The future of electronic medical records in Canada

Zhao, Eric J.

doi:10.1503/cmaj.71858

Cited by 5 publications

(4 citation statements)

References 1 publication

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“…In addition, there has been studies on CHI's impact [17], [41] and the future development for HIT in Canada. The latter topic includes: 1) calls for restarting HIT development from scratch [18]; 2) modifying existing systems for common standards [42], [24], [41]; and 3) abandoning a national strategy [43]. No literature, however, has estimated the costs and savings of these options.…”

Section: The National Health Information Technology System Debatementioning

confidence: 99%

Economic Efficiency of an Open-Source National Medical Lab Software in Canada

Peplinski

Pearce

2023

Preprint

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Although the Canada federal government has invested over $2.6 billion developing health information technology (HIT), all 10 provinces still have their own separate HIT systems, which are non-interoperable, expensive, and inconsistent. After first reviewing how these systems operate, this paper analyzes the costs and savings of integrating the common billing, lab results, and diagnostic imaging (BLD) functions of these separate systems using free and open-source software and proposes a system for this, HermesAPI. Currently, 8 provincial governments representing over 95% of Canada’s population allow private companies to create their own electronic medical records (EMR) system and integrate with provincial BLD systems. This study found the cost to develop and maintain HermesAPI would be between CAD$610,000 to CAD$740,000, but would prevent CAD$120,000 per company per province in development costs for a total savings of $6.4 million. HermesAPI would lower barriers to entry for the HIT industry to increase competition, improve the quality of HIT products, and ultimately patient care. The proposed open-source approach of the HermesAPI is one option towards building a more interoperable, less expensive, and more consistent HIT system for Canada.

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Section: The National Health Information Technology System Debatementioning

confidence: 99%

Economic Efficiency of an Open-Source National Medical Lab Software in Canada

Peplinski

Pearce

2023

Preprint

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“…The ability to date of digital health solutions, including electronic health records (EHRs) to meet the demands and complexity of modern medicine has been underwhelming. 37 However, all patient safety leadership organizations including the Institute for Safe Medication Practices (ISMP), the Canadian Patient Safety Institute (CPSI), and the Agency for Health Care Research and Quality, agree that EHRs must be part of the medication safety solution, as system factors in addition to human factors, are always amongst the key root causes of adverse events. [38][39][40] Epic is a world-leading EHR software.…”

Section: A Innovation In Digital Healthmentioning

confidence: 99%

Improving Medication Prescribing-Related Outcomes for Vulnerable Elderly In Transitions on High Risk Medications (IMPROVE-IT HRM): A Pilot Randomized Trial Protocol

Holbrook

Perri

Levine

et al. 2023

Preprint

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Rationale: Transitions in, through, and out of hospital define the highest risk periods for patient safety. Hospitalized senior high-cost health care users taking high risk medications, are a large group of patients, usually highly complex with polypharmacy, and at high risk of serious adverse medication events. We will assess whether an expert Clinical Pharmacology Toxicology (CPT) medication management intervention during hospitalization with follow-up post-discharge and communication with circle of care, is feasible and can decrease drug therapy problems amongst this group. Design: Pragmatic pilot randomized trial at SJHH with 1:1 patient-level concealed randomization with blinded outcome assessment and data analysis. Participants: Adults 65 years of age and older, admitted to Internal Medicine services for more than 2 days, who are high-cost users defined as at least one other hospitalization in the prior year, taking 5 or more chronic medications including at least one high risk medication. Intervention: CPT consult service identifies medication target(s), completes consult, including priorities for improving prescribing negotiated with the patient, starts the care plan, ensures a detailed discharge medication reconciliation and circle-of-care communication, and sees the patient at least twice after hospital discharge via integrated virtual visits to consolidate the care plan in the community. Control group receives usual care as provided by admitting services. Outcomes: Include a) Feasibility Outcomes and b) Clinical Outcomes including the number of drug therapy problems improved, medication appropriateness and safety, the quality and coordination of transitions in care, quality of life, and health care utilization and costs by 3-month follow-up. Impact: If results support feasibility of ramp-up and promising clinical outcomes, a follow-up definitive trial will be organized using a developing national platform and medication appropriateness network.

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“…The incomplete adoption of electronic medical records (EMRs) illustrates the lag in digital infrastructure integration despite electronic record technology being available. The Canadian Federal Government’s Economic Action Plan provided funding to health care providers toward establishing EMRs in primary care in 2010, leading to an increase of EMR adoption [ 18 ]. A similar progression took place in the United States in 2014 [ 19 ].…”

Section: Limitations Of Current Infrastructurementioning

confidence: 99%

Tempering Expectations on the Medical Artificial Intelligence Revolution: The Medical Trainee Viewpoint

Hu¹,

Hu²,

Yau³

et al. 2022

JMIR Med Inform

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The rapid development of artificial intelligence (AI) in medicine has resulted in an increased number of applications deployed in clinical trials. AI tools have been developed with goals of improving diagnostic accuracy, workflow efficiency through automation, and discovery of novel features in clinical data. There is subsequent concern on the role of AI in replacing existing tasks traditionally entrusted to physicians. This has implications for medical trainees who may make decisions based on the perception of how disruptive AI may be to their future career. This commentary discusses current barriers to AI adoption to moderate concerns of the role of AI in the clinical setting, particularly as a standalone tool that replaces physicians. Technical limitations of AI include generalizability of performance and deficits in existing infrastructure to accommodate data, both of which are less obvious in pilot studies, where high performance is achieved in a controlled data processing environment. Economic limitations include rigorous regulatory requirements to deploy medical devices safely, particularly if AI is to replace human decision-making. Ethical guidelines are also required in the event of dysfunction to identify responsibility of the developer of the tool, health care authority, and patient. The consequences are apparent when identifying the scope of existing AI tools, most of which aim to be physician assisting rather than a physician replacement. The combination of the limitations will delay the onset of ubiquitous AI tools that perform standalone clinical tasks. The role of the physician likely remains paramount to clinical decision-making in the near future.

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The future of electronic medical records in Canada

Cited by 5 publications

References 1 publication

Economic Efficiency of an Open-Source National Medical Lab Software in Canada

Economic Efficiency of an Open-Source National Medical Lab Software in Canada

Improving Medication Prescribing-Related Outcomes for Vulnerable Elderly In Transitions on High Risk Medications (IMPROVE-IT HRM): A Pilot Randomized Trial Protocol

Tempering Expectations on the Medical Artificial Intelligence Revolution: The Medical Trainee Viewpoint

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