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Physician IT

New podcast available from CanadianEMR

VANCOUVER – CanadianEMR, a comprehensive web site for physician IT, has posted its second Quarterly Roundtable Forum. A panel discusses the role of Information Technology in the management of patients with one or more chronic disease.

Topics discussed include Shared Care and the experience using Shared Care Plans in British Columbia, the experience with EMRs and Chronic Disease Management in Alberta and Ontario and the role of home monitoring devices in the management of patients with complex and chronic conditions.

The participants include:

• Dr. Alan Brookstone, Moderator

• Dr. Karim Keshavjee, Ontario, Family Physician and Founder of Infoclin, a consulting company based in Toronto

• Doug Stich, Alberta, Program Director for TOP – Towards Optimized Practice

• Dr. Chris Rauscher, British Columbia, Geriatric Specialist and medical and clinical improvement advisor to the BC Ministry of health

• Judy Huska, British Columbia, Director of Impact BC

• Guest commentary: Dr. Bill Clifford, Director of Clinical Informatics for Northern Health Region
The participants note that chronic disease management programs can have dramatically different levels of effectiveness and that much depends on the design of the program.

Said Doug Stich: We have a tendency when looking at population data to blame the patient population or try artificially influence the measures in order to achieve a better target number rather than a better actual outcome. In terms of population data, we need to focus on not trying to ascribe to the population a challenge, but look at it in terms of what we need to do differently. Example, in working with two different programs, one program was achieving 80-90% compliance with medications and the other program was achieving less than 50%, despite being the same patient population. Therefore, we should not be looking at the patients and asking “Why are they not cooperating or complying?” The real question should be “What is program two doing differently than program number one and how can we replicate it?”

The effectiveness of EMRs in chronic disease management is also raised:
Said Dr. Chris Rauscher: When we started working with EMRs, we found that it took about a year for the GP office to understand what an EMR is from an efficiency point of view in the office. Let alone the effectiveness of Chronic Disease Management. Part of this was due to how EMRs have been developed, not to match the business or clinical aspects of needing to look at what needs to happen in a GP office with their own patients, even once we group them in populations. Instead, EMRs were developed more on what the IT systems where at that time, without a lot of change support. Now we are chipping away from that and building in conformance standards around CDM and EMRs, but we are still being challenged with the change support and for GP offices to really see the benefit for managing populations differently, and even going past flow sheets which was used to capture clinical information and to build into their process of care with registries and flow sheets.

To listen to the complete podcast: