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What is Best for the Patient?

First published in Healthcare Information and Communications Canada:

A little over two years ago I took a left hand turn in my career path when I joined a regional EHR program as their Project Manager. Having written and spoken about interoperability and digital health solutions, I wanted to “put my money where my mouth is” so to speak and devote my time and talent to realizing the vision that I so often advocated.

I am fortunate to be working with a dedicated group of people committed to making a difference for patients in Ontario. Whenever we are faced with a di cult situation or are choosing from what appear to be similar options, at least one member of the team always asks, “What is best for the patient?”

My wife is one of these patients.

Diagnosed about ten years ago with a chronic illness, Tracy recently embarked on a new journey to speak for those whose voices are not quite loud enough and to provide perspective to those who want to listen.

A talented writer, Tracy uses her blog to share her own experiences engaging the health system, offers insights on the view from the other end of the stethoscope (or, of interest to readers of this magazine, healthcare apps) and, from time to time, advocates for change.

Tracy has discovered, to her dismay, what others such as the McMaster Health Forum have observed: the patient is often not at the centre of care.

In a brief prepared to stimulate discussions by a citizen panel on strengthening care for people with chronic diseases in Ontario, the McMaster Health Forum notes:

“Health professionals don’t always work together to get people the care they need, despite this being important for improving patients’ outcomes.”

A briefing note prepared by the Institute for Clinical Evaluative Sciences (ICES) on variations in quality indicators across Ontario physician networks offers a similar perspective:

“Patients living with chronic disease have the best outcomes when they are treated throughout the progression of their disease, in a coordinated manner that engages all medical professionals involved in their care. However, in Ontario there has been a history of fragmentation of chronic disease care, leading to serious gaps.”

According to the McMaster Health Forum brief, access to their own health information can “help patients set goals for their health, manage their own care and better engage in decisions about their care with their providers.”

Unfortunately, the same brief also notes that there is “a lack of electronic health records that put all of a patient’s health information in one place” and, as a result, “patients also do not typically have access to their health information.”

As Internet pioneers and founding executives of several Internet start-ups (different companies before we met), Tracy and I both witnessed the creativity and innovation that was unleashed when entrepreneurs were given access to a platform (in this case, the Internet) on which to construct new applications and services

The banks recognize this same potential and are creating similar environments

to encourage innovation in financial services. Scotia Bank, for example, created the Digital Factory which they describe as a “hub for creation and incubation of new and partner-led ideas to deliver game-changing solutions for Scotiabank customers.”

Can the health system take a similar approach to encourage the development of applications and services to manage their own care and more e ectively engage their healthcare providers? Mohawk College and eHealth Ontario think so. They have partnered to create the eHealth Ontario Innovation Lab, an online, open provincial EHR platform that allows testing of digital health solutions in a virtual EHR environment.

Operationally and physically isolated from eHealth Ontario’s production environments, the Innovation Lab’s Virtual Lab Environment contains copies of eHealth Ontario EHR test environment assets and a fabricated, integrated EHR data set. These assets currently include the Ontario provincial client registry and the Ontario Lab Information System (OLIS), with the Ontario provider registry soon to be available.

Whether the eHealth Ontario Innovation Lab generates new and useful digital health solutions remains to be seen. At the very least, it provides developers with access to the provincial systems in which patient information is stored, information that patients can use to manage their own care and more effectively engage healthcare providers.

I recently shared Tracy’s blog with a friend of mine. He commented, with a wry smile, that we must have very interesting dinnertime conversations. We do. She inspires me each and every day to do what is best for the patient.

You can at themadnessmaven.ca