital Health Drug Repository (DHDR). He also knows that the Digital Health Immunization Repository (DHIR) will also be integrated with his EMR so he can access and submit immunization data for his patients. This is great for Dr. Savvy and it’s great for Leslie too. Her data will be in the DHDR and DHIR whenever Dr. Savvy or any other clinician cares for her.

OntarioMD and Digital Health Week

To recognize this year’s national Digital Health Week, OMD is hosting a variety of educational activities for clinicians to learn about digital health tools and tips. This includes a Virtual Open House to share OMD’s innovative work and its suite of products and services to support clinical practices with their digital needs. We will also hold a privacy and security webinar to address the many questions from clinicians on this important topic. There will be further opportunities to engage online throughout the week, focused on all things digital health and virtual care. Learn more about Digital Health Week and OMD’s lineup of activities.

For help with digital health and virtual care tools for clinicians at any time, or to learn more about these tools for your practice at a time that’s convenient for you, connect with OMD’s expert staff and clinician Peer Leaders by contacting support@ontariomd.com.

Join the Digital Health Week conversation on social media using the hashtag #thinkdigitalhealth.