NEW BRUNSWICK
EMR PROGRAM
WORD FROM THE
PRESIDENT
For five years, the New Brunswick Medical Society worked to create an electronic medical record program. In partnership with the federal and provincial
governments, the moment has finally arrived.
The New Brunswick Provincial EMR is now up and running in Fredericton, Oromocto, Saint John, Moncton, Woodstock, Caraquet, Nackawic, Miramichi, and Perth-Andover. We have over 150 family physicians who have signed up and almost a hundred specialists in cardiology,
dermatology, endocrinology, otolaryngology, general surgery, internal medicine, nephrology, neurology, obstetrics and gynaecology, paediatrics, physiatry, respirology,
rheumatology, and urology. It's up and running for specialists and family doctors, in french and english, in fee-for-service and salaried environments. For a province with less than a thousand physicians who are even eligible for the EMR, this is quite a
response in the first year of the program. In fact, the year isn’t over – there are still hundreds more physicians who have expressed interest and need to make their decision soon.
At current levels, well over 300,000 New Brunswickers will have their health information available on the provincial EMR. EMRs will save millions of precious health care dollars – and even more importantly, EMRs will improve patient care.
Lynn Hansen, MD FRCPC
President, New Brunswick Medical Society
of physician recruiters said an EMR is an “important or essential factor” for most residents when they decide to tour or visit a practice.” (CASPR 2013)
95%
• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •BACKGROUND
Electronic Medical Records are computerised tools intended to help care providers share relevant patient information safely and securely. They help ensure patient information is up-to-date and that all patient information – lab results, referrals, medical histories, and more – are stored in one place. They help doctors apply their skills more effectively, lower the paperwork that medical office assistants wade through, and help with access to care for patients as productivity improves.
The New Brunswick Medical Society announced a partnership with government in August 2012 that created a program to do two things: get EMRs in doctors’ offices, and connect with other provincial health information systems. The NBMS created a company, as has happened in
most other provinces in Canada, to lead the charge in these areas. It is led by doctors and is called Velante.
After a lengthy, fully-transparent procurement process, doctors and information technology experts together chose an EMR called Intrahealth to use in New Brunswick. After months of complex integration work, ensuring the system was bilingual and contained information relevant to New Brunswick, the first doctors started using the program in November 2013. Today, doctors are implementing the Velante Intrahealth program at a rate of 10-20 physicians a month.
PHYSICIAN
QUOTES
With an EMR, Dr Jean
LeBlanc from Caraquet
is able to see more
patients in a day.
“So many things that were time-consuming are now easier. For medication renewals, we had to write everything down. Now, once prescriptions are in the system, it’s very easy – click and print. You save a lot of time doing these little things. It’s a lot better.”
PHYSICIAN
QUOTES
Dr Tom Barry knows why
he’s getting an EMR late
in his career.
“I’m getting EMR because it’s the future. Either I’m going to quit practice now or I’m going to stay current, and I’m getting it. It’s fair to my patients because having one is a best practice, and someday I would like to get another doctor to come into my practice. I won’t be able to attract them without the EMR.”
63%
• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •of Canadian doctors “feel that the quality of patient care throughout the healthcare system has improved due to the use of EMR”. (Accenture, 2013)
Dr Naomi White is a family doctor in Oromocto, and
has noticed some key differences already with her
EMR.
“The instant access to the Electronic Health Record has made a big difference,” she said. Before, the paper chart system was organised chronologically. “When a patient said, ‘when was my last ultrasound?’ I was rooting through a stack of paper. Now it’s a lot more timely.”
93%
• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •of physicians in Alberta report that access to a summarized patient history means that patients spend less time repeating the same information to care providers (Alberta POSP Benefits Survey, 2012).
Dr Ben Hoyt is an ENT surgeon in Fredericton, and
was one of the 21 physicians who participated in the
selection process for the EMR. He signed up right
away.
“I’m at an advantage in that I was part of the selection committee and I’ve seen the EMR displayed right next to its competitors,” he explains. “I’m confident it’s the best solution available to us.”
Dr Roxanne MacKnight
is part of a team of
physicians in Miramichi.
“The EMR is certainly something we felt we needed to have to help our team work well. A lot of the goals of collaborative care – teamwork, flow of information, data collection – are
accomplished much easier with an EMR. In fact, it’s next to
impossible for us to do those things in any kind of efficient manner on paper.”
Dr Mahamadou Chaibou
is a paediatrician in
Moncton.
“It’s really a question of
accessibility to information. It is not easy to track down the required information to deliver quality patient care now in the paper system. With the EMR, everything will be right there, in one place. That alone will improve the quality of patient care that can be given by a large margin.”
ENROLMENT
INFORMATION
Who’s enrolled in the first year?
•36%
of eligible doctors in Fredericton •35%
of eligible doctors in Miramichi •23%
of eligible doctors in Moncton •22%
of eligible doctors in Saint JohnEnrolled doctors by
language
•73%
anglophone •27%
francophone •71%
of eligible endocrinologists •57%
of eligible paediatricians •50%
of eligible rheumatologists •35%
of eligible otolaryngologists •27%
of eligible neurologists •25%
of eligible family doctors •18%
of eligible gastroenterologists10%
Have a different EMR15%
Unknown24%
Enrolled/Live21%
Interested17%
Near Retirement13%
Not interestedEligible Physicians in New
Brunswick: 956
INTEGRATION
TIMELINE
Billing through Medicare.
Punch-through viewer to the province’s One Patient, One Record system from the EMR. Results available through the viewer include: Labs (chemistry, hematology, coagulation, challenge, anatomical pathology, cytopathology, and serology); diagnostic imaging (Reports); Encounters for inpatients and emergency room visits. Integration with demographic information through the provincial Client Registry.
More information in the viewer like cardiac catheterization and echocardiography, microbiology, molecular genetics, and transfusion medicine.
Moving lab data directly into the EMR, consult reports.
Integration with the Drug Information System (to be completed by the Department of Health in 2014-15). eReferral between users of Velante (controlled by Velante).
WHAT’S NEXT?
Over the next year, we will be moving a number of physicians and patients onto the provincial electronic medical record. We also would like to help providers work more efficiently together, so we plan to pursue agreements with the province on moving
Community Health Centres onto the Velante system.
Family Health Teams will also appear around the province and will need the provincial EMR, as do nurse practitioners working with doctors across the province today.
Finally, we’ll be working on a program to help early adopters – physicians who chose another EMR in the past – move on to the provincial system.
So much integration work remains to be done and the Medical Society wants to achieve greater integration hand-in-hand with the Province as they review and update their own health information technology.
