Computers are used in your doctor’s office, and by just about every other member of the health care team. Computers record and track your health information. They help your health care team to provide you with better care.
Computers are part of managing a health care system that is becoming more complex, a process called health information management. We have come a long way in a short time. Changing to a digital health record has not always been smooth. The system has been consistent in one thing – change. This is not the health care system you once knew, and you can expect more changes in the future.
Health information management has evolve. Once, filing cabinets stored observations about your health, medications, laboratory tests, and diagnostic imaging tests (x-rays, ultrasound, and CT scans). Now this information is being managed with greater sophistication. Its potential continues to expand. Imagine discussing a medical problem with your health care provider. A glance at your file shows everybody involved with your care, along with their observations and suggestions about your total care management. Your provider can quickly see your latest lab results, and view a diagnostic image as soon as it has been done, from any accessible, secure computer terminal. Secure online consultations with specialists and other members of the health care team are possible. Such technology would provide point-of-care advice that is quickly available, trusted, up-to-date, and specific to your particular problem. These are certainly important benefits.
Medication use can also be better managed. Any prescription you might receive could be cross-referenced with your other drugs (including holistic products). It would be checked for possible drug interactions, the best dosing, and how appropriate it is to your condition. More than one trade name can exist for the same medication. The pharmacy system would be able to screen for duplicate therapy in different trade names, or medications of the same class. This would be done quickly, and the resulting prescription could be sent to your pharmacy electronically.
Your health care provider would be able to check your status on a waiting list. It would be possible to see where you currently receive care, and the status of that care – be it day or major surgery, or a diagnostic test. Imagine your care provider being able to know whether you’ve had that test yet, or that you are taking your medications properly.
Many of these benefits are being developed, and soon will be or are in the testing phase. The ability to cut out duplicate tests and repeat medications, and being able to access your historical data, all lead to an efficient system.
Systems have been developed to give patients access to their own health information. This is called a personal patient portal. Think of it as your connection to the digital world of health care. Some benefits include health information from trusted sources, and secure messaging with your health care team. You can also see lab and diagnostic reports, and book and receive reminders about appointments. This open access to your own health information allows you to become much more involved with your care.
Along with the benefits, there are risks in gathering and transmitting electronic information. Health care information is sensitive. Electronic information can be passed on very quickly. A security breach could be devastating. The security of patient information has been a guiding principle when developing these systems. The sensitivity to the importance of security has slowed more rapid use of information systems. This shows the extreme care used in developing methods to protect the information.
If you have concerns, most provinces have an office of information and privacy (See sidebar.) Perhaps you are worried about the sensitivity of your information, and who might have access. You have the right to mask your health care information. To protect your privacy, any health care providers accessing masked information must first identify themselves. You also have the right to know who looks at your information. To find out, talk with your doctor or contact the information and privacy office in your province.
The electronic record is a very necessary part of the way your health care team provides you with care. The vision allows dedicated well-trained professionals to work together to the full scope of their defined practice. Perhaps right now your care could be best managed by a nurse practitioner, a pharmacist or a dietitian. Your doctor would get involved only if you have disease issues, or complications from a condition like diabetes. After an accident or an illness like a stroke, a kinesiologist, physiotherapist and occupational therapist might work together to get you moving. A social worker could help with financial concerns that often result from illness.
These examples help to illustrate what is being called the medical home. It is also called a patient-centric model. It is hoped that every patient will have one. A good electronic record is essential to its functioning. It would allow you to receive, and your team to provide, comprehensive care needed at different stages of your life. This might include reminders of screening tests, and coordinating home care services. All members of your health care team could stay in touch with you, either by electronic messaging or face-to-face meetings.
Protecting you from harm is another benefit of integrated care that is always being monitored. (Consider the harm that could come from a medication error or missed diagnostic information.) Through patient involvement, examination and system analysis, the medical home concept is proving itself.
The medical profession has always had at its heart a code of ethics that guides doctors in providing care to their patients. Similar codes of ethics exist for other health professions. There has been a long tradition of the greatest concern for patient safety. Great care is being used while progressing towards an electronic patient record. It remains to be seen how this new direction will improve patient care and work toward an efficient, sustainable Canadian health care system.