For ten years, Infoway has been exploring with different ways of measuring progress that accurately and coherently convey the progress in digital health across the country. Earlier in our mandate, availability of systems was deemed to be a core measure since it tracks clinical data in provincial/territorial assets for the use of clinicians and other health system professionals. This measure did an excellent job in conveying progress in building infrastructure right up to the point of go-live. However, what it did not do was give an indication of how many people were actually using these systems and how often they were doing so.
The active use of the interoperable electronic health record (iEHR) metric, defined by Infoway as users with access to two or more integrated clinical domains (e.g., lab, digital imaging, and/or drug information systems) who have accessed the system a minimum of one time during a month, is a metric that has reliably provided a measure of the increasing usefulness of the iEHR over time to end users. The accelerating growth experienced in the past three to four years, garnered 50 per cent growth in 2015 over the previous year serves to demonstrate not only the reliability of this metric but also the increasing usefulness of a provincial EHR once a critical mass of users has been reached.
As users access the iEHR, it’s equally important to understand their experience with the system and if benefits can be realized from the use. To this end, Infoway developed a System and Use Survey (SUS) that is commonly employed in projects to allow us to understand user experiences in a standardized manner. Between 2006 and 2014, six jurisdictions in Canada evaluated their iEHRs using customized versions of the SUS tool. This gives us the ability to take a step back and look at what nearly 2,300 clinicians in hospital and community settings are saying about their access to important patient information such as lab and diagnostic imaging results, medication profiles, and immunization records.
Overwhelmingly, clinicians report satisfaction with iEHRs and value having access to more complete patient information from multiple care settings when they need it. Clinicians also attributed iEHRs to benefits such as improved sharing of information among care providers, productivity and quality of care for patients.
We also learned that the quality of the iEHR systems, breadth of adoption, richness of information availability, interoperability, as well as effective leadership and change management strategies play a key role in continuing to accelerate the value for clinicians. More information is available regarding the active use of iEHRs across the country and the resulting benefits that have been demonstrated on our website.
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Bobby works with stakeholders in academia, private and public sectors to develop and monitor performance targets for initiatives such as PrescribeIT®, Canada’s national e-prescribing service, to ensure widespread adoption of technology and to demonstrate tangible benefits of investments in digital health. He holds an MHSc in Health Policy, Management, and Evaluation from the University of Toronto.
Sukirtha is Manager of Evaluation Methods at Canada Health Infoway where she works with diverse stakeholders and partners to evaluate the impact of digital health investments.