Connected care through a better integrated digital health infrastructure in Ontario is a key part of the vision for a reformed healthcare system outlined this week in a white paper released by a group of primary care leaders.
Primary Care 2025 lays out a roadmap for health care in the province based on inter-disciplinary primary care hubs where providers would have responsibility for geographically defined populations. Linking primary care to all other aspects of care in the community would be facilitated by “an inter-operable electronic medical record (EMR).”
In discussing how care has been provided during the COVID-19 pandemic, the study authors note that the lack of shared EMR created a challenge of data access. “While adoption of electronic medical records in Ontario ranges, many physicians are still using EMRs in the same fashion in which they used paper records: as a standalone patient record accessible only to the family physician in that practice,” the report states.
“(A) robust cross-platform referral management modules would help coordinate referrals to eliminate costs or delays to care while helping to coordinate diagnostic workups to avoid repetitive and unnecessary testing. A shared database enables communication among providers as well as supporting systematic sharing of best practices. The economies of scale can be significant.”
The report goes on to say that implementing an EMR that contained both health and social care data by 2025 “would provide more seamless care for patients who require care by multiple sectors, facilitating collaboration between the primary care provider and providers working in home, community, mental health and addictions care.
The study authors point to a particular issue in Ontario with the separation of public health labs from primary care EMRs. “The inability to understand risk for a whole population for which primary care has a shared responsibility is a challenge that must be overcome in a post pandemic era. This is one example of the need to strengthen the connection between primary care and public health.”
The report as calls for the ability of all providers including those providing homecare to be able to communicate via instant messaging. “In the pre-pandemic era, most Ontarians did not have access to virtual care via phone or video appointment. Only small numbers of Ontario patients were able to communicate via email with their primary care team.” The report also contains a number of other recommendations intended to reform the system from medical education to more consideration of the social determinants of health