Technology Lagging for Canadian Doctors?
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From the CP:
Canada lags far behind other countries except the United States in an international study of effective primary health care for patients released Thursday by the Commonwealth Fund.
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The survey suggested Canada has a long way to go on many fronts to catch up with the other countries, which included the United Kingdom, Netherlands, New Zealand, Australia and Germany.
Only 23 per cent of Canadian doctors use electronic medical records, the lowest percentage and far behind 98 per cent in the Netherlands.
Most Canadian physicians don’t use computers to prescribe medications, access test results and hospital records, receive alerts about potential problems with drug doses or interactions or know when patients are overdue for essential care.
It wouldn’t be fair to suggest that we’re still at the banging-the-rocks-together stage, but it is always surprising to see that technology is not more involved in process management in health care.
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Finally! Something I can talk with a shred of authority on!
First of all, I totally agree with the data from the study; the pickup of technolgoy is woefully slow in Toronto (if that is any barometer for the rest of Canada) — ironically slowest in the downtown hospitals.
Its taken years to get electronic prescribing in order, and really only one hospital’s gotten it done.
Two others have such abysmal systems that I think someone’s lost their job over it (costing the hospital millions of wasted $$$), and in the other case its 2 years later and still no order entry.
Another specific example — Sick Kids, the bastion of research and research dollars, as of a few years ago — bafflingly enough, had a clinical system reminiscent of a pre-Windows, pre-DOS era. That’s right — it felt like Circa 1982.
On the other hand, just because the systems are not electronic doesn’t mean the health care isn’t effective; electronic systems have their advantages and disadvantages too. When there is a system failure or power outage (which happens), absolute chaos erupts.
Cheers
t @ dji
True enough, Tony - though I expect the systems would evolve to the point where critical systems were appropriately supported by backup power. A acouple of years ago I went to Buffalo for an MRI. I was astounded by the technological sophistication of their
practicebusiness. the nurse at check in entered all of the info directly in their database, including a photo taken from a webcam, and scanned documents I had with me with a slim HP unit sitting right at her workstation. After, my results were printed out for me and I was given CDs with the reports. All ready within minutes of me leaving the exam room. It’s an extreme example, perhaps, because this is apracticebusiness that you would expect to be designed for information mobility, but still.As I said, we’re not at the banging-rocks-together stage, but sometimes I think we’re just out of it.
Your Buffalo MRI example is very apt, Rob. The dichotomy also exists locally. Visit the Rudd Clinic, or better yet one of the semi private service providers that now exist and you’re likely to encounter such ‘modern’ activity as emailing your forms to you in advance. No such behavior can be found in most private practices or hospitals. Faxes aplenty, email unlikely. I’ve personally a thousand different experiences as well as plenty of fellow patient anecdotal experience to base these statements on.
“On the other hand, just because the systems are not electronic doesn’t mean the health care isn’t effective”
My personal experience is such that I disagree totally. Our health care system is very badly broken. There are narrow categories of illness or injury which we treat swiftly and efficiently. Everyone I know that has required heart surgery, for example, received immediate and relatively effective care. The vast majority of us, however, are living Kafka.
Asked how to locate diagnosticians in areas of, say, neurological or skeleto-muscular or infectious disease, more than one physician has told me that we do not have such specialties in Canada. My husband’s wry response to this is that we have Dr. House.
I had a conversation with a neurologist at Mt. Sinai on this topic, which he ended by saying that he’s considering working with thoroughbred horses instead of humans, and not just because there’d be both money and appreciation to be had. His primary reason was the strong need to *do* something; to be a useful and effective doctor. The extent to which our remaining specialists are angry and disillusioned is alarming.
Vera
No neurologists? no Infectious disease specialists? No physiatrists? I don’t know what your situation is Vera, but that is all very untrue; moreover, I’ve worked at Mt. Sinai as well. Its a pity that particular neurologist is as jaded as he is.
No question that some older specialists are unhappy; across the board specialists over the decades have seen their own prestige and compensation erode. Being a physician now means something much differently than when it did decades ago.
Sorry, Tony, I must not have communicated that well. My experiences, and those of friends, are as a patient and I do not have any medical training. Yes, we have many neurologists here. I’m not familiar with physiatrists. What we do not have, I am told by the doctors, is specialized diagnostic centers, such as the Mayo Clinic. The neurologists and other specialists I’ve dealt with personally have been mostly sub-specialists rather than diagnosticians per se.
Practically speaking, it is my understanding that our GPs have traditionally acted as a patient’s primary conduit to multiple specialists when required, however since complex cases often require more time than our typical 15 minute appointments (with at least half that time set aside for paperwork) the number of GPs handling complex cases well continues to dwindle. They also often sound rather frustrated at average wait times of 1 year for patients referred to a good specialist. I had a referral myself a year ago to an orthopedic surgeon who let 6 months of referrals pile up ignored. After waiting for months, I tried tracking it down myself, and finally learned by accident that this doctor was leaving for a position in the US. None of the referring doctors were contacted or otherwise informed.
Again, we do usually receive prompt care here for urgent and life threatening problems, but most of the people I know who have been diagnosed with and treated for complex or less common conditions went out of the country for diagnosis.
I agree that it is sad when doctors become so jaded, however the conversation I mentioned is not an isolated instance. These outbursts of frustration are becoming more common. It also saddens me, as a patient, to see anger and despair growing on the faces of doctors I’ve seen over the past 15 years.
Back on the topic of Rob’s original post about technology, I also wonder if more efficient data transfer and storage processes would improve the quantity and quality of care, or whether our lagging behind in this area is just one more symptom of a crippled system. This was the point I was adressing in my first comment.
Vera