In our previous post we highlighted a leading insight from the 2018 Canadian Physician Survey where 92 per cent of family physicians who use six to nine EMR functionalities stated that they ‘provide more efficient health care with electronic records.’ It has been a general assumption that physicians will integrate advanced EMR functionalities to support patient care as their years of experience using an EMR increases. Beyond just improving practice efficiencies, evidence has also highlighted clinician, patient and system value of using multiple EMR functionalities to support patient care, suggesting that advancing meaningful EMR use is a key catalyst to realizing value-based outcomes.
But can we assume that primary care physicians will integrate the use of more/multiple functionalities as they gain more experience using EMRs? Findings from our survey suggest that the majority of physicians in their first year of EMR use (58 per cent) use only one to two basic functionalities (entering/retrieving notes and prescribing). Overall, regardless of how long they have been using an EMR, most primary care physicians in Canada eventually only use a total of three to five EMR functionalities (or less) to support patient care after their second year of use.
Our findings suggest that there isn’t a strong link between duration of EMR use and integration of advanced functions over time. As Canadian physicians gain more years of experience using EMRs, meaningful use (use of six or more functionalities) and the associated value to the health system and patients may be challenging to realize. That is, unless strategies by industry, physician groups and primary care associations can mobilize, inform and support new physicians to integrate a broad set of functionalities into their practice pattern. Ensuring that new functionalities introduced have a clear and significant value proposition to support widespread practice integration will also go a long way in advancing meaningful use of EMRs in Canada.
The 2018 Advanced and Meaningful Use of EMRs, Best Advice Guide published by the College of Family Physicians of Canada (CFPC) and Canada Health Infoway is a key strategic resource aimed at advancing meaningful use of EMRs in Canada.
The launch of Canada Health Infoway’s PrescribeIT®, Canada’s e-prescribing service, is also an example of how a new EMR functionality is being deployed to advance meaningful use and enhance value for primary care practices, community pharmacies and patients without disrupting clinician workflows. PrescribeIT™ enables physicians to transmit prescriptions electronically from their EMR straight into a pharmacy management system instead of printing or faxing a prescription, thereby eliminating a potential source of medication errors. It also enables pharmacists to send messages and questions about prescriptions straight into the EMR, cutting out the need for physicians and pharmacists to play phone or fax tag, creating even more efficiencies and continuity of care.
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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.
Chad leads national research, evaluation and communication efforts for Infoway’s Evaluation Services and Consumer Health & Innovation investment portfolios.