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Electronic medical record

eClinician makes primary care records shareable

EDMONTON – Capital Health is launching a region-wide electronic medical record to allow patients to schedule appointments, look at their laboratory results and send simple questions electronically to their doctors, according to a report in the Edmonton Journal.

The eClinician system will also allow doctors in specialist clinics to look at medical charts from family physicians. “It’s a very complex thing to do,” said Dr. Allen Ausford, a doctor at the Meadowlark Clinic and chief medical information officer for Capital Health.

Many people already think their electronic medical record – equivalent to their doctors’ paper chart containing their medical history, allergies, reasons for visits, referral notes and blood test results – is shared among doctors, so that if patients end up in the emergency ward, the information they gave their family doctor is available at the click of the mouse in the hospital.

That’s not yet the case.

About 2,000 – or one-third – of Alberta doctors can electronically access X-rays, results from blood tests or MRI scans from laboratories through an electronic health record called NetCare. But NetCare doesn’t give them access to any electronic medical notes made by other doctors in their electronic files. That’s because even though 2,500 Alberta physician have an emergency medical.

That means if a patient first sees her family doctor, then gets an appointment at a fertility clinic or rushes to the emergency room, the doctors at the clinic or hospital can’t look at her doctor’s personalized medical notes. Because of that, the patient needs to repeat the information about medication allergies and the tale of her troubles.

With Capital Health’s new $5-million- per-year eClinician system – different from the province’s Physician Office System Program, which gives individual doctors cash to buy their own systems – doctors and clinics who voluntarily sign on will become part of a larger network.

At first, only day clinics – immunization and mental health clinics, heart clinics in the Mazankowski Heart Institute and fertility clinics in the Lois Hole Hospital for Women – will use the eClinician scheduling system. It will allow receptionists to schedule various appointments at multiple clinics without having to pick up the phone and juggle daytimers.

If a patient is due for a cholesterol test, eClinician will notify the doctor’s office, who in turn can remind the patient. The system will first focus on new moms, who need regular reminding to have their children immunized.

By the end of 2008, one million patients are expected to visit the clinics with eClinician and 1,100 doctors, nurses, dieticians and pharmacists will be able to look at their patients’ medical records, depending on their security clearance level. An obesity specialist, a dietician, a heart doctor and diabetes nurse could all look at the chart of a patient getting care for several chronic diseases.

In theory, if a patient goes to one doctor’s office and gets a prescription, then goes to another doctor and needs a different prescription, the second doctor could sign on to eClinician, enter the patient’s name and be warned the patient could experience medication interactions.

Such electronic communication could help avoid a situation like that faced by actor Heath Ledger, who took a deadly cocktail of painkillers, sedatives and antidepressants from various doctors.

“It’s going to improve the quality of care down the line,” said Dr. Harvey Sternberg, a specialist in sports medicine whose clinic has an electronic medical record. Those records can currently be shared among 57 doctors in the area’s primary care network, but only when a doctor gives approval. Sharing will happen automatically with eClinician among specialists involved.

“Medicine is the last bastion of professions to become electronic,” Dr. Sternberg said. “We’re going to catch up. It is the way of the future.”