The amount of patient data that’s amassed through increased adoption and implementation of Electronic Health Records (EHRs) has been phenomenal; however, is this making any difference to improving patient care? Data is largely kept isolated, rather than shared and exchanged amongst clinicians or used for the purpose of actionable intelligence to improve patient outcomes.
Canada’s health care system is still fragmented
Digitizing health data for EHR alone doesn’t suffice. Though a step in the right direction, greater emphasis needs to be placed on meaningful use of data, making it readily accessible and fluid between facilities and clinicians across the continuum of care, not in silos, as it is now.
The late Canadian statistician, Martin Wilk, whose work eventually led to the development of the Canadian Institute for Health Information (CIHI), once described Canada’s health information as being in a “deplorable state” due to extensive fragmentation, and lack of collaboration and coordination. Health information exchange across Canadian hospitals is among the lowest across OECD (Organization for Economic Cooperation and Development) countries. Fewer than three out of ten Canadian primary care physicians have electronic access to clinical data about a patient who has been seen by a different health organization. This system fragmentation has been one of the primary reasons for Canada’s slow adoption of clinical technologies, including EHR, which is currently at 77% adoption by primary care physicians. Even among secondary care clinicians, intercommunication is only at 28%. Evidently, void of any pressure or incentive for greater interoperability, the process is not given due priority.
Few Canadian health care organizations have introduced electronic versions of clinical documentation, physician referral systems, or notifications of hospital admission and interactions with other health professionals. This lack of interconnectivity and collaboration stifles innovation and hinders progress in the health care sector.
Moving towards meaningful data use and greater collaboration
Traditional EHR systems organize data into predetermined categories with easily structured, “relational” data such as patient demographics, imaging and lab results, medication history, etc. However, advancements in electronic health have begun to focus on collecting and organizing “non-relational” data with an increased focus on population health. Non-relational data places greater emphasis on social history information from clinician notes along with patient reported data. Prior to this, these types of insights were hidden in handwritten progress notes and saved as PDFs in an EHR repository. The shift to contextualizing patient data lends itself to more personalized patient care, which is critical as we move towards an Activity-Based Funding model, centered around the unique needs of a particular patient.
Reports find that patients and their families are increasingly ready for innovation in health data, and are willing to do their part to making health care more efficient. A 2015 survey found that most patients are willing to share their health data with a doctor (88%), especially if it they understand that it will be used to give them a more personalized path to better health outcomes. Unfortunately, the current fragmented, rigid EHR infrastructure in most health care organizations does not effectively incorporate these data advancements, thereby further hindering intercommunication amongst clinicians. According to a recent American population health survey, only 17% of US health care providers have actually been able to integrate non-relational data technology into their current EHR programs.
Interconnectivity as the only option
Introducing innovations of this sort into our health care system requires an absolute shift in culture, with managerial determination to integrate data advancements into daily work flow. Developing regional partnerships with other health care organizations, as well as implementing modern data sharing tools to leverage EHR is necessary to bring Canadian health care up to speed. Especially as activity-based funding and outcomes-focused care gains traction across the world, health information exchange and collaboration across the continuum of care will be the only credible option to delivering quality care in a timely and efficient manner. If providers don’t take a progressive and open mindset towards open health data, any advancements to technological tools and data analysis will prove completely counterproductive.
Ultimately, the difference between delivering the most basic care, versus the best quality, patient-centric care is by embracing the future of health care—a collaborative model, fueled by readily accessible, shared data through the latest technological tools.
- Health Council of Canada. 2012. “How do Canadian primary care physicians rate the health system?” Toronto.
- Accenture 2012. “Connected Health: The Drive to Integrated Healthcare Delivery”. December.
- Canada Health Infoway. National Physician Survey (2014).
- eHealth Initiative (2015, 20 October). “2015 Population Health Survey Results” Retrieved from https://www.ehidc.org/articles/435-webinar-2015-population-health-survey-results.