Why aren’t Canadian family doctors embracing e-communication?
In the last decade, technology has revolutionized the way we live and work. We email and text more often than we phone or fax. We share photos with friends using Facebook and debate with colleagues in real-time using Twitter. We pay bills, book plane tickets, and buy clothes on-line. We can effortlessly post opinionated blogs in cyberspace for all to read.
But, if you have a question for your family doctor, chances are you still have to pick up the phone – perhaps wait on hold—and then negotiate with a receptionist a convenient time to come in – likely during the middle of a work day – to speak in person with your physician.
If your family doctor has a question about your care, they send a fax to a specialist requesting an appointment for you. Sometime after you see the specialist – perhaps days or maybe months – your family doctor gets a fax or letter in the mail with “an answer”.
iTunes can tell you which songs you might want to buy based on your purchase history. In contrast, most of our electronic medical records aren’t sophisticated enough to alert physicians when a patient is overdue for a test or would benefit from a certain medication.
It seems that we’ve become complacent and just accepted that this is the way it is in healthcare. Change is too hard. Ensuring privacy is too important. We can still deliver high quality care, right?
But, a new Commonwealth Fund study finds that Canada lags far behind other countries when it comes to using information technology in primary care. In 2009, Canada was dead last among ten other developed countries when it came to the percentage of family doctors using electronic medical records. Three years later, Canada is still dead last among these countries.
Only 56% of family doctors in Canada use electronic medical records but even worse, only 10% are able to use them in a sophisticated way – to guide clinical decisions or generate summary information of their practice. In contrast, 98% of primary care doctors in the UK use electronic medical records and 68% of them use them in a sophisticated way. Not surprisingly, only a minority of Canadian practices routinely receive and review data on the quality of their patient care.
Canada also ranks last when it comes to exchanging patient information electronically between doctor’s offices. And we are least likely to allow patients to request appointments online, ask for prescriptions refills online, or email their practitioner with a medical question.
Perhaps it’s not a coincidence that Canada is at or near the bottom of the pile when it comes to providing after-hours care or same or next day appointments. Embracing new technologies would no doubt free up physicians’ time to see the patients who need to be seen.
The good news is that 82% of primary care physicians in Canada were satisfied or very satisfied with practicing medicine. But how satisfied are our patients?
Perhaps we are old and set in our ways. When a group of first year family medicine trainees at the University of Toronto were asked about ideas to improve the health system, near the top of their list was a desire to communicate with their patients using technology. Not just email, but twitter and text messaging.
We need to stop making excuses for not using communication technologies in healthcare that are commonplace in every other aspect of our life. And perhaps, we need to hand over this file to our new physician graduates, who are more in touch with our patients and the changing ways of the world.
Tara Kiran is a family physician and researcher at St. Michael’s Hospital. She also works part-time as a Primary Care Advisor for the Toronto Central Local Health Integration Network. Follow Tara on Twitter @tara_kiran.