Primary care practices in Canada which use electronic medical records (EMRs) identified patients who need preventive or follow-up care approximately 30 times more quickly than paper-based clinics. This is a key result from a recent “practice challenge” commissioned by Canada Health Infoway, a not-for-profit organization funded by the country’s federal government.
Researchers from St. Mary’s Research Centre, MedbASE Research and McGill University, all located in Montreal, challenged participating clinics to review their patients’ records to identify those who would benefit from six different types of evidence-based interventions: immunization, follow-up care after a heart attack, cancer screening, diabetes management; as well as two medication recalls. Eleven community-based primary care clinics in various provinces, including 21 individual physician practices, took part in the one-day challenge; 17 practices used EMRs while four practices used paper-based records.
“These results demonstrate the value of EMRs in enabling clinicians to deliver high-quality patient care in a timely fashion,” underlined Richard Alvarez, President and CEO of Canada Health Infoway. “The good news is that the number of family physicians using EMRs has grown significantly in recent years, improving quality of care and supporting more efficient care delivery in practices across Canada.”
Practices using EMRs reviewed the records of all their active patients in an average of 1.4 hours. Paper-based practices of approximately the same size reviewed 10 per cent of all active charts in 3.9 hours, which means that they would have needed approximately 40 hours to conduct a full practice review.
Practices with EMRs were also more confident in their ability to contact all the right patients to receive the appropriate treatment or intervention in a timely manner. On a scale of one to five – where 5 is very confident and 1 is not confident – EMR-based practices were more confident in their reviews than paper-based practices.
“Using an electronic medical record gives me the peace of mind of knowing I can more quickly identify patients who would benefit from immunizations or other preventive care, as well as those who might be impacted by events such as a medication recall,” explained Dr. Michael Golbey, Family Physician and Chair of Canada Health Infoway’s Clinical Council. “Studies such as the practice challenge demonstrate the clinical value that electronic medical records can deliver across Canada.”
The basis for the practice challenge is an approach to primary care called “practice-based population health management”. This approach uses information to help improve care and clinical outcomes across the patients in a given practice. This can include common tasks, such as helping patients with hypertension to manage their condition, or less-frequent yet critical tasks, such as a medication recall. This approach to care has been cited by the College of Family Physicians of Canada as a key element in the transformation of primary care, and can help practices to continuously review their services and improve the quality of care that they provide.
It is also an approach that Canadians are seeking, according to Canada Health Infoway: in a 2012 survey, 73 per cent of respondents agreed that they should receive reminders if preventive or follow-up care is recommended because of their age or health problems. Most of these individuals felt that reminders should come from their family doctor or regular place of care.