Zoom Logo

Choosing Wisely Talks | Using Electronic Medical Records to Choose Wisely: Push, Pull, Nudge - Shared screen with speaker view
Jaana Ranchithan
Jaana Ranchithan
Please feel free to enter your questions or comments in the Chat.
John Coppola
Given that it appears that practices that don’t use CWC recommendations well also don’t seem to use the EMR functionality effectively how does one get value where it may be most needed
Jason Vanstone
One thing I often see is a lack of data and ability to implement nudges due to physicians not using their EMR to its full potential. Any advice on how to promote more training among clinics so they can become more familiar with their EMR and actually make full use of the technology?
Alex Singer
Really interesting presentation - my question relates to one of the key barriers to implementing nudges in the EMR - all of the EMRs that I am aware of in Canada operate as "electronic paper records" and don't process req's and rx's as data but rather paper/fax. Are there any system level initiatives that could be leveraged to demonstrate the potential of an actual digitized health record?
wendy levinson
we will get to all the questions shortly
Guylène Thériault, Dr.
Can we make sure we don’t simply tick boxes but for example decisionâid tools are provided for shared decision making (ex: mammograohys screening)
Charles Bruntz
There is also the issue of the lack of interoperability between EMR and lack of access to the right data which I don't see being fixed without patients having ownership of their won records through blockchain. web 3.0 is not going away.
Guylène Thériault, Dr.
One other issue is access to data for Qi. Shouldn’t we ask for it to be easier?
Andrea Macyk-Davey
Dr. Curran, I want to hug you for that - I'm a lab physician who tears her hair out routinely with unnecessary repeat orders :)
Alex Singer
Mike, the issue with TSH isn't just from NL, it's actually international... https://pubmed.ncbi.nlm.nih.gov/33733562/
Alex Singer
Darren, back to my question, is the problem the EMRs or is the problem the lack of connectivity/digitization of the rest of the system
Andrea Macyk-Davey
I'm a laboratory physician in Alberta. Several years ago we were repeatedly told, "when we get to an electronic medical record, we'll have CPOE and that'll solve all our problems with unnecessary testing and lack of provided clinical history." I didn't believe it then, and we are doing our EHR rollout across the entire province now, and guess what, I still get no history with the specimens sent to my laboratory. I've pointed out to AMA/CMA that ordering behaviors won't change just because we moved from one type of requisition to another. Is this something that is being discussed where you are, because I keep getting the feeling it isn't!
Brian Holroyd
There needs to be much greater market pressure to push EHR vendors toward developing electronic tools that support efficient clinician workflow and to ensure their EHRs facilitate development of CDS tools to “make it easier to do the right thing”! “Bolt on” work arounds are destined to have minimal impact….
David Barber
Here is an example of an antibiotic feedback report that CWC developed with CPCSSN. Piloting now and then will be able monitor effectiveness!
Deborah Johnston
In Ontario the province announced money in the fall economic statement to link hospital EMR's to Long term Care EMR's - a made in Ontario solution called Harmony
Alex Singer
That's because we are filling out a piece of paper (typed and scanned) and you can't read our clinical notes, which you should be able to!
Guylène Thériault, Dr.
Often training is costly sadely
Charles Bruntz
Signing up to the digitization initiatives such as eReferrals, PrescribeIT, etc. Ask help from QI staff.
Alex Singer
Great point Darren! Yes INRs are easy to measure and CPCSSN has done this...https://www.cfp.ca/content/65/6/416/tab-e-letters
Darren Larsen
michael curran
I think with PHR projects increasing across the province we can really push cwc Canada to patients through that module
Jason Vanstone
Is the cost of training offset by the benefits patients receive in having a more complete record? More opportunity for improvement work and using data to drive better practice?
Jaana Ranchithan
Survey Link (English): https://www.surveymonkey.com/r/6B62NRHSurvey Link (French): https://fr.surveymonkey.com/r/6BZ6JBG
Jaana Ranchithan
If you have any questions following this presentation, please email us at info@choosingwiselycanada.org.
Jaana Ranchithan
Jaana Ranchithan
e-learning module: https://www.cfpc.ca/choosingwisely
Darren Larsen
Jason.. good question. For our office it was a definite YES.. and as the Clinic Lead and IT lead… paid off again and again
Stewart Gray
Thank you Darren!