Canadian physicians want to use more online tools to consult with their patients, but they say there are obstacles. And one of those obstacles is remuneration.
"In Canada and in the U.S., physicians don't get reimbursed for a secure e-mail exchange, and time is money for physicians. If they can't get reimbursed, they have less incentive," says Frances Dare, a director with Cisco's health care group.
This sentiment is echoed by Dr. Stephen Chris, a former Toronto-based family physician, who says the process of deploying IT for physicians is both expensive and time-consuming.
Chris, who now looks after residents in nursing homes, is also currently chairman of the board of Ontario MD, a subsidiary of the Ontario Medical Association (OMA).
Ontario MD manages a fund established by the Government of Ontario to promote the use of IT, in particular electronic medical records and secure e-mail communications for physicians, says Chris.
"We subsidize family physicians who are purchasing approved electronic medical record systems, or what we call CMS (clinical management systems)," he says. "We validate the vendors, make sure their products meet minimum specifications, and give assistance to physicians in the process of implementing electronic medical records."
He adds that Ontario MD had enough money to subsidize just over 500 doctors, but they received over 2,000 applications.
"There's a tremendous appetite in the family physician community to move to an electronic medical record environment, but its expensive and very time-consuming to establish what you need and get it installed," says Chris.
And it would appear that patients are also hungry for this electronic interaction. A recent U.S. survey showed that consumers would like to see their doctors embrace online tools within their practice.
A key finding of the survey was that patients would like to see this happen in three main areas: directly e-mailing their doctor, accessing lab results online via a secure Web site and scheduling appointments online.
The survey, conducted by Illuminas for Cisco's health care division, was based on the responses of over 4,000 participants. "We were interested in how a relatively healthy population can be well served by health care services that are provided online," explains Dare.
"It becomes clear, when you examine these findings, that consumers are very much interested in health information online," she says. "People aren't just going out as curiosity seekers; they actually are making decisions based on what they find."
Dare cites Grand River Hospital in Kitchener, Ont., as a leading Canadian example of providing health care information online. Grand River Hospital has built a portal dubbed My Care Source, used by patients managing cancer, and plans to launch another for patients with chronic kidney disease.
The Cisco executive says that while hospitals and health systems such as those at Grand River have been reaching out to consumers, physicians have not.
"I don't think anyone in the industry has felt that the primary care physicians needed to carry that banner," says Dare. "Hospitals typically have bigger budgets, more people resources to manage IT and all of the things that make that more doable."
Canada Health Infoway is one of the partners working on Grand River's new portal. Dr. Sarah Muttitt, vice-president of innovation and adoption, says patient portals are becoming more prominent.
"We haven't had a lot of deployments in Canada, but there's evidence that suggests being able to empower patients, getting them to engage in their self-management, can really improve their outcome and sense of wellbeing," says Muttitt.
Continued: Key findings of survey on online health care tools
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Experts: US electronic health records still a way off
Nursing portal finally ready to go
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