TJ News

Electronic medical records overdue and essential

Norbert Cunningham

Leaders across the provincial healthcare system generally agree instituting electronic medical records is essential to improving primary care in New Brunswick and it will also be essential to be given more provincial funding to finally bring our system into the 21st century almost 25 years late.

The issue has been arising periodically since the dawn of the internet age during Frank McKenna’s premiership (in hindsight, when technology was still becoming outdated as fast as it could be sold).

It was raised by board members of the Horizon Health Network during meetings a few weeks ago.

Susan Brien, senior vice-president of medical, academic and research affairs for Horizon, observed that nationwide,“the most significant changes to help with primary healthcare provision have been integration of electronic records.”

Another board member said 46 per cent of Horizon’s primary care facilities still use paper records.

It ought to be self-evident paper records take longer to access, are easier to misplace or misfile, and if handwritten, harder to decipher. Multiply it by almost half the services in hospitals, modern electronic systems with portable readers/ input devices would vastly improve efficiency, ease backlogs and improve quality of care.

Yet the Department of Health hasn’t approved a comprehensive electronic record system to do any of that yet, nor allocated money, though they are apparently considering two “pathways” - one for hospitals and another for primary healthcare centres (presumably clinics, physician offices, nursing homes, etc. although that wasn’t entirely clear). Funding and target dates are also unclear.

“It’s being discussed” is akin to yesteryears’“the cheque’s in the mail.” Not good enough so belatedly.

We need clear targets, logical goals, timelines, continuous, and consistent rollouts that improve the health system immediately but don’t hamper those next in line. How comprehensive are the systems being discussed? Who’ll have access and who benefits most? How? And by what methods, and will all concerned be served - equally care provider and patient focussed?

Do the plans include a portable patient record via a chip on a card, as it also must to be complete, or is that still unreasonably on the back burner? Will its use be mandatory for independent physicians, as it must be to work well? If so, how will it be implemented while respecting their concerns and objections, which appear to remain fairly strong and some reasonable?

Hundreds of other important issues will need sorting out too, like security measures, finding or creating software that’s compatible with all major operating systems on reasonably quality hardware that can handle the different data formats, or convert them well.

None of it is insurmountable today, unlike in the early days. It has been done elsewhere.

Today’s NB Medical Society president, Dr. Paula Keating, claims it has supported transitioning to electronic care records for “over a decade” and supports “additional investments”in necessary electronics, but nary a peep that any doctor might legitimately have to buy a new enough office computer. I think at the individual physician level requiring an up-to-date computer (good enough today to last a long time without becoming obsolete) isn’t any more unreasonable than physicians having to finance their own furniture.

But whatever the details and complete overview, if one even exists yet, the province urgently needs to get cracking on these issues, consult widely across the board, on everything, keep the public and professionals informed all along the way, and make continuous improvements if we want the best possible. Everyone needs to be consulted and understand the necessities well.

Having governments just giving us election goodies then expecting everything will work well is an approach almost guaranteeing failure. So too would be too many professionals within the system focussing only on narrow silos. Now let’s get moving.

Norbert Cunningham is a retired editorial page editor of The Times & Transcript.

Opinion

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2023-12-27T08:00:00.0000000Z

2023-12-27T08:00:00.0000000Z

https://tjnews.pressreader.com/article/281904482992310

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