Virtual Care Tips and Tricks

Contributors include OntarioMD Practice Advisor Tania Hunt with recommendations from OntarioMD Physician Peer Leaders from our Virtual Care Webinar Series

This is part two of our blog series on virtual care for clinicians. Check out part one on Virtual Care: Preparing your staff and notifying your patients here.

In part one, we discussed setting up your practice for a virtual care environment, preparing your staff and notifying patients. With your practice set to go, and everyone prepared, let’s review some of the different virtual care options you may wish to consider for your practice.

Telephone visits are the easiest virtual care platform for most practices and will be part of your virtual care toolkit. All patients have access to a phone and do not need any instructions on how to use it. Phone visits are quick to set up, and do not use internet bandwidth. Remember to always use a private number when calling patients that will not be visible on the phone’s call display. To maintain privacy on the patient’s end when you call, ask them if they are able to speak to you privately without being overheard.

It is important that your staff tell the patient that when you call at the agreed-upon time, their phone will display ‘unknown caller’ so the patient knows to answer the call. When speaking to a patient, always confirm the patient identity.

If the patient needs lab work/DI, determine if it is really necessary or if it can be delayed to limit the patient’s exposure during COVID-19. If you and the patient both feel it is absolutely necessary, have the patient follow up with a lab to schedule an appointment.

When it comes to other virtual platforms, if it is difficult for you, it will be difficult for the patient and you will become tech support for them so pick a platform that you and your team understand and can operate smoothly. Purchase necessary equipment such as back-up headsets with built in speakers and a desktop camera. If possible, work with two laptops, one with the EMR and the other with the video visit tool (OTN, etc.). If multiple screens are not an option, leverage your smart phone for the virtual visit and keep your computer for the EMR. Remember, for both phone and video visits, you will need the patient’s consent before you begin the visit. See part one of this blog series for how to obtain consent.

When you start the video visit, it is always reassuring for the patient  to have a quick scan of the room you are in so they see no one else is in the room while you communicate with them and their privacy is preserved. Ensure the patient’s privacy and security on their end as well. Ask questions like “Are you in a quiet room?” “Can you hear me properly?” “Is anyone else hearing this call?” “Do you feel safe having this discussion?” Look into the camera, not the screen, when asking questions. If a video visit does not work, revert to the telephone.

How can video visits be most helpful? They are especially valuable for patients with mental health issues. Connecting with them in their own home can be a more positive experience and put the patient at ease. Video visits are also helpful for patients with rashes, burns, cellulose, etc. Use an app with imaging capabilities to capture an image of the patient’s issue for tracking and uploading to the patient chart for comparisons during future visits.

Video visits are a great way to learn more about patients by seeing their home, and meeting pets and family members. This will put patients at ease before you start the visit. Remember to always hang up the phone or disconnect the camera after a virtual visit. Turn the camera off when not using it or use a webcam blocker to avoid any unwanted visibility of your surroundings.

Be on time for your virtual appointments. The patient is not in the waiting room so they will not know if you have forgotten them or if you are behind. Be considerate of language barriers, and if you can, leverage a medical translation service during visits. This can be achieved by 3-way tele-conferencing, 3-way video conferencing, or having the patient on video and the translator on speaker phone. Regardless of the approach, consent should be obtained from the patient to use a translator and documented in the chart.

Some other tips for using virtual care in your practice:

  • For specialist referrals, consider using eConsult instead of sending a referral by fax. You can get a response from the specialist in about two days and sometimes within hours. eConsults also helps avoid unnecessary visits (in-person or virtual) for patients.
  • If your EMR allows for ‘stamps’, use them to prevent typing the same messaging repeatedly.
  • Doing group visits? Google Hangouts for psychotherapy or used with diabetes patients works well and is free. You can conduct a video call with up to 10 people. A virtual environment can work well when patients who do not like talking or leaving their homes see other patients with similar issues.

