While nothing is more private for most individuals than their health, many Canadians don’t realize they legally own their personal health records — or how they would obtain them. As we look to evolve our health care system, however, putting this data into patients’ own hands, rather than locking it away in government-run repositories, is essential to improving outcomes and efficiency.
The power of such a patient-centric approach is already being demonstrated by early adopters. Kaiser Permanente, a managed care group in the United States, has found that patients who receive medical results prior to appointments with their doctors are more than three times more likely to feel calm and satisfied than confused or worried. In Nova Scotia, 98 per cent of the 6,000 patients who participated in a pilot for MyHealthNS, a secure online tool for accessing health records, said they wanted to continue getting results online; 85 per cent said it made a positive difference in their health management. Physicians also said patients using MyHealthNS were better informed and more frequently came to them with educated questions to make the most of their appointments.
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As evidence mounts, many Canadian hospitals and health care providers are developing information portals to help patients access details like test results from the comfort of home. These portals are a good start, but they are often limited by implementation only at the hospital or clinic level. A patient who receives care at three facilities might require three separate logins and has to switch between different portals to get a full picture of their health. The strict regulations on who can access electronic medical records (EMRs) also means that not all of these portals are connected to a patient’s central heath file. Notes from a physiotherapist may never be seen by a patient’s primary care provider and vice versa, potentially leading to contradictory or counterproductive advice or wasteful, duplicate tests.
The solution is not to give every health care provider unhindered access to EMRs. Where this has been attempted, it has resulted in convoluted vetting processes, which have deterred most physicians from signing up at all. Instead, patients should be able to control who can access their health data using secure cloud-based tools.
This is where innovative technology startups excel. As impartial third parties, they can create software that functions across specialties, facilities and borders in a way that helps both patients and health providers. Historically, regulations have stood in the way of access to government-run health data repositories. Private EMR vendors have also created obstacles. But in recent years, progress has occurred at an accelerating pace. Dot Health, for example