Ontario Health Teams are Coming!

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

This post originally appeared at http://darrenlarsen.com/ontario-health-teams-are-coming/ on April 23, 2019

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.

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.

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. As a doctor, I welcome this change because the current path is unsustainable. As a patient, I cannot wait for change because I never want to be trapped in a transition. For myself and for my patients, I demand transparency along my healthcare journey. Moreover, as a health system leader, I am incredibly enthused as I 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.  

Screening tool addressing poverty in patient populations

Submitted by Jerry Zeidenberg 

This article references a session that was presented at the EMR: Every Step Conference. Make sure to register for the EMR: Every Step Conference Ottawa at https://www.ontariomd.ca/about-us/events/emr-every-step-conference/emr-every-step-conference-ottawa-2019 for engaging content on OntarioMD digital health products and services.

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.  

Tapering opioids for chronic non-cancer pain patients using an EMR tool and academic detailing

Submitted by Dr. Kevin Samson

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

Results

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.

Resources available

  • 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.

References:

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. 

Single EMR for Canada: A Second Opinion

A national electronic health record for primary care – – http://www.cmaj.ca/content/191/2/E28 

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.

OntarioMD

Darren Larsen, CMO

Sarah Hutchison, CEO

 

Maintaining the healthcare system is hard work: My decision to the deep dive into Canada’s most complicated system

Contributed by Janet Song

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.

 

OntarioMD’s EMR Quality Dashboard and the Important Role of Data Quality

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.  

For more information on OntarioMD’s EMR Quality Dashboard initiative, please visit https://www.ontariomd.ca/products-and-services/proof-of-concepts or email us at emrdashboard@ontariomd.com. To talk to an advisor about the quality of your EMR data or about any digital health tool, contact OntarioMD at support@ontariomd.com.  

 

What Digital Health Means to Primary Care

What do you think of when you hear the words digital health? Is it the latest medical health tracker app? Your electronic medical record? Robot doctors?  

Digital health includes all these tools, and many more. But the true essence of digital health – and the reason why it’s worth celebrating with its own Digital Health Week – is something much bigger than the technology itself.  

Digital health is a technology-led evolution aimed at empowering patients and clinicians. It allows us to better monitor, manage and improve our own health and well-being, while allowing clinicians to improve patient outcomes through more responsive technology and better use of patient data.  

In Canada and around the world, digital health is providing tremendous clinical value through improved  access to care for patients, reduced costs, cost avoidance, greater efficiencies, and better quality of care. 

The work we do at OntarioMD is guided by our aim to empower physician practices and enhance the care they and their teams provide patients using EMRs and digital health. We do this through focusing on innovation, and on forging strong relationships and collaborating with health care industry partners to offer products and services that deliver measurable value to the Ontario health care system.  By connecting clinicians with the right tools to meet their practice objectives and ensuring they understand how to effectively use those tools, we help them follow up faster with patients, ensure better coordination of care between all health care providers connected to a patient’s circle of care, reduce unnecessary hospital readmissions, lower wait times, and avoid administrative costs. 

Consider our award-winning Health Report Manager (HRM), for example.  Clinicians using an OntarioMD-certified EMR can use HRM to securely receive patient reports into their EMR from participating hospitals and specialty clinics. With HRM, primary care providers know when their patients get discharged from a hospital or specialty clinic, and all medical record and diagnostic imaging reports they need to ensure effective follow-up are transferred directly into the patient’s medical chart in their EMRs. This eliminates the need for mailed or faxed paper reports and time staff spend handling them.  Most importantly, it lets clinicians be more proactive and provide patients with the quality care they need, fast. 

We’re also helping clinicians use digital health to take action to combat Canada’s growing opioid crisis. According to Health Canada in 2017, there were 4,000 opioid related deaths, up 25% from the year before.  

Digital health offers the tools needed to better combat crises such as this. By tapping into the power of their EMR, clinicians can analyze their patient data to learning more about trends and demographics. Armed with this information, clinicians can identify those patients who are most at risk of opioid abuse, and monitor them to prevent addiction and overdoses.  

OntarioMD’s Peer Leaders and EMR Practice Enhancement Program (EPEP) staff provide clinicians with important hands-on support to help them optimize how they input and use EMR data. Our Peer Leaders and staff have helped primary care providers learn how to use their EMRs to quickly identify their patients taking opioids, the number of different drugs prescribed, and the length of time they’ve been taking the drugs. Clinicians can then create alerts within the EMR to monitor patients on high doses and create a narcotics contract between clinician and patient that can help reduce the risk of addiction and further harm by opioids.  

