What I've found is that although my strategy is still focussed on e-Health systems (Electronic Medical Records (EMRs), Electronic Health Records (EHRs) and Personal Health Records (PHRs)), I'm definitely blazing a new trail.
For example, I distinctly remember when I first started, I was all gung ho to set-up my office in Queen's Park (the Legislative Assembly of Ontario) and help enact new legislation mandating an EMR system in every doctor's office in the Province within a couple of years.
I soon realized this would be counterproductive, since doctors are not Information Technology (IT) specialists -- sure, the various organizations such as OntarioMD would be assisting procedurally and financially to set things in motion, but when the implementation party is over and the doctors are left on their own to manage the various aspects of their systems, the shine could disappear pretty quickly in a busy practice!
This could result in the necessary processes for backups, security, and software updates for the EMR system being given a low priority -- not a good thing if you want to maintain patient data integrity and privacy.
A rather severe thunderstorm struck the Greater Toronto Area (GTA) last summer; it convinced me that the Application Service Provider (ASP) model should be the way to go (this is where the vendor hosts the application and the doctor accesses it using a browser -- see my August 2009 article for more details) -- at least the burden for data security would be offloaded -- or so I thought!
I was derailed again late last year following my attendance at a seminar on the "OSCAR" EMR system -- someone made a comment to the effect that handing over the management of patient data to vendors could be akin to putting a kid in a candy store and expecting them not to be interested in sampling the wares; in other words, you can't expect vendors to have access to such a huge database and not be interested in legally selling it for research and marketing purposes.
So basically, I was back to square one -- the EMR system was back in the doctor's office...
However, a couple of months ago, I had an epiphany; it struck me that I did not maintain an E-mail system, yet I'm able to read my business/personal mail on a daily basis -- I simply use a browser to log on to the hosting company's web site (e.g. Google Mail) and manage my mail effortlessly and reliably via a process known as Software as a Service (SaaS -- see my February 2010 post).
It begged the question: Why can't healthcare providers have similar functionality without losing control of their patient data/privacy? Why shouldn't it be possible for your doctor to enter the exam room with say, a tablet (an iPad is an example of what's in the marketplace), sit next to you, tap the device a couple of times to access your healthcare record and start having a meaningful discussion, all without having to worry about the activity occurring behind the scenes?
This is where I'm at today -- my passion is now geared towards removing the management aspect of IT, but adding the functionality to enhance the provider/patient relationship.
In other words, we need to remove the computer hardware and it's associated software components from the front line of patient care (e.g. the exam room) and replace it with a non-intrusive mobile device that uses a simple web browser interface as an enabler to superb patient care.
The technology described above is available, so why are we still encouraging healthcare providers to become IT experts?
Well, a comment was added to my last article that I found succinct -- it was suggested that what we really need is political leadership!
With the size of the debt/deficit these days, I think it's only a matter of time.
We got off lightly this fiscal year (at least from a healthcare perspective) because elections are looming on the horizon, but watch out, 2012 may prove to be really interesting!.
Ernest A. James
President/CEO
Regal Informatics Inc.