Virtual visits are not appropriate for all patients. You will want to see some patients in person during COVID-19. You and your staff should be in full PPE when you are in the office. Our clinician Peer Leaders recommend that you try to set up your schedule so that vulnerable patient populations (prenatal, well-baby, geriatric, immune-compromised) come in only during protected time slots so that the risk of exposure to potential COVID-19 patients is limited. For more information on virtual care and tools to consider and other useful resources, visit OntarioMD.News, . For questions about a specific tool on this site, please contact the vendor directly. If you have any general questions about using virtual care tools, please contact support@ontariomd.com

Virtual Care: Preparing your staff and notifying your patients

Contributors include OntarioMD Practice Advisor Tania Hunt with recommendations from OntarioMD Physician Peer Leaders from our Virtual Care Webinar Series

With the onset of the COVID-19 , clinicians have quickly adapted to physical distancing with their patients and using virtual care to avoid unnecessary trips to the office. You may decide to make this change in how you practice medicine an ongoing option for your patients beyond the current global pandemic.  The change to a practice that offers virtual care options can be done easily and efficiently by selecting a virtual care platform that’s right for you and your patients. There are many virtual care tools on the market and the choices may seem overwhelming. OntarioMD has facilitated your review of virtual care tools available to Ontario clinicians by bringing them all together in one convenient spot, OntarioMD.News. This site contains lists virtual care tools for video visits, direct-to-patient interactions, virtual clinics, EMR-integrated tools, and more. The tools have been curated, but not endorsed by OntarioMD. Please contact the vendors directly for product-specific questions.

You may wish to delegate the task of finding a virtual care platform to one of your staff who will also be using the tools and you can also ask your family and friends for recommendations. Involving staff is an opportunity to keep them feeling needed and invested in any new tools for your practice. A critical success factor for virtual care is being able to network with colleagues on similar platforms for support and advice so you may wish  to select tools that colleagues in your social network, study groups, etc., are using.

The transition to offering virtual options might be challenging for some staff. You can leverage Zoom or similar platforms to train staff on the benefits of the virtual tools. You may also want to consider an Interactive Voice Response (IVR)system to route phone calls for staff working from home.

Before you adopt a virtual care tool, a good idea is to keep your schedule flexible when you start using it and until you and your staff get used to the tool. This will help to ease stress, give you and your staff space and plenty of time to learn from using virtual care tools. You can see what works well and how your patients like the tool.

One of the most frequent requests from patients is for online appointment booking. Online booking is a great way to introduce your practice and your patients to virtual care tools. Check out the options for an online booking platform. Online appointment booking will cut down on phone calls asking for appointments. This frees up your staff to do other things. You should allow for some same day appointments, and leave only options video or phone options for the patient to choose from. Work with a nurse or your admin to triage who you need to see vs. who you can treat over the phone or eVisit.

So you’ve prepared yourself and your staff to use virtual care tools. Now it’s time to notify your patients that your practice has gone mostly virtual. Your staff can implement the IVR and voicemail system so patients are informed that your clinic has gone virtual when they call. If your staff are booking appointments over the phone, ensure they ask the patient what virtual platform they would like to use (phone or video). If they are booking an appointment from your website, change your website to only show the video visit or phone visit options. Let patients decide which technology they are most comfortable with. Once an appointment is booked, have staff confirm the patient phone number and email so you have the most up-to-date information. It’s also a good idea at this point to obtain the patient’s consent in advance of the virtual encounter. This can be done by admin staff.

A consent statement that your admin can read to patients over the phone was prepared by OMA and OntarioMD Legal teams and vetted by the CMPA.  It should be posted on your website and in your office for your patients to read. You can also obtain consent by email. In both cases, record consent for each patient in your EMR. Instructions for how to obtain consent to initiate a virtual care encounter and the consent statement are available on OntarioMD.News.

