For patients waiting for test results, learning your doctor is on vacation can be alarming.
It means the wait for results will be longer. Doctors with web-based electronic medical records (EMRs), however, can consult their patients' results even from remote locations - especially if they are worried about a serious case.
"Electronic medical records and other forms of health information technology allow us to provide better care, sooner to Nova Scotians," said Maureen MacDonald, Minister of Health. "It's reassuring to watch health care practitioners, like family doctors, increasingly use this technology, especially now that we have diagnostic imaging, lab results, and as we build our electronic health records system and prepare to add a drug information system."
Dr. Andrew Wawer, a North Sydney, Nova Scotia, general practitioner, sent a patient with a suspected aneurysm for a computerized tomography (CT) scan just before he left the country for a short time. "I was concerned," he said. "I knew she needed to know the results fast. With an aneurysm, you need access to care as soon as possible."
By accessing his EMR system from Greece via the Internet, Dr. Wawer was able to read the radiology report when it arrived. An aneurysm was confirmed and he immediately filled in the consultation forms for the neurosurgeon. "I forwarded them through the system and alerted my staff. They got the paperwork to the surgeon and the patient got seen as soon as possible."
For Dr. Wawer, stories like this are why he was an early adopter of EMRs. "I used my own electronic patient record back in the 1990s but switched to the EMR system here at the (Northside General) hospital where I have my office because I saw the advantages of using it. I get the test results for my patients very fast - usually the same day. I can see their profile and diagnose and prescribe accordingly. Being able to access the system remotely is an added advantage for both doctor and patient."
Dr. Wawer says a big improvement is that doctors can now fax prescriptions to the pharmacy. "It has made the job easier for pharmacists and allows me to ensure the patient's prescription goes directly to be filled."
As an example of how computer-literate patients are today, Dr. Wawer cited one case in which an enterprising patient sent pictures of his wife's skin lesions via email, "even though I was out of the country at the time." Dr. Wawer was able to diagnose shingles, a sometimes painful condition that, if not treated within 72 hours of onset, can cause complications and take a long time to heal. He prepared a prescription and had his staff fax it to the pharmacy.
Dr. Wawer is among the 30-35 per cent of Nova Scotia's general practitioners who are using an EMR system. The province's goal is to double that number over the next three years. In addition, Nova Scotia is developing its province-wide Secure Health Access Record (SHARE), an electronic health record. SHARE will give health care providers patient information that they need to provide care, regardless of where in the province they provide that care. About 100 users in various clinical settings, including hospitals and primary care, took part in the first wave of implementation called the Discovery Wave. Funded by Canada Health Infoway and the provincial government, SHARE will be rolled out across the province in 2011.