Call me a cynic, but earlier today when I reviewed the Canada Health Infoway “Knowing is Better” toolkit and associated materials to encourage clinicians to adopt technology in their practices, I had the distinct feeling that the objective was more about catering to the needs of Infoway than helping physicians improve patient care.
According to a November 22 article in CMAJ “Clinician, upgrade thyself”, Dr. Karim Keshavjee, an Ontario family physician, CEO of InfoClin and an advisor to CanadianEMR argued that “there’s no legitimate explanation for the duration of time that it has taken Infoway to focus its attention on clinical use of EMRs, and that a clinical education campaign is hardly an indicator that Infoway has abandoned its fondness for ‘big projects’ in favour of measures that integrate EMRs with the electronic systems of hospitals, labs, pharmacies and other elements of the health system.”
The Knowing is Better than not Knowing toolkit is described as being designed for “clinical champions” and comprises of a downloadable PDF orientation guide with links to a number of videos, a PowerPoint template containing user modifiable content that can be presented to an audience, and a list of FAQs. There is a kindergarten-level animated video described as providing “an overview of the Canada-wide initiative and progress for a network of interconnected point-of-care and electronic health record systems”. Watching the video, I cannot imagine why my clinician counterparts would be interested in presenting this content to a group of colleagues. In fact, in my mind’s eye I can see the quizzical looks on the audiences’ faces as they view this vidoe. And, what are “Point-of-Care systems”? This terminology has no relevance to physicians or allied health professionals. Call them EMRs.
Clicking on the TImely Access to Information video through the orientation guide generates the following message:
Note: This document was released on September 20, 2012.
Upon reviewing the PowerPoint deck, the entire presentation is geared towards selling the Infoway Kool-Aid. A word of advice: physicians do not care about progress with implementation of provincial data repositories across the country!
Over 60% of doctors already have EMRs and are struggling to optimize their systems and use them effectively. This is where the energy should be directed. For example, how does one manage medications most effectively through an EMR? Is there any liability for physicians if they view information through a provincial EHR and do not place a note in their EMR? What are the best practices for managing shared clinical information in a family care network? These are the types of questions for which help and guidance is needed.
One bright light: there are a couple of good videos, particularly interviews with clinicians who discuss how EMRs are helping deliver better care.
Perhaps the Knowing is Better than not Knowing campaign would have been relevant in 2003 before most of the EMR work in Canada began.
However, based upon what is presented now, I think that Not Knowing is better!