A recent report titled “Valuing Time Saved: Assessing the Impact of Patient Time Saved from the Adoption of Consumer Health Solutions” was commissioned by Canada Health Infoway and conducted by the Conference Board of Canada. It draws from a survey of approximately 3,200 Canadian adults conducted in April 2012. Respondents were asked about their “recent health care experiences, time spent at appointments, and how often they felt that they could have avoided in-person visits or telephone calls had they been able to connect with health care providers and access their own health information online”. The study’s authors examined only the “potential economic impact of the time saved by patients from the adoption of consumer health solutions in the Canadian health care system”.
The projected benefits are significant. According to the authors, “secure access to online health information, tools could have avoided 47 million in-person medical appointments and could have gained nearly 70 million hours of time in 2011 if they been able to consult with their health care providers, access test results (lab tests, MRIs, and X-rays) and request prescription renewals electronically.” These are big numbers and represent some very bold projections. Even under ideal circumstances, the likelihood that online access could provide this degree of improvement in efficiency and time saving is very small. However, it is an interesting academic exercise.
So, how are we really doing with respect to secure patient access to online health information and tools? The Commonwealth Fund 2012 International Health Policy Survey of Primary Care Physicians (published November 15, 2012) provides some interesting insights. In this 10-country survey, Canada performs worst with respect to patient access to online appointment requests or referrals, requests for prescription refills, and email communication with their physician. (Click on image below to see the results.) Australia was barely ahead of Canada with twice the access to physicians via email and Sweden was the clear leader across all three areas. These questions are not exactly the same as those used in the Conference Board of Canada survey; however, they are a reasonably close proxy. Canada is way behind in terms of providing patients access to their health information in comparison to a number of other countries.
It is also worthwhile noting that in Sweden, 88% of physicians surveyed use an EMR in their practice, vs. 56% in Canada.
Part of the reason for the lack of patient access is the stage of adoption of EMR in Canada. Many provinces are still focused on encouraging adoption. We have not yet reached the optimization phase during which many of these capabilities will be assigned a higher priority.
Clearly, we have a long way to go in order for Canadian citizens to gain 70 million hours of time per year. We need widespread adoption of EMRs and related technologies such that patient access becomes a logical extension of providing care. At the moment, all that we have are “pipe dreams”.