The 2010 National Physician Survey (NPS) offers some hard data on adoption and use of electronic medical records by Canadian physicians. In response to a question regarding “Thinking about your MAIN patient care setting, which of these describes your record keeping system?”, respondents indicated that:
- 16.1% use electronic records
- 34.1% use combination of paper and electronic charts
- 37.6% use paper charts only
- 12.2% either did not respond or indicated that the question was not applicable to them
So, it would appear that slightly more than 50% of Canadian physicians use some form of electronic chart. Interestingly, of these physicians, roughly two thirds still use a mix of electronic and paper charts.
The NPS does not provide detailed data on use of EMRs in physician offices. The closest statistic in this regard is the answer to the question “In which setting do you use electronic records most often”, Respondents indicated:
- 43.1% in “Office/community clinic/community health centre”
- 38.8% in “Hospital/AHSC/Emergency Department”
- 1.5% in “University/faculty of medicine/research unit”
- 0.4% in “Nursing home/home for aged”
- 1.5% in “Other” settings
- 0.9% felt that the question was not applicable
- 13.8% did not respond
One of my best sources of information is Twitter. The people that I follow are well read and are constantly bringing interesting articles and documents to my attention. As I skimmed my Twitter feed this morning, I couldn’t help but notice several Tweets about a recent Canadian Business magazine article entitled “The worst-run industry in Canada: Health care”. The title was so provocative that I immediately clicked on the link to read the article.
To say that I was disappointed in the article is an understatement. While it raises some very good points, the article did not once put any quantified statistics on the table to prove the contention that Canadian healthcare is the worst run industry in Canada. By what measure? Steadily increasing healthcare costs, while worrisome, are not a sign that they system is poorly run. I expected better analysis from a leading Canadian business magazine.
One point that I do believe merits further discussion and debate is the lack of information with which to analyze health system performance. The Auditor General raised similar concerns in her presentation to the Canadian Medical Association’s General Council this past August. In a news conference following her presentation, Sheila Fraser stated that “We don’t know if we’re getting good value for money”. If the Auditor General can’t make such an assessment, how can Canadian Business magazine make the assertion that Canadian healthcare is poorly run?
I was also concerned by Senator Kirby’s assertion that “Health care is a service business pure and simple.” While there is a certain logical appeal to this statement, I contend that the implications of this statement are profound and should be carefully considered. How do we value extra years of human life, for example? Do we permit those with extra dollars to spend to receive a different level of service like we do in many other industries? I don’t pretend to have the answers but I think that the debate regarding the challenges facing our healthcare system are much more profound than articulated in the Canadian Business article. I am concerned that sensationalism trumped rationale debate in this article.