If you use Facebook, a newsletter or another method to communicate with your patients, try and get the word out on how patients can reach you and provide links to resources if they have traveled outside of Canada or think they may have developed COVID-19 symptoms.

Search your EMR for patient email addresses and send a mass communication to notify patients of clinic updates, COVID-19 updates and that they can email you. This “keeping the door open” approach has proven to be popular with patients.

All the best as you move forward with your virtual practice.

This is part one of a two-part blog. Part two will focus on virtual care tips and tricks.

Dear Doctor, your computer can help you with time management

Author – Dr. John Wyatt Crosby, OntarioMD Physician Peer Leader

John Crosby

As an OntarioMD Peer Leader, I act as an efficiency expert for family doctors. OntarioMD Peer Leaders are a network of over 60 physicians, nurses and clinic managers across the province who are expert users of OntarioMD-certified EMRs and are available to help physician practices realize more clinical value from their EMRs. Peer Leaders usually get a referral by word of mouth from other doctors or OntarioMD practice advisors talk to the doctor’s staff and tell them an OntarioMD Peer Leader can help for free. The Peer Leader will help the doctor to become more comfortable with the computer and EMR software.

I help prepare for my visit to the doctor by sending the doctor my free eBook on time management (email me for your free copy at drjohncrosby@rogers.com). I ask them and their staff to read it. They can also hear it on audio book hands free while driving. It is on YouTube and you can listen to it using Bluetooth. I then book a two hour meeting with the doctor in his/her office without interruptions. No phones or patients.

I ask the doctor what his/her goals are. Some want to improve patient care, cut paperwork and learn how to utilize their computers better.

Some want to work less and earn more.
Some want to cut stress and avoid burnout.
Some want to avoid malpractice and college complaints.
Some want to improve billing.
Most want all of the above.

I get them to describe a typical week. When do they get up? When do they go to work? I look at their patient appointments in the computer. How many per hour? How many coffee breaks? How much time off for lunch? When do they get home? What do they do at night, on weekends and holidays? Do they take work home? Do they do office work on their laptops in the off hours?

I then walk them through their computer. Many doctors don’t realize how much time the computer can save them and how it can improve patient care. I click on everything to show all the tools. For example, with capitated practices paid a set amount every month like Family Health Organizations (FHOs) and Family Health Teams (FHTs), I find almost all have not rostered all their patients leaving tens of thousands of dollars unclaimed yearly. They usually tell me their staff is too busy, and being doctors (like me), they are too cheap to pay a high school student $14 per hour to do this on a weekend. They often work through breaks and lunch and get home exhausted at 7:00 pm risking their marriages and relationships with their kids and friends.

I show them how to use the computer to write consult letters, graph weights and heights and use stamps or templates to type faster and more thoroughly. I often get push back on this as ‘cookbook medicine’. I tell them that the best chefs use a cookbook. Also, the Rourke Baby scale is a stamp as are the Ontario Prenatal Forms.

I show them how to use ‘Find notes containing only’ to find MRIs and CT scans.
I show them the absentee note feature.
I show them how to click on the left side of the chart to have a green bar come up that they can attach to consult letters.
I show them how to double click on an existing medication to reorder it.
I show them how to double click on a lab value to get a trend which can be printed off and given to the patient or specialist.
I show them how to cut and paste for repeat visits for the same problem.
I show them how to load and use the handout function.

After 2 hours, their heads are exploding so I send them a brief email a week later with a summary of my recommendations. I then set up a phone chat weekly for 1/2 hour at 8:00 am or noon to go over each recommendation.

I find that the use of stamps is the biggest time saver for doctors. It also improves quality because it encourages the doctor to be more thorough and not forget anything.

Here is a recent example (some items changed to ensure privacy):

The OntarioMD Practice Advisor for Waterloo Region, Sunny Hayer, emailed me with a request from a doctor with 10 years of practice who was buried in paper. Sunny and I set up a 2 hour meeting on a Wednesday morning at 9:30 am. Sunny met with the clinic staff and I met with the doctor. I asked her what her problems were, and she pointed at her desk which was buried in paper. Also, her computer was chock full of lab results and imaging.

