For all its talk of equal and universal access, Canadian medicare is now an environment where every physician is offering a somewhat different experience to his or her patients which could be leading to dramatic variances in the quality of care provided
This may sound like an exaggeration. But consider the fact that for the first time in hundreds of years the fundamental process whereby a physician records the patient visit has changed.
It used to be – and in many instances still is the case – that you went in to see a doctor and he or she took notes with a pen or pencil and entered this information into your chart which was then manually stored in a big room with hundreds or thousands of other charts.
But since the advent of the electronic medical record (EMR) that has changed.
Physicians who use EMRs enter your medical information electronically and this is stored in a medical record which again is digital. EMRs are different, and absent enforced standards, the taxonomy by which that information is stored or portrayed can differ from practice to practice.
Now within that population of physicians who use EMRs, the degree of sophistication they apply to using that digital information varies across a huge spectrum. While some just store the data electronically and use it for basic record keeping, others use the available technology to improve the care they deliver such as sending reminders to patients who have been identified as requiring screening tests. Yet others are working with other health care providers and sharing the electronic record to provide integrated care or advanced disease management support.
But nobody mandates that they have to do any of this. Writing your medical information down with a pen and keeping it in a paper chart is still perfectly acceptable. And even with physicians who do use EMRs, the overall sense is that the majority are still just using the new technology for basic record keeping, albeit in a more legible form.
So, the adoption of EMRs which already varies widely depending upon which region in which you live and the practice characteristics of your doctor, is further varied by the degree to which the physician is using the functionality available.
The EMR may yet to prove a holy grail in the delivery of better patient care but until all doctors are using the technology equally well, we have a long way to go until we can ensure all patients are getting the standard of care available to them.