Reported in Technology for Doctors, May 26, 2011, by Rosie Lombardi, OntarioMD has developed data portability requirements for transfer of information between different EMR systems. Eleven EMR vendors in Ontario are certified in Ontario under the version 3 specifications.
However, there are some challenges to transferring data between EMRs that have nothing to do with the technical specifications.
One issue is that doctors often don’t use fields for the purposes they were intended. “They might put in different things in a field designated for lab tests as a workaround. Doctors use EMRs differently. We’ve run into weird problems, like someone cut and paste text from the Web into a comments field, which confuses the system.”
Another issue is that most EMR systems have been set up for text data rather than coded data based on standardized medical terminology such as SNOMED. “We often run into problems when doctors migrate from older EMR versions built on previous specs. The edits on fields were not strong in these legacy systems if doctors didn’t put in the data correctly.”
These are not simple issues to resolve; however, data portability is a critical issue that has to be resolved.
It is also not just about transfer of information between EMR systems for the purposes of migrating from one EMR to another. Patients are mobile and there is always some churn and movement between different practices. Unless there is a mechanism to transfer an electronic patient record from one practice to another, the only options are to print a copy of the electronic chart, which is then sent to the new practice to be scanned or manually entered into the EMR, or to export the record as a .pdf document. The UK dealt with the transfer issue by creating GP2GP, however this is dependent on data being stored in the same standard format.
Earlier this week I had an opportunity to spend some time with a colleague from Denmark. Transfer of clinical information is completely electronic in Denmark, with the ability to send referrals and consultation reports electronically and E-Prescribe directly to the pharmacy. In order to test the structure of the data that is transferred from one EMR system to another, the Danes have set up a test whereby the data is transferred consectively between every certified EMR to confirm that when it reaches the last EMR system, the data is still readable.
What are your thoughts on the importance of data portability between EMR systems? How should we deal with data portability in Canada?
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