Big concerns about information sharing (or lack thereof) in the BC health care system

VANCOUVER (NEWS 1130) – When you go to the hospital, have you ever discovered doctors there don’t have access to the same records as your family physician?

Serious concerns are being raised about the way medical information is — or isn’t — shared across the province. The provincial NDP’s health critic says the fact all records can’t be accessed anywhere in BC is a big problem.

Judy Darcy says she gets complaints all the time from doctors, nurses, nurse practitioners, pharmacists, physiotherapists, and dieticians. She says they tell her it has a major impact on their ability to provide the best possible care.

Darcy argues while the government has committed hundreds of millions of dollars to bringing electronic health records into health authorities in the Lower Mainland, they’re getting it wrong.

“Because they’re not engaging the front line health care providers in designing it — so, already tens of millions of dollars have been wasted, and we’re a couple of years behind time.”

She says there are steps being taken in various health authorities. For instance, in Northern Health, all doctors and the health authority use the same IT platform.

But in the rest of the rest of the province, Darcy says, “the government of British Columbia provided incentives for doctors to bring in electronic health records in their own offices, but they were free to use one of many different programs. Therefore, you don’t even have all doctors using the same electronic medical records systems, much less the health authorities.”

Response from the Ministry of Health

In an email statement, the BC Ministry of Health says all health authorities have some form of an electronic health record system in place.

“A fully integrated provincial electronic health system would require the entire province to establish common clinical and process standards and move to one large database – run by the same software. This would be a tremendous logistical challenge with significant costs. B.C.’s system is generally consistent with systems like this around the world – they are usually consolidated to a certain level (such as across a health authority) – but they also work to ensure that some patient information can be easily shared between systems,” reads the statement.

“The ministry and the health authorities are working together to implement standards for exchanging personal health information to support the delivery of care as patients transition from one point of the health system to another. The first area of focus is on enabling the delivery of clinical documents, such as laboratory reports, from health authorities to community practitioners. Incrementally, over time, as these standards are refined, the exchange of information can expand to include more health organizations,” the statement adds.

Doctors of BC weighs in

Doctors of BC President Alan Ruddiman says if information can’t be moved seamlessly, patients get caught in the middle.

“We’re now in an environment where there’s been huge uptake in family doctor’s offices and specialists offices where we’re using electronic medical records to store that information. And we readily receive information from the health authorities, emergency departments, laboratories, [and] imaging departments.

“But again, we don’t have a seamless health information exchange whereby if you as a patient presented to the emergency department in any of the province’s regions tonight, we can’t guarantee you that the information that’s kept in your family doctor’s office — which is up to date, probably very comprehensive — would be transportable into that emergency department. So that again it sort of highlights some of the gaps that exist in not having a health information exchange in the province,” says Ruddiman.

He tells us there is a lot of work to do, but adds we are much further ahead than we were 10 or 15 years ago.

Ruddiman works within the Interior Health Authority.

“Interior Health has been using a program called Meditech for quite awhile right now. That’s their information health record, and it does push electronic records to a family doctor or specialist’s office that might be a summary of your discharge from hospital. It may be a progress note when you were in the emergency department, for example.

“But, it’s very static. It’s time-based information and really, what I think you — as a patient — would be interested in is no matter where you moved around this province or where you moved across the country, it would be really nice to know that no matter which health care provider or physician that you encountered in a time of need, that your medical record is up to date, it’s accurate, it reflects your medications that you’re currently being prescribed, it captures your allergies, and we don’t really have that degree of integration yet either provincially or certainly at a national level.”

Ruddiman adds more work to be done, and so frontline care providers should have an opportunity to work with government and health authorties to deliver the right tools.

He thinks there needs to be continued investment in training to realize the full potential of e-records, and is hearing some commitment from government.