I got her to describe a typical week in her life. She got up weekdays at 6 am and took her two young kids to school at nine and she started at 9:30 am in her office. She took no breaks and at 1:00 pm she grabbed a sandwich and ate it in 10 minutes, then went back to seeing patients. She worked until 7:00 pm then had a reheated supper alone (the kids were fed by the nanny at 5:00 pm). Her husband got home at 6:00 pm. She then did computer work from 8:30 to 10:30 pm, collapsed into bed and got back up again the next day at 6:00 am like in the movie Groundhog Day. She did this 5 days a week. The weekends were all about getting caught up on cleaning and laundry. She was exhausted and rarely had time to enjoy herself, her husband or kids. She was using her office computer like an expensive typewriter.

My solution:

I told her to read my eBook (reminder to email me for a free copy) on time management. She didn’t have time, so she listened to it in her car while driving to work. It comes in eight 10 minute chunks.

When she got to her office, she loaded in stamps for the top 10 most common problems seen in her general practice. This helped her stay on time with her patients. She had a 10 minute break at 11:00 am to go for a walk around the block. Lunch was blocked out in her computer appointment screen at 12:30 pm for one hour with the phones on answering service to give her staff a break too. The last appointment in the morning was booked at 12:00 noon.

The last patient was booked for 4:30 pm and she was home at 5:00 pm to have dinner with the kids. Her husband arranged to be home by 5:00 pm too. Computer and paperwork were done from 12:30 to 1:30 pm daily in her office. She got caught up on her backlog of paper and computer work by coming into the office one time at noon on a Sunday and working with no distractions until 6:00 pm. Her smart phone calendar and office patient appointment list has an appointment booked with herself from 12:30 to 1:30 pm weekdays for paper and computer work. Her off hours are free. No work texts, calls or emails. She hired a home cleaning service and now she has time for her husband, their kids and herself. She has a night out alone with her friends every Thursday night. She hired a high school student to roster 500 patients which earned her $50,000 more per year by paying out $14 per hour x 40 hours or $560 – not a bad return on investment.

Computers can help doctors improve patient care and office efficiency. You don’t have to do it alone. Contact OntarioMD (support@ontariomd.com) and ask for help from a Peer Leader.

Integration and Enterprise Primary Care: A Point of View

 

Paul

Author – Paul Sulkers, Healthcare Consultant

The COVID crisis is placing huge demands on the Ontario health system, with a heavy reliance on acute care, perhaps our last line of defense. COVID has also brought in to focus the need for strong primary care and population health management, as we seek better ways to assess and manage COVID patients, many with other health or social challenges. To achieve population health, we need a health system that is integrated from a consumer perspective, understanding their needs and tailoring strategies to improve the health status of the entire population.

We understand that population health management must be enabled by primary care and consumer engagement, and we understand the policies needed for integration[↓1][↓3]. However, we have launched an OHT strategy that integrates around hospitals, fragmenting primary care into regions, and challenging consumers affiliated with multiple OHTs [↓4]. Our OHT approach also lacks the ability to scale investments, such as Toronto’s SCOPE, [↓5] or Sunnybrook’s “One-Team” [↓6] which could be classified as the ‘right idea’ in the ‘wrong place’, trapped within OHTs. Under the pressures of COVID, there is a natural tendency to fall back on OHTs as the ‘right path’, reinforcing acute-centric culture [↓18] rather than building capacity with primary care and consumer engagement to manage population at the front lines.

