Canadian doctors should be enticed to adopt electronic health record systems through a combination of subsidies and results-based incentives similar to those employed in New Zealand, suggests a group of Kiwi experts on tour in Canada. EHR systems will be widely used only when physicians realize the benefits the technology offers.
"What's needed is a compelling enough reason for doctors to shift from paper-based records to computer-based systems," says Roger Brown, director of information technology at MedTech Ltd., one of the largest providers of EHR systems to primary healthcare professionals in New Zealand.
Brown, and other New Zealand-based IT vendors, is touring Toronto, Edmonton and Vancouver this week to meet with Canadian healthcare experts. Sponsored by the governments of both countries, the tour aims to share ideas and experiences, as well as explore potential markets in Canada for healthcare technology, specifically EHR systems.
Brown suggests Canadian physicians could be enticed to adopt EHR systems through a combination of subsidies and "results-based incentives" similar to those employed in New Zealand. He says simply providing money for doctors to purchase e-record software and devices would not be effective.
"Throwing money at the problem won't work. Australia did just that. A lot of doctors bought computers, but their efforts were not focused."
In New Zealand, subsidies were provided for purchasing e-record equipment, but doctors were also given a set of patient care benchmarks to achieve. The benchmarks could be reached by effectively using the e-health record systems
"The doctors received incentive pay when they reached a certain goal," says Brown.
Most large Canadian hospitals already use electronic health records. Several healthcare facilities here have also linked their databases via shared networks. Members of the e-health mission, however, seek to get family physicians to adopt the technology.
In addition to funding, physicians must show a willingness to adapt to change, says Craig Longstaff, director of sales and marketing, Intrahealth Systems Ltd.
"Of course money will be a challenge, but doctors have to be prepared to accept and train themselves by using the technology."
Longstaff notes the average Canadian physician is 40 to 50 years old, and "most are deeply rooted in paper-based record systems."
Michael Martineau, director of Branham Group Inc., a marketing research and consultancy firm in Ottawa, says New Zealand e-health companies are an ideal fit for the Canadian market because the health systems in both countries share certain similarities.
For instance, both Canada and New Zealand have numerous remote areas and aboriginal groups with specific health delivery needs, says Martineau. Both countries also employ a type of government-funded healthcare system.
"These companies will be familiar with the needs and challenges of our doctors in various provinces," says Martineau, who is also part of the e-health mission.
Longstaff says while more than 95 per cent of general practice physicians in New Zealand have their patient records in computer-based systems, only a small portion of Canadian doctors are taking advantage of the technology.
In Ontario, funds are also available to help doctors purchase e-record systems, according to Dr. Val Rachlis, a Toronto-based family physician. Last year, he bought a system from Nightingale Informatix Corp. in Markham, Ont., a clinical management software provider.
Rachlis used a subsidy of $28,000, provided by Ontario's Family Healthcare Network, a government agency that aims to connect medical services in the province and foster the cost-effective use of IT assets in the industry. The subsidy, however, is available only to doctors who join the network.
"I think e-health is the future," says Rachlis. "I can't imagine myself going back to paper records."
Rachlis is a past president and currently member of the executive committee of the Ontario College of Family Physicians. Before deploying the system, he says, he had to wade through pages of records to obtain an update on a patient's condition. He was often bogged down by his own handwriting.
"Now I can access patient history, lab reports and other information from my office or home computer."
Unlike his old file folder, the software also allows Rachlis to view graphs of treatment in progress. The system also alerts him if a certain test or appointment is coming up soon.
The process of moving over to an electronic system can be quite daunting, as Rachlis discovered. "Transferring all my files is proving to be a challenge," he says. "I guess in another three months all my records will be in and I won't need paper."
Rachlis advises new doctors to venture into practice with electronic systems. "New grads would be nuts to start out with paper records."
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