In this fourth entry in our video series on the EMR Quality Dashboard, OntarioMD CMO Dr. Darren Larsen discusses the importance of good data quality and how analytics can help patient care through population health management.
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 firstname.lastname@example.org.
Submitted by Dr. John Crosby
I am a family physician in Cambridge with 1,400 patients serving 2 nursing homes in an 18-physician family health team with 30,000 patients in total. I have spent 26 years as a physician, with 20 years’ experience as an emergency physician.
A recent survey in the Medical Post listed paperwork as the biggest stressor for physicians. Luckily for me, paperwork is a thing of the past as we have eliminated paper coming from hospitals and specialty clinics and gone digital using Health Report Manager (HRM). It was easy to implement, and both my office manager and I have found that it saves us time to focus on delivering better patient care.
HRM is simple to implement as OntarioMD does all the work in helping to get your practice set up. OntarioMD came into my practice to sign subscription and user agreements and TELUS helped with the set-up of the system. Report types such as imaging, emergency, specialist and other hospital reports automatically downloaded into our EMR system. This eliminated the need to store paper reports. If I were to get an MRI report showing a brain tumour, I can quickly call the patient in and refer them to a specialist.
I can also access lab results through my EMR via the Ontario Laboratories Information System (OLIS). I simply login into my computer and click on lab reports to view any abnormal patient results. If a patient’s potassium level comes back low, I can simply tell my office manager to tell they will need to change their diet or take certain medications.
One of the newer digital health tools I’ve connected to is eConsult. I can send a message and documentation to a specialist anywhere in Ontario without having to send my patient for an in-person visit. This means faster advice, usually within a couple of days, I can use for my patient who doesn’t have to wait months to benefit from a specialist’s advice.
These tasks are all done without paper. Prior to using an EMR, HRM, OLIS and eConsult, receiving, sending and viewing patient health information was tedious and time consuming. In the past, all my reports were mailed or faxed. We would have to physically travel to the hospital and pick up the paper reports daily. Then the paper report was scanned, the patient’s file had to be opened and the report dragged there. Then my office manager would mark it as seen by me.
With HRM, I see a patient’s report as soon as it downloads. With a couple of clicks, the information is posted into the patient’s chart. I no longer need to go to the hospital and wait for mail and faxes. Now I can receive specialist reports the same day of the patient’s visit all thanks to HRM. HRM also sends me eNotifications so I know when my patients were in the hospital and know that I can expect hospital reports to follow.
My practice is more efficient all thanks to my EMR and other digital health tools like HRM. They have benefitted my practice by:
- Enabling me to find patient information quickly
- Allowing me to spot trends and abnormalities
- Providing faster patient follow-ups
- Accessing specialist advice and getting responses sooner
- Enabling more time spent on patient care
- Creating workflow efficiencies
- Less time spent on administrative and operational tasks
Physicians and other clinicians need digital health tools to practice medicine today. They really need the services of OntarioMD to advise them on how to go digital. You can start with one digital service and OntarioMD will help you integrate it into your workflow. Or, you can start with multiple digital health tools. OntarioMD can connect you to all of them and help you understand how to use them effectively to care for patients and to manage your practice. If you hate paperwork like I do, contact OntarioMD to get HRM, eNotifications, OLIS, eConsult or any other available provincial digital health tools (e.g., ONE® ID, ONE Mail, ConnectingOntario Clinical Viewer and more). Call 1-866-744-8668 or e-mail email@example.com.
Contributed by Marsha Foster, OntarioMD Practice Enhancement Consultant
Does this sound familiar? Your clinic has had an electronic medical record (EMR) for some time now. Things seem to be running OK… but maybe you expected everything to be a little easier by now. Some questions linger in the back of your mind: Is my data truly sound? Could I use my EMR to better understand my diabetic population? Is there an easier way to keep tabs on my preventive care?
OntarioMD’s EMR Practice Enhancement Program (EPEP) is aimed at helping physicians answer these types of questions to optimize their EMR data and functionality. EPEP is a service available to all Ontario primary care providers and community specialists using a certified EMR. A typical EPEP engagement will start with a meeting between you and your Practice Enhancement Consultant (PEC), held at your office at a time that’s convenient for you. Together, you’ll discuss your areas of interest and practice priorities. Your PEC may also ask you to demonstrate some of your favourite ways to document information in your EMR. Your PEC will then perform an in-depth analysis of your EMR data.
After all this initial work is done, your PEC will present their findings and recommend steps you can take to streamline your workflow and use your EMR to achieve your practice objectives. The choice is always yours as to how closely you follow your PEC’s recommendations.
An EPEP success story
The services of a PEC were requested by a family health organization in the Greater Toronto Area that was concerned about the inaccurate data they saw in their EMR around preventive care and cancer screening. They knew their team of five physicians was providing good care, but this was not being reflected in their ministry reports. Instead of documenting their work in an easily trackable manner, they relied on detailed documents sent from the ministry, and spent many hours manually updating patient charts.
The PEC’s data analysis uncovered an issue with the clinic’s roster status process. This process gap was the cause of the poor preventive care reports being produced.
The PEC demonstrated a best practice that could be used to correct the roster status within the EMR. The clinicians and staff agreed to implement the changes suggested by the PEC, and the data gap was closed within a short amount of time. The roster clean-up dramatically improved the clinic’s preventive care reports, and eliminated the hours needed for manual updates. That was time the clinic could start dedicating to other activities and services.
This is just one story of how small changes can have big impact! To meet with a PEC and see how EPEP can improve your practice efficiency, please contact firstname.lastname@example.org.