We can learn from others. Leading jurisdictions have invested in primary capacity, scaled across entire populations, and are now reaping the benefits of a seismic shift in the way that health is managed, funded and measured [↓7][↓13]. Spain established a population health strategy for Catalonia, segmenting their population into 320 risk categories [↓10]. Denmark reduced the number of acute hospitals from 98 to 36, shifting funds from acute to primary care [↓11]. The NHS uses community outreach and partnerships with the post office, re-defining health as a “team sport” to better manage the elderly closer to home [↓13]. In the US, Kaiser Permanente has created an integrated care delivery model that emphasizes preventive care and management of chronic disease [↓12]. Geisinger utilized centralized clinical leadership across enterprise-scale primary care, reducing costs per patient by 11% over five years, and reducing avoidable readmission rates by over 35% [↓8][↓9].

In all cases, enterprise-scale primary care was key, recognizing primary care’s critical role to be consumer-facing and leader of population health management. Enterprise-scale means moving from individual practices to integrated primary care governance, including standard care models, shared resources including virus surveillance capacity, paediatrics and palliative care, and partnerships with home care to manage care closer to home. Enterprise data enables central physician leadership to develop new funding models, addressing cohorts with similar risks, co- morbidities, and social determinants. Consumers view an enterprise or integrated system, including their care plan, educational content, health reminders, appointments and referrals.

A critical enabler of their enterprise primary care was a shared EMR, with the ability to scale care models and process, enable jurisdiction-wide view of population data, and a single digital view for consumers regardless of their residence [↓14]. Clearly, Ontario is not going to move to a single EMR any time soon! However, we can learn from other industries who have used digital process automation to integrate the ‘front’ end of the enterprise across a variety of disparate IT systems. Digital process automation will allow the fragmented Ontario health IT landscape to ‘appear’ integrated, shifting from variable and open loop process (using fax, phone and pagers) to digital processes that are patient-centred, closed loop, and measured, evidenced by Toronto’s ConsultLoop [↓14] [↓15].

Digital process automation across our primary care practices will enable enterprise status, including the ability to scale innovation across the entire population. Supported by outcome measures and innovative funding models, primary care will leverage shared resources and partnerships with home care and community services to better manage complex patients closer to home. Enterprise primary care will engage consumers via ‘extended reach’, moving knowledge to the patient, and reducing patient administration costs via the ‘healthcare manager’ in each household [↓14]. Social distancing has exacerbated the importance of communication and extended reach, not only with providers, but also among families, split apart by COVID.

Enterprise primary care will also achieve increased productivity by leveraging healthcare AI, including virtual care, predictive early warning, digital assistants, as well as digitally supported case managers [↓16] [↓17]. Increased productivity will free-up clinical resources to focus on in-person care, critical to manage patients drifting towards high cost cohorts.

However, digital is not the core competency of our health system. We must leverage the Canadian private sector to invest in enterprise primary care, pulling Ontario in to the 21st century. Private sector has the know-how gained from other industries successfully addressing similar integration challenges. Importantly, Ontario’s health digital expenditures must become an investment to build a new digital health & health AI economy in Ontario [↓14].

Together with private sector, we must start with enterprise primary care to integrate the ‘front-end’, ensuring consumers see a seamless view of Ontario healthcare, regardless of any OHT-defined relationship. COVID-19 presents a watershed moment to either continue acute-centric models or invest in enterprise primary care, at scale – rapidly!

References

1. World Economic Forum; Value in Healthcare Project

2. Peggy Leatt, George H Pink, Michael Guierre, Towards a Canadian Model of Integrated Healthcare, March 2000

3. Dr Robert Bell, August 2019

4. A Healthy Ontario

5. UHN’s SCOPE

6. Sunnybrook Case Study

7. Primary Care Patient Centred Collaborative

8. D Maeng et al. “Can Telemonitoring Reduce Hospitalization and Cost of Care? Geisinger’s Experience in Managing Patients with Heart Failure”. Journal of Population Health May 2014

