A Look at Electronic Health Records

Information Technology:
Electronic Health Records

An Electronic Health Record (EHR) is an individual health record that is accessible online from many separate, interoperable automated systems within an electronic network. (Health Canada)

An EHR is an electronic health record in digital format. Individual patient records are maintained in digital format, enabling their coordinated storage and retrieval using computers, and accessed over networks.

EHR technology encompasses a wide range of purposes, from administrative through to health care delivery. To truly benefit the health care system this technology must be interoperable, allowing different systems and technologies to work together, across jurisdictions. This is an extremely exciting area of technology, and one that can have real and significant benefits for Canadians.

In Canada all levels of government and members of the private sector are working together to create a network of interoperable EHR’s that will link together individual doctors, clinics, hospitals, pharmacies, and patients. This network will provide greater access to the Canadian health care system, improve the quality and safety of patient care, and modernize the health care system, helping it become more efficient and cost-effective.

How it Works:

The Canada Health Infoway organization has created a national framework to approach the development of an interoperable EHR system, based on the EHRS Blueprint. The EHRS Blueprint is:

“a flexible business and technical design framework that allows solutions, components, and best practices developed in one jurisdiction to be reused or shared in another. It ensures that all EHR solutions can seamlessly and securely exchange patient health information.”

(Healthcare Information and Management Systems Society)

To improve interoperability the EHR Blueprint relies on coordinating standards for EHR communication, including national messaging standards. This means that health care workers can use a common messaging system to share information, even if they have used different applications to collect the data they are sharing.

  • Health care workers gather information directly from patients, including lab results and diagnostic images. This means that health care information is coming from different operational applications in a given jurisdiction.
  • This information is then copied and stored in jurisdictionally coordinated repositories, using a common messaging language.
  • Care givers can then use a computer to easily access and view complete, coordinated patient information.
    The final EHR is composed of many electronic health records, shared through a message-based, peer-to-peer network, and accessed online by medical practitioners across Canada.
  • Benefits of EHR Systems:

    Benefits of using a standardized EHR network include:

  • Complete, up-to-date, patient information that is accessible to all health care workers at all points of care.
  • Reduction in the duplication of services, such as lab tests, resulting in saved time and reduced costs.
  • Fewer prescription errors and negative drug interactions.
  • Allows patients greater access to their own medical records, and greater participation in their medical treatment.
  • Secure systems ensure patient privacy and confidentiality.
  • Improved billing accuracy.
  • Information Sources:

    Professional Associations

    Canada Health Infoway
    A not-for-profit organization formed in 2001, whose members include Canada’s 14 federal, provincial, and territorial Deputy health Ministers. Infoway is dedicated to creating a standardized, pan-Canadian EHR system. Their mission is to provide leadership for EHR implementation in Canada, in partnership with the provinces and territories.
    Contact: www.infoway-inforoute.ca

    Canadian Standards Association
    A not-for-profit association composed of representatives from government, industry, and consumer groups. It’s primary product is safety and performance standards. The CSA is working with Canada Health Infoway to create health information technology that supports interoperability and ensures security and confidentiality .
    Contact: www.engineers.ihs.com/news/2006/csa-infoway-health-it.htm

    BC Health Information Standards Council
    This council was created in June, 2006 to facilitate British Columbia’s contribution to the development and approval of EHR standards.
    Contact: www.sl.infoway-inforoute.ca/downloads/provincial_HICs_Update.pdf

    Health 2008: Extending the Reach
    An e-health conference to be held from May 4th to May7th, in Vancouver, British Columbia, at the Vancouver Convention and Exhibition Centre. The focus of this conference will be the interoperability showcase. The showcase will consist of different vendors demonstrating interoperable EHR systems, based on clinical scenarios. The conference will provide an excellent forum for seeing EHR systems in action.
    Contact: ehealthinfo@advance-group.com

    Publications and Websites

    Health Canada
    Health Canada is a federal department dedicated to maintaining and improving the health of Canadians. Health Canada has an excellent website that provides current and reliable information, research, and resources regarding the implementation of a national EHR network.
    Contact: www.hc-sc.gc.ca

    Vision 2015: Advancing Canada’s Next Generation of Health Care
    This paper is a Canada Health Infoway publication that outlines Infoway’s strategy for the next ten years of investment in EHR systems. This paper will act as a roadmap for “advancing Canada’s healthcare infostructure and forms the strategic framework to guide Infoway’s investments and priorities in the years ahead.”
    Contact: www.infowayinforoute.ca/en/pdf/Vision_2015_Advancing_Canadas_next_generation_of_healthcare,pdf

    Framework for an Electronic Health Record for British Columbians: Presented by the Health Chief Information Officer Council, January 2003
    A very informative and readable paper that outlines British Columbia’s framework for creating and implementing an EHR system. It also details British Columbia’s contributions to the national effort to develop an interoperable EHR system.
    Contact: www.himss.org/content/files/DrArnold20011207EISPresentationsWhitePaper.pdf

    Electronic Health Records: A Global Perspective
    A Healthcare Information and Management Systems Society publication, 2007.
    This paper provides an overview of global healthcare information technology. It also identifies four common threads that hinder EHR implementation across the globe (communication, standardization, funding, and interoperability) and offers possible solutions.
    Contact: www.himss.org/content/files/DrArnold20011207EISPresentationWhitePaper.pdf

    E-Health Knowledgeway
    E-health Knowledgeway is a Canada Health Infoway website that provides bilingual resources for all topics related to the implementation of a national EHR, including newsletters and discussion forums.
    Contact: infoway@infoway-inforoute.ca

    User Groups

    Health Care Providers
    EHR’s will benefit all types of medical professionals, from doctors and nurses, to lab technicians and administrators. All of these professionals will need to learn how to use the EHR.

    The implementation of an EHR will allow patients greater access to their own medical records. Patients will have accurate records available, even when their health care providers change. Depending on the EHR that is adopted patients may be able to access their records online.

    IT Professionals
    IT professionals are, of course, instrumental to the creation and maintenance of an EHR. They will be necessary for training, maintaining, updating, and supporting EHR usage by other user groups.