A 2009 survey of more than 10,000 primary care physicians in Australia, Canada, France, Germany, Italy, the Netherlands, New Zealand, Norway, Sweden, the United Kingdom, and the United States has just been released by The Commonwealth Fund. A similar survey undertaken by the same group in 2006 in response to the question, "Do you use Electronic Medical Records in your practice?" showed that Canada was last (with 23% reporting that they did use EMRs behind the US in second last place at 28%). When repeated in 2009 with a slight proviso (the question was amended to clarify the use of EMRs (not including billing systems) the US had increased to 46% while Canada had increased to 37% (still dead last). The gap has widened between the US and Canada from 5% to 9%. Remember this was all prior to announcing the ARRA funding in the US to support physician adoption of EMRs. You can be sure that when this survey is done again, US physicians will be reporting a signficant jump in the use of EMRs. Can Canada achieve similar increases?
While we are likely to see increases, because of a lack of a coordinated national strategy for EMRs (for primary care physicians and specialists), it is highly unlikely that Canada will be able to match the gains that the US will demonstrate. The $20 Billion+ that the US will be investing will ensure that EMR adoption will occur.
Critics of my statement above will point out that adoption of EMRs and the broad interpretation of use is extremely insensitive in terms of demonstrating how physicians are actually using their EMRs. We know that the numbers of physicians who use their EMRs fully is a much smaller number than those who state they have an EMR, however I would point out that having an EMR is the first step towards more effectively using your system.
Can we do a better job adopting EMRs in Canada? Without a doubt. Do we need to spend the equivalent of $20 Billion US to get there? I don't think so.
We have to be strategic, we have to create a value proposition for physicians that is a no-brainer, we have to ensure that information is able to flow EMR-to-EMR and between EMRs and the other third parties and we have to do this at the national level so that we do not strangle our EMR vendors who are already challenged to support multiple versions of their software in different provinces.
We have great EMR companies in Canada - no less innovative than anywhere else in the world, however they have little time and resources to innovate as they expend a good part of their energy achieving and maintaining conformance across multiple provinces. With the right support and facilitation, Canada could even become a net exporter of EMR technology as the developing world embraces EMRs.
To review the commonwealth fund survey data, click here.
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