The Ontario government is currently promoting the increased use of digital resources to manage patient bookings as well as medical records. According to Ontario Health Minister Christine Elliott, the province is looking to allow patients to both schedule and meet with physicians online, as well as review their medical and health records online by 2021-22.
The plan would enable patients to book appointments online as well as engage in remote visitations with doctors when physical proximity is not required for an appointment, through the use of video-chat software. Additionally, the increased use of electronic patient records would better facilitate the sharing of resources among treating physicians, saving patients from having to retell their stories multiple times to different health care providers.
News of this announcement came out in November of 2019, however just yesterday, a study was released showing that Canada currently lags in the area of access to digital health records. A recent survey of over 13,000 physicians in more than ten countries including the United Kingdom, France, the United States and Norway, showed that while Canadian doctors are among those seeing the most patients per week (an average of 110), our use of electronic health records is lacking.
In Canada, currently 86 percent of doctors manage patient records electronically, up from 73 percent just four years earlier. However, this is less than the average of 93 percent among the other countries in the survey. In addition, less than half of the Canadian doctors surveyed use electronic records to manage quality of care decisions, and only 26 percent sent out automatic reminders to patients regarding annual check-ups or flu shots. Among other countries surveyed, the average was 51%.
A small percentage (23% vs. an average of 65% in other countries) of doctors allow patients to ask questions via email, which can save a patient from making a trip to the doctor for minor inquiries. This also saves doctors time when waiting rooms are currently filled to capacity and However, this may be owing to the fact that some jurisdictions do not have billing codes that doctors can use for electronic communications with patients. In addition, only 10% of Canadian patients can request prescription renewals online compared with over 50% in other countries.
Shifting focus back to the provincial announcement in November, it appears that some of the goals will help to improve online access for patients in Ontario if the goals are carried out as planned. Under the plan, there are strategies to allow patients to book appointments with their health care providers online, as well as access and review their secure medical records.
Security of these records will surely be a big focus of the initiative, particularly in light of the recent hacking of Life Labs in October, which saw the records of approximately 15 million Canadians compromised. Life Labs is the largest provider of diagnostic services in Canada, and routinely completes and stores lab work and results for millions of Canadian patients. The hackers were able to gain access to a host of information including lab work results, health card numbers and personally-identifying information of nearly 40% of the Canadian population. This breach of patient privacy, as well as several other recent instances of security issues affecting digital patient records throughout the country, demonstrates a clear need for better protection of digital information.
The plan announced in November by the Ontario government indicates that the Personal Health Information Protection Act will be strengthened in preparation for the expansion of the digitization of health information, but these changes remain to be seen. While increased electronic access could certainly benefit both patients and physicians, data protection is top of mind for everyone and must be prioritized.
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The Chief Medical Officer of Health for Ontario has issued an updated Directive #2 (dated May 26, 2020) for Regulated Health Professionals in the province.
Pursuant to the updated Directive #2, all deferred non-essential and elective services by health care providers may be gradually restarted – subject to the rest of the requirements set out in the Directive.
The updated Directive #2 does not provide particularly detailed guidance to health professionals on how to proceed, likely because it applies to such a broad spectrum of health care and health professionals. It does, however, provide some principles to assist health care providers in making decisions as we enter this transitional period.
In addition to the mask and hand sanitizer shortages, Ontario’s response to COVID-19 highlights the need for more frontline health care workers. Each regulated health profession’s college responded differently, and we have discussed some of those changes in other posts to keep you apprised.
Today, we focus on the College of Physicians and Surgeons of Ontario (CPSO), who set out to increase the number of available and licenced physicians out on the frontlines through certificates of registration that authorize supervised practice of short duration. The temporary licences authorize practice for 30 days.
Undoubtedly, COVID-19 has affected how health professionals practice. Pharmacists across the country are not only experiencing changes in how they practice (for example, accepting emailed prescriptions, where appropriate) but the scope of their practice as well. The latter change is not permanent, although the disruptions in practice may be felt long after the COVID-19 emergency subsides.
On March 19, 2020, Health Canada issued a short-term section 56(1) exemption under the Controlled Drugs and Substances Act (CDSA) that would authorize pharmacists to prescribe, sell, or provide controlled substances in limited circumstances, or transfer prescriptions for controlled substances (the CDSA Exemption).