said.
OntarioMD doesn't expect this limitation will exist in the next phase of the program.
"The first phase was really just to prove the investment was a sound one, which I think we can definitely demonstrate because of the survey we did last year. As well, there are solutions other than just EMRs that are quite appropriate and are very suitable to specialists as well, so they may not need an EMR per say, although they need an electronic tool in order to exchange the information between the GP and the specialist," said Forster.
Workflow and training
While funding is a barrier to EMR adoption for physicians in Ontario, Forster said another large obstacle is the change to the way they practice.
"Physicians use paper records at this point. Changing to electronic medical records means there is an impact to the workflow in their office, so reengineering that workflow is a key aspect of the functionality of the EMR," he said.
OntarioMD is working on improving the circuit deployment so physicians can get the EMR up and running faster as well as training physicians on how to use them productively, he noted.
Part of OntarioMD's Transition Support Program is the Peer-to-Peer Network, which was established by Canada Health Infoway and OntarioMD along with the Ministry of Health and Long-Term Care to connect physicians with colleagues to support their adoption of EMRs.
"The network is composed of peer leaders who are physicians experienced in using electronic medical records to improve practice efficiency and patient care. Peer leaders are mentors who support their physician colleagues in selecting and implementing an EMR system," said Canada Health Infoway.
The Transition Support Program and Peer-to-Peer Network are very good projects, according to McLaren. "But the person still has to roll up their sleeves and do the end work as far as implementing ... there's a fair bit of work there and as you know work means you've got to devote some time, and getting time from physicians is a real challenge," he said.
Providing incentives for physicians to use EMR systems is a critical part of the process, according to Pinhas. "The question has always been whether or not doctors view EMR as having a reward or not," he said.
Another major obstacle, according to Pinhas, is that doctors don't realize the workflow benefits. Electronic systems eliminate errors and call backs from the pharmacists, for example, which reduces the interruptions in the day of the physician, he pointed out.
"Physicians are by and large in the business of providing professional time," said Pinhas.
EMR has to either help physicians treat patients better in the same amount of time or allow them to reduce the amount of time to treat patients at the same level of care or provide more time to increase the patient load, he suggested.
OntarioMD doesn't have numbers on whether EMR systems increase the number of patients doctors can see in one day. "What we've been hearing is that's not the issue," said Forster. "They aren't looking for this productivity boost, but better healthcare. What they're able to do when they're a team is work more effectively with the team."
In a survey of physicians using EMR through funding from OntarioMD, 68 per cent of physicians said their patient safety had improved, 62 per cent said continuity of care improved and 57 per cent reported an increase in the quality of care, Forster pointed out.
Benefits include the ability to monitor patients, such as when patients are due for annual tests; access to patient records remotely and securely, for example, when located in a hospital performing specialist work; and submission anonymous patient information for research, which helps identify preventative care.
Who gets what
The question is whether or not you want to speed up EMR adoption, said Pinhas. "I think overall there needs to be a step back in terms of what the system provides to physicians and increasing that," he said.
While EMR provides benefits to doctors, the majority of
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