Whether you need help managing a high opioid risk population, or have other practice challenges and goals, OntarioMD Peer Leaders and staff are like a Geek Squad for clinicians. These clinical practice and technology experts can: 

  • Help you better understand your EMR’s functions and tools; 
  • Analyze your data entry and practice workflows, to improve the quality of patient data in your EMR;  
  • Proactively use EMR patient reminders, reports, population health informatics and more to improve your population health practices; 
  • Implement best data quality practices to access the most relevant patient information at the point of care 

Digital health has the power to improve patient outcomes and help us live longer and healthier lives. But like any technology, the impact depends on the user’s understanding of how to tap into its full potential. By working with patients, clinicians, health care stakeholders and technology vendors, OntarioMD is working to advance digital health care, for the benefit of clinicians and patients across Ontario and all of Canada.  

Keep up to date on digital health advances and our work by following OntarioMD on FacebookTwitter, and LinkedIn. Also, subscribe to our blog at www.ontariomd.blog and visit us online at www.ontariomd.ca for more info on all our products and services. If you have any questions or want to get connected to digital health products and services, please call us at 1-866-744-8668 or e-mail support@ontariomd.com.

How EPEP Helps You Reach Your Practice Goals

OntarioMD’s EMR Practice Enhancement Program (EPEP) helps you realize even more value for your patients and your practice by tapping into more of the benefits of your EMR. EPEP staff will work with you and your staff to achieve your unique practice goals, at a time that’s convenient for you. We will analyze your EMR workflow and data quality, and identify quick wins that achieve tangible results or save your valuable time. EPEP emphasizes hands-on support as you move beyond basic data capture to use your EMR for enhanced patient care and improved practice efficiency. 

Watch the latest EPEP Success Story to find out how EPEP helped one practice focus on population health through better prevention and screening management. For more information on EPEP, visit https://www.ontariomd.ca/products-and-services/emr-practice-enhancement-program

Digital health helped me breathe again!

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Contributed by Surya Qarin, OntarioMD Practice Management Assistant 

Anyone that has known me long enough knows I have spent much of my life in and out of hospitals – and that’s not because the doctors are cute. As a matter of fact, Etobicoke General’s nurses and I are on a first name basis now, and they know exactly which vein works best when drawing blood, and which ones “hide.”

As a child, I was hospitalized every other week for severe asthma. It seemed to subside after I turned 12… at least I thought it did. I didn’t even think asthma was a real issue for adults. I’d always been told people outgrow it. But this is not the case: According to the Centers for Disease Control and Prevention, 9.7% of women aged 18 or older have asthma and are more likely to die of asthma than men. Adults are also four times more likely to die of asthma than children. Asthma Canada stats show that up to 250,000 Canadians are living with severe asthma.

Asthma returned to my life a few years ago, as a moderate condition. I had become more active, believing it would help with my other health issues (which it did). As long as I took my puffers before and after working out, I would not have any issues with breathing.

Then flu season hit, and I got sick a few times between December 2016 and February 2017. Those who know me understand my strong belief that I am super woman and do not like to complain about being sick or having “a little cold.” Unfortunately, this was not just a small cold: it had turned from a cold, to bronchitis, to full blown pneumonia by April 2017. Even then, I still refused to see a doctor. One day, on my drive home from work, I felt a sharp chest pain, and something didn’t seem right. I was not just having a little difficulty while breathing as I had been the last few months. I actually could not breathe.

Gasping for air, I pulled over, sent a quick text to my sister and drove to Humber River Hospital. There, I realized how difficult it would be for me to get my medical records: My family doctor was not affiliated with the hospital, nor was Etobicoke General. They were, however, able to pull my past drug history from my pharmacy and go based off that information. I was stabilized and discharged.

A few days later, my breathing difficulties returned. I went into Etobicoke General, and they were able to pull my history right away and admit me to hospital within the hour. Turns out my lungs had started shutting down due to the pneumonia and asthma, and as it was high-humidity and high-allergy season, being outside did not help me. During my stay in the hospital, my family doctor received hospital reports via Health Report Manager (HRM) and he was kept updated on my condition, as were my respirologist and cardiologist.

After a few weeks of recovery, I thought all was well. However, I caught a “cold” again in October, and this time things deteriorated fast! I ended up in hospital yet again. My respirologist was made aware of my condition in real time via the hospital’s EMR and was able to work with the other respirologist on duty and doctors working on my case to provide the best course of treatment given my history. My current spirometry test results were easily available for the clinicians, and the instant connectivity between those on my medical team helped improve my care and recovery process.

Once again, my family doctor’s ability to receive hospital reports to his EMR through HRM enabled him to follow-up accordingly, ensure I had the contacts I needed for my health, schedule regular testing, and most importantly, help ensure that I didn’t end up in the hospital again. I’m happy to say that I have not been hospitalized overnight since November of 2017.

As a member of the team at OntarioMD, I help clinicians across the province understand the value that EMRs and digital health tools such as HRM can bring to their practice and the quality of patient care they’re able to provide. But being a patient in the health care system has really demonstrated the importance of these tools to me first-hand. If you’re a clinician who has questions about optimizing your EMR use, or you want to connect to HRM or the wide range of other digital health tools in Ontario, contact OntarioMD at support@ontariomd.com.