This practice was recognized as a LEADing Practice by Canada Health Infoway as part of the “Knowing is Better” education campaign, in partnership with Accreditation Canada
Advancing Professional Practice
The practice implemented an Electronic Medical Record (EMR) in 2000 with a goal of making the office as paperless and connected as possible. EMRs are shared among physicians, nurses and allied team members within the practice. Lab results are directly downloaded to the EMR from community labs and the Ontario Laboratory Information System. Practitioners are connected to regional hospitals via the regional Electronic Health Record and portal, Clinical Connect, which includes access to hospital and oncology data as well as information from the Community Care Access Centre. The practice has also initiated a secure email solution where they can connect with their patients electronically. Lastly, the Ontario Telemedicine Network’s Teledermatology Program is used by providers to obtain quick dermatological consultations.
The EMR in combination with Clinical Connect allow the health care team to continuously evaluate the care they provide to their patients. For example:
• Dietitians monitor the diabetic patients meeting care targets;
• Physicians monitor eligible patients for cancer screenings (e.g., cervical and colorectal);
• Mental health counselors use standardized questionnaires (e.g., PHQ9) embedded into EMRs to measure treatment success; and
• Pharmacist use EMR tools to monitor and review pain medications for appropriate and safe care.
Improving Continuity of Care
Through the use of an EMR and access to Clinical Connect, providers are able to capture the patient’s journey at all points of care including home-care and oncology.
“Patients are reassured when they know that we have the most up to date care plans and test results. For example we are frequently able to reassure anxious patients the day after having a colonoscopy. With access to discharge summaries we are able to reconcile patients’ medications when they transition to the community, reinforce rehabilitation plans after a fracture or follow up with a patient with pneumonia that was diagnosed the ER.”– Dr. Barbara Teal, Family Physician
Impacting Providers and Patients
With Clinical Connect, hospital-based data is seamlessly downloaded into the EMR, which enables timely access to hospital diagnostic reports, consults and lab data. Prior to the implementation of Clinical Connect, it took up to two weeks before a report was received. Further, leveraging telemedicine to obtain quick dermatological consultations via digital imagery is resulting in responses within 1-2 days compared to a 3-6 month wait for appointments. These electronic tools have helped the practice become more efficient and patients have reported improved access to care.
Critical Success Factors
• Having a shared vision of providing efficient and compassionate primary care;
• Sustainability requires ongoing physician leadership and continued cooperation between hospitals, community health and EMR vendors;
• The team is essential to the ongoing journey; seeking team input and training staff is critical;
• Continuously evaluating workflow by asking “How can we do this better electronically”; and
• Ensuring that the EMR is current and up-to-date.
For more information on Drs. Lamb, Mielke & Teal‘s LEADing Practice, contact Dr. B. Teal, Family Physician at dr.bteal@gmail.com or 905-388-2447
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