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Improving health care for remote communities with electronic medical records

It has long been a fact of life for those living in northern and remote communities that health care is hard to access. Many services are unavailable. Patients, as well as doctors, must frequently travel great distances.

Now technology, in the form of telehealth services and Electronic Medical Records (EMRs), is bringing sophisticated health care to the doorsteps and desktops of remote communities.

It was partly in response to these challenges that Dr. Ewan Affleck lobbied the local health authority in Yellowknife, NWT, to fund an EMR for the Great Slave Medical House.

"It's very helpful because up here people go off to different clinics and different sites to get care, and these clinics can be enormous distances apart," says Dr. Affleck. "And the people in clinic one don't really know what the people in clinic two have done, and vice versa."

"Really, this is the standard of care now."

EMRs are the modern version of a doctor's paper files and an important component of Canada's plan to make the health information of Canadians available to health professionals electronically. They can be used to capture important patient information - medical history, medications, X-ray results, lab results - and assist with everything around the office from billing and scheduling to ordering tests and generating prescriptions.

Prior to EMRs, Dr. Affleck says there was, "confusion about drug databases, allergies, history, what's been done, so forth."

That's no longer the case.

"Now, we have a record of their care, irrespective of where they live, and what different clinics they have visited. And that means we are better able to take care of them," he says.

"Really, this is the standard of care now. We're well past the stage where people debate if this is a tool that is required. It is absolutely required to provide effective care."

And that effective care can now be better provided right across the Northwest Territories thanks to the remote access provided by the EMR.

"We have the capability now when we go to remote communities in NWT to log on to this system," says Dr. Affleck. "So physicians who travel all day to remote communities can now check their labs for patient results. There is far less chance that things will get missed, and a far greater opportunity for providing the kind of care people need."

Dr. Affleck says that with patients living so far away from his clinic, the EMR's online support tools make a critical difference. He points to one of his patients who was suffering with bursitis. He was able to use the EMR to pull up the latest articles on the disease, research the exercise that made the biggest difference and communicate all the information to the patient online.

"He knows exactly what his problem is, and he'll deal with it, and the likelihood is that he won't need to follow up as often. I can provide significantly better care."

To learn more about the use of EMRs in Canada, read Experiences from the forefront of EMR Use, a joint publication of the Canadian Medical Association and Canada Health Infoway.

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