One EMR to rule them all: The @HQOntario #HQOchat


Recently, Health Quality Ontario hosted a lively and informative tweet chat (#HQOchat) on integrated care – and again and again the need for a shareable electronic source of patient information was mentioned as key enabler.

The chat featured a distinguished panel of moderators: Health Quality Ontario VP of Quality Improvement Lee Fairclough (@lfairclo), patient advocate Annette McKinnon (@anetto), University Health Network President and CEO Dr. Kevin Smith (@KevinSmithUHN) and Marathon, ON family physician Dr. Sarah Newbery (@snewbery1). With more than 100 participants, the discussion was wide-ranging and focused on what is already being done and what could be done better to integrate the care patients receive in Ontario.

The importance of a unifying electronic medical record (EMR) or source of patient information to allow patients and providers to better manage care and help ensure the seamless transition in care across different environments was raised repeatedly.

Those who have been following discussions about EMR and health technology over the last couple of decades will recognize this as a riff on the old theme of interoperability and the need for EMRs and other systems housing patient data to be able to communicate better with each other.

“Today it seems so possible, and (it’s) time to put focus on digital solutions to support integration,” was how one participant put it. Asked what integrated care meant to them, another responded “from a patient’s perspective, the whole team knows what it’s going on – there’s no need to repeat that story / circumstance over and over again,” to which a physician responded: “(we) need a way to have easy digital transitions of this info.”

In response to a question about what was needed to build a fully integrated health care system, Health Quality Ontario Interim President and CEO @annagreenbergON answered in part “patient and caregiver access to their own records. EHR. Virtual care.” Another participant answered: “A fully integrated system is 1 inspired by patients & caregiver needs, as articulated by them. Patients & caregivers are fully involved co-designers of that system. There is single portal where all medical data are held, synchronously accessible by patient & doctor.”

On the flipside, the lack of accessible electronic patient information was identified as a barrier to integrated care.

“ …. who can take lead in shepherding all providers into using common EHR (electronic health record) framework? It’s tragic that even hospitals across from each other can’t share easily. We also block innovative private partners who are lost/blocked from plugging into a standardized network,” one physician wrote in a post.

“…we don’t have access to our primary care records and even access to hospital records and lab results is uncommon. So, we need access to more info,” @anetto posted.

Another doctor tweeted: “I think the genie has already left the bottle to consider a single EMR – need instead to focus on joining up the info out there – Connecting Ontario is probably the best option to build on!”

“We need multiple options to access and share information,” stated one post.

And this post put some context to the discussion: “A province wide record would definitely be helpful, but I think it’s more than that. The technical solutions are important, but we also need to be mindful of things like relationships, good communication, & having time/skills to collaborate.”




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