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The Evolving Story of Digital Health

Posted on June 20, 2017 by Dr. Rashaad Bhyat

The story of digital health in Canada has taken many twists and turns over the years, but steadily, we are approaching a point of critical mass.

The story of digital health however, is really the story of the new and evolving role of the patient.

As I noted in a previous blog post, generations of Canadians increasingly favour text, instant messaging, and video as a preferred means of communicating.

However, as health care continues to evolve in the context of new technologies, a number of digital health myths persist in the mindset of clinicians and the general public. In this blog, I will address three of them.

Myth 1: There has been little to no progress in digital health in Canada.

Myth: There has been little to no progress in digital health in CanadaAlthough the health care system is in the process of catching up to other industries with respect to integrating and effectively using information technologies, there is good news.

Key components of Canadians’ health records are now 93.8 per cent digitized and available electronically through provincial Electronic Health Records (EHRs).

National electronic medical record (EMR) adoption rates for family physicians went from 23 per cent in 2006 to 73 per cent in 2015. In many provinces, adoption rates for family physicians exceeds 80 per cent.

An article by Gheorghiu and Hagens indicates that the availability of core Electronic Health Record (EHR) data in each province and territory continues to advance, although there is quite a bit of variability in terms of the clinical settings in which this data can be accessed.

Patient access to their health information is increasing across the country, through patient focused initiatives including MyHealth NS, Sunnybrook Hospital’s MyChart, and the Excelleris laboratory portal initiative in British Columbia to name only a few.

Myth 2: The introduction of virtual visits means I won’t see my doctor anymore.

Myth: The introduction of virtual visits means I won’t see my doctor anymore.In-person visits will continue to be essential in medicine, but as I noted in a previous blog post, many visits do not actually require the patient to be physically present in an office — for example, when a patient follows up to discuss laboratory results.

A recent study in B.C. found patients who use virtual visits want to: save time; access care in a more timely manner; and avoid missing work.

Ideally, virtual visits should augment and enhance an existing patient-physician relationship.

Myth 3: The patient-physician relationships suffer when there is a computer screen in the exam room.

Myth: Patient-physician relationships suffer when there is a computer screen in the exam roomWhile the patient-physician relationship can be negatively affected by a computer screen in the exam room, ideally it should not be affected.

A literature review by Canadian medical informatics scholar Dr. Aviv Shachak and colleague Dr. Shmuel Reis found “The use of EMR exerts both positive and negative impacts on physician-patient relationships. The negative impacts can be overcome by some simple means as well as better designs of EMR systems and medical education interventions.”

That is, if physicians are appropriately trained on how to effectively use an EMR during a clinical encounter, and if the EMR is well designed, patient-physician relationships should not suffer. The computer screen can become an effective tool for physicians to share information with patients, and, as patient portals become more widespread, for patients to share information with their physicians.

It is for this reason that Infoway has partnered with the Association of Faculties of Medicine of Canada (AFMC) to raise awareness about the need to educate physicians about digital health through our medical schools. This award-winning partnership has produced an online toolkit of digital health resources that medical educators can use to teach their medical students and resident physician trainees. Module 4 specifically addresses the appropriate use of EMRs in a patient-physician encounter.

To Conclude

We may have reached a tipping point in terms of the adoption of digital health technologies in Canada. However, much work remains to enhance the flow of information between systems, and to educate both physicians and patients on the optimal use of these technologies.

Meanwhile, many myths persist relating to digital health. Hopefully this post has helped to dispel a few of them.

Visit our myths page for more insight into digital health myths.

Do you have any digital health myths that you would like to share? Our team would be interested to hear from you.

Have a comment about this post? We’d love to hear from you.


rbhyat 100Rashaad Bhyat

Dr. Rashaad Bhyat is a Clinical Leader in the Clinical Adoption group at Canada Health Infoway. He is a family physician with a special interest in Digital Health. He currently practices in an EMR-enabled family practice in the Greater Toronto Area.

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