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Digital Health Myths

Digital health is transforming the way Canadians access health care as more and more are able to view their personal health history online, connect with their care provider through a virtual setting, and e-book medical appointments. It has also changed workflows for clinicians who are able to pull up information about their patients as needed and whose patients may now be able to also access their health information. This has created some uncertainty and concerns — not always based on the facts — about what digital health means for Canadians as well as clinicians. We set out to dispel some of these myths.

Myth: I won’t understand my lab results if I access them online because they are too complicated.

Fact: In a study, 76% of patients who first saw their lab results online were confident they understood the results.

The study also showed patients who view their results online are no more anxious than those who don’t. In fact, people with chronic conditions are less anxious when they get their results online. Timely access to lab test results is an important part of patient engagement and empowerment, which are directly linked to improved chronic disease management.

Source: Mák G, Smith Fowler H, Leaver C, Hagens S, Zelmer J, “The Effects of Web-Based Patient Access to Laboratory Results in British Columbia: A Patient Survey on Comprehension and Anxiety,” J Med Internet Res 2015;17(8):e191 DOI: 10.2196/jmir.4350

Myth: The quality of care offered in a virtual visit is not as good as the care in a face-to-face visit.

Fact: While in-person visits are essential in some cases, there are many scenarios in which virtual visits can provide the same standard of care. A BC study found 79% of patients who had a virtual visit said the quality of care was the same as in an in-person visit. 91% said the online visit helped them with the health issue for which they needed the appointment.

Source: Virtual Visits in British Columbia: 2015 Patients Survey and Physician Interview Study

Myth: Digital health will marginalize populations who may not have online access.

Fact: Canada is one of the most connected nations in the world and 90% of Canadians have Internet access. Additionally, many Canadians face barriers to accessing care — and virtual care helps reduce those barriers.

Digital health can also reduce marginalization for people living in remote communities or with mobility issues. For example, some Canadian initiatives and programs support access to certain populations by providing smartphones or remote monitoring equipment to participants.

Source: 2018 Canadian Internet Registration Authority (CIRA) Factbook, http://bit.ly/2MZR1Pp. For more information, see: http://bit.ly/2lsEVgR, http://bit.ly/2mmhslE and http://bit.ly/2MGCCJq.

Myth: Digital health is only for the young and tech savvy.

Fact: Canadians are very connected, including seniors. 90% of Canadian households have Internet access and 74% of Canadians over 55 years old own a smartphone or tablet.

Digital health also offers important opportunities for advancing care for seniors through programs such as telehomecare. Telehomecare can help seniors with chronic conditions improve their quality of life and reduce the number of ED visits and hospital stays they may have.

Source: Diffusion of Smart Devices for Health in Canada — Final Report, September 2017. 2018 Canadian Internet Registration Authority (CIRA) Factbook, http://bit.ly/2MZR1Pp. See also: http://bit.ly/2MZyDpX.

Myth: If patients are able to view lab test results online before talking to their doctors, they will be overly anxious.

Fact: Patients who view their results online are no more anxious than those who wait to learn about them in person. A study showed 93% of patients who accessed their lab results online said they had more informed discussions with their doctor. Additionally, patients with one or more chronic conditions were less likely to report being anxious.

Source: Mák G, Smith Fowler H, Leaver C, Hagens S, Zelmer J, “The Effects of Web-Based Patient Access to Laboratory Results in British Columbia: A Patient Survey on Comprehension and Anxiety,” J Med Internet Res 2015;17(8):e191 DOI: 10.2196/jmir.4350

Myth: Doctors will be flooded with calls if patients have access to their lab results online.

Fact: Patients who have access to their lab results online are less likely to call their physicians while waiting for results and they’re less likely to have an in-person visit related to their results. Additionally, patients who have access to their health information through a patient portal are less likely to call or make requests for information, with one Ontario study finding a 61% decrease in requests for information when a patient portal became available.

Source: Impacts of direct patient access to laboratory results – Final Report, August 2015, SRDC. Ontario Shores’ HealthCheck Patient Portal Benefits Evaluation Report, 2016. See also: Group Health Centre’s myCARE Benefits Evaluation Plan, 2016.

Myth: Patients don’t want to see their health information and won’t find the information useful.

Fact: Currently, 79% of Canadians say they can access or would like access to their health information online.

Furthermore, Canadians who do have access find it beneficial. In one study, 94% of patients who use portals said they valued viewing their health information online. In another study, 74% of Canadians with access to digitally-enabled health services say it helps them have more informed discussions with their doctor.

Source: Connecting Patients for Better Health: 2018. myCARE Benefits Evaluation and Final Report, Group Health Centre, 2016.

Myth: Digital health is just for health care providers.

Fact: 50% of Canadians now report they can access at least one health service online, such as viewing their health information, making an appointment with a physician and consulting with a health care provider.

Providing patients with timely access to their health information is an important part of patient engagement and empowerment, which are linked to improved chronic disease management. In fact, engaged patients use less urgent and after hour services.

Source: 2018-2019 Annual Report, Canada Health Infoway. 2019 Annual Tracking Survey, Canada Health Infoway. See also: http://bit.ly/2n4PRpZ and http://bit.ly/2MUORAK.

Myth: There has been little to no progress in digital health in Canada.

Fact: 85% of family physicians in Canada were using an electronic medical record (EMR) in 2017, up from 23% in 2006.

An estimated 330,000 health care professionals are users of connected health information across all provinces and territories. At least seven in 10 Canadians can access some portion of their record now, up from two in 10 at this point in 2015.

Source: Connected Health Information in Canada: A Benefits Evaluation Study. CMA Physician Workforce Survey, http://bit.ly/2YMhTcT. See also: http://bit.ly/32EKGOI.

Myth: The government and insurance companies will be able to see my digital health records.

Fact: All provinces and territories in Canada have laws that protect the confidentiality of your personal health information. Governments and insurance companies do not have access to the identifiable information in your digital health records. There are only certain circumstances (lawful purposes) such as public health situations or when you have provided consent, when your identifiable data may be disclosed to them.

For more information, see: http://bit.ly/2YM4WQu

Myth: Canada has spent billions of dollars on digital health with nothing to show for it.

Fact: Infoway estimates that more than $30 billion in benefits have accrued from digital health solutions since 2007. These benefits include avoided expenses, such as travel, for patients and their families, increased productivity for clinicians through access to digital tools, such as lab information systems, and increased value to the health system, such as avoided ER visits.

Source: 2018-2019 Annual Report, Canada Health Infoway.

Myth: I don’t have a right to access my health record.

Fact: Your health care provider is the custodian (trustee) of your health record and is responsible for proper use and management of the record. However, the information in the record is yours and you have a right to access it. In fact, 36% of Canadians asked for their information, with seniors being the most likely to ask. You can access it through a formal request process, as outlined in law, but many custodians are pleased to share the information if you ask to see it and, in fact, many custodians are creating online portals or personal health record systems that patients can access whenever they wish.

Source: Connecting Patients for Better Health: 2018. For more information, see http://bit.ly/1d1eyd5 and http://bit.ly/2YM4WQu.

Your Myths Explored

We asked you to submit digital health myths you’d like our help debunking. Here are the myths you asked us to bust.

Myth: Digital Health Apps Are Not Evidence-based and Do Not Work

We chatted with Dr. Kendall Ho on whether digital health apps work and are evidence-based. Read the blog post.

Myth: Physicians who use electronic medical records (EMRs) see fewer patients per day than those who use paper.

Fact: While practices may slow during implementation, Canadian studies show that EMRs do not adversely affect a physician’s ability to see patients. One study looked at billings before and after EMR implementation and found no decreased billings or government payments for office visits. Another study of practice finances showed that, in fact, community-based practices quickly experience efficiencies in workflow as staff time is redeployed and actually increase active-patients-to-clinician-FTE ratio to positively increase clinic net revenue. Clinics recoup their investment in an EMR in 10 months on average.

EMRs also result in health system-level benefits, such as reduced numbers of duplicate tests and adverse drug events.

Source: Effects of implementing electronic medical records on primary care billings and payments: a before–after study: http://bit.ly/2rdqa4Q. Return on Investment in Electronic Health Records in Primary Care Practices: A Mixed-Methods Study: http://bit.ly/1u37zTv. The Emerging Benefits of Electronic Medical Record Use in Community-Based Care: Executive Summary: http://bit.ly/2sjs4o0.

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