9. Geisinger Case Study

10. Catalonia Spain

11. Denmark: Australian Financial Review

12. Kaiser Permanente Integrated Care Models

13. Jersey Post – Call and Check Program

14. Sulkers, P. “Integrating Ontario Healthcare: A POV”

15. ConsultLoop Case Study

16. Case Management: Mobiheatlh News, David Muoio, January 4, 2018

17. Productivity of Case Management: AHIP blog, Darcy Lewis, January 25, 2018

18. COVID-19 Assessment Centre

 

 

 

 

Track Your EMR Improvements with an OntarioMD EMR Progress Assessment

If you’re using an OntarioMD-certified electronic medical record (EMR) in your practice, you’re one of approximately 17,000 primary care clinicians in Ontario who’ve integrated this valuable patient management tool into your workflow. You’ve seen how your EMR makes your work better, more efficient – and has a direct impact on your patients’ health.

You’re entering patient data into your EMR. You may be capitalizing on the power of that data to run preventive care reports for more proactive care. And speaking of proactive care, perhaps you’re one of almost 10,000 clinicians getting hospital discharge summaries and other reports to your EMR through Health Report Manager (HRM). That’s the power of your EMR – and we know most Ontario primary care clinicians are discovering that power.

But are you really using your EMR to its fullest potential? Do you understand what else you could be doing with it to reach your practice goals? If you’re not sure, OntarioMD can help you. Our EMR Progress Assessment (EPA) is an online self-assessment tool designed to help you measure your current EMR use, help you prioritize what else you want to do with your EMR, and track improvements in your EMR use over time. With EPA results at your disposal, you can easily determine what you’re doing well with your EMR, and how else you could be using the technology for better practice management and improved patient care.

Your EPA results can also help us help you – which is what we’re here to do. With your EPA results as a guide, OntarioMD practice advisors can customize a hands-on support plan that works for your practice. We know not all health care technology is right for all clinicians. The more insight we have on what you want to do, the more we can do to help you get there.

The EPA and EPEP in action

Want to better understand the EPA in action? A research paper from JMIR Human Factors uses real-life case studies to illustrate how OntarioMD’s EMR Practice Enhancement Program (EPEP) helps clinicians make better use of the patient data in their EMR, improve practice workflows and meet practice clinical goals. In most cases, EPEP engagements start and end with an EPA as an essential component of the EPEP team’s analysis and work. EPA results help reveal how a clinician’s EMR knowledge, data quality and practice efficiency improve as a result of taking advantage of OntarioMD’s complimentary EPEP support.

Consider the case of Dr. F, who the EPEP team first met within 2016. At the time, an EPA and initial analysis revealed that the practice wasn’t entering data consistently into the EMR – which meant they couldn’t properly measure the quality of care they provided. Over several months, the practice and EPEP team focused on ways Dr. F’s practice could use their EMR to better capture important preventive care and diabetes data – and act on it for more responsive patient care.

An EPA and data analysis conducted six months after the engagement began showed improvement in EMR use and data quality. Another check-in more than a year later showed even more dramatic – and sustained – improvements.

Data Quality review – Dr. F

Contact us. We’re here to help!

You’ve invested a lot of time and money into adopting an EMR and building workflows around it. And we know that you probably want to do more with it. But you can’t improve what you can’t measure and track. That’s where an EPA comes in. Complete an EPA today to get a clearer picture of what you’re doing right with your EMR – and what else you could be doing with it. Find out more at https://www.ontariomd.ca/products-and-services/emr-practice-enhancement-program/emr-progress-assessment or contact us at support@ontariomd.com.

Ontario Health Teams are Coming!

Contributed by Dr. Darren Larsen, Chief Medical Officer, OntarioMD

Change is happening now in Ontario healthcare. It has been needed for some time, but a new provincial government with a demand to deliver high value for public dollars is making the change imminent. OntarioMD is front and centre of assisting with this change as it relates to digital demand for care.

So what, exactly, is “value”?

Value is best defined as quality (in all of its domains) divided by cost. It can be measured from different perspectives (patient, provider, health system, funder) but ultimately the same principle applies. If we increase safety, efficiency, effectiveness, access, patient-centered care, and equity, and can offer it up for a lower provincial spend, we have created value.

How do we do this in our current fractured, silo-based system? It won’t be easy. It will involve letting go of certain tightly held concepts. It will include changing structures we have known for a long time. It will take real leadership. OntarioMD is showing such leadership.

Whether we are patient, clinician, or Ministry planner, many feel the same systemic pain. We see a lack of integration, from the services being delivered to the data generated from them. Transitions in care present substantial risk. There are rarely warm handoffs between care settings. They are loaded with processes that remove personal accountability and ownership for outcomes (good and bad). We measure, but not necessarily the right things. We default to quantitative metrics when the tough job of looking at behaviours and action drivers (qualitative measures) are ignored or downplayed. The opportunity for change is here.

If transitions in care are the primary points of error and loss in healthcare, what is being proposed to change things?

Integrated care delivery systems are a potential solution. In Ontario, the government hopes the new Ontario Health Teams will accomplish this. They will take many forms, as they should, to reflect the diversity in local healthcare needs. Some will be led by communities and primary care. Others will have a hospital at the core. All are meant to blend and offer seamless care for individuals, whether in the home, doctor’s office, nursing home, or hospital. They will succeed in some fundamental principles, common to all.

  • People moving between different parts of the system will have care coordinated as they move between them.
  • Navigators will assist to ease the burden for those who have no energy or experience in health maneuvering.
  • Care follows the person, and eventually, so will the funding to pay for that care (bundled payments)
  • There are financial rewards for doing better than a benchmark (gainsharing) and disincentives for doing worse (risk-sharing).
  • Silos of care delivery will be brought down. Acute care hospitals, home care in the community, primary care and long-term care form a fluid continuum for patients who move between them. There will be a focus on difficult care areas: mental health, palliative, frail elderly, indigenous patients, those disproportionately impacted by the social determinants of health.
  • Information will flow between system partners to ensure that accountabilities and decisions made are factual and data-driven
  • The patient will experience nothing about them without them. They will have full transparency into where they are in their journey. As an extension, they deserve full access to their health records.
  • Digital care tools will be front and centre. Use of existing digital products created by system partners will be recommended or mandatory. New tools that meet current needs will be designed and allowed. Options for patients will include virtual visits, e-consultations, data viewing portals, online booking, and more.
  • Records systems will not be one size fits all but important core data will be exchanged between all of them for transparency and appropriate care.
  • Privacy and security rules will be modernized to reflect patient needs and expectations for sharing, while still ensuring that only the data which must move for care moves. Personal health information is held sacred.
  • Antiquated procurement rules built to reduce the risk of failure will be modernized to allow new technology to move forward quickly. Legacy products that no longer, or perhaps never did, meet our needs should not be protected
  • Changes that succeed will be promoted and celebrated along with failures as learning points for others. Lessons will be shared between OHT’s.

The pace of change we are seeing now in Ontario is unprecedented. In a few short months, we have witnessed the introduction of Bill 74, creation of the Ontario Health super-agency, and movement toward integrating acute, primary, community and long-term care. Doctors welcome this change because the current path is unsustainable. Patients cannot wait for change because they never want to be trapped in a transition. They demand transparency along their healthcare journey. Moreover, as a digital health system partner, OntarioMD is incredibly enthused as we watch duplication and waste disappear, silos break down, honesty and transparency increase, and higher quality care produced at a lower cost. All of this motion should lead to a healthier, more sustainable, coordinated system. We will, when we get this right, have reduced the burden of care for all, and will be well on the path to real improvement!

It’s Amazing What I Can Do with My EMR!

Dr. David Weinstein

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 support@ontariomd.com to connect your EMR to the services I mention above as well as additional services to help you use your EMR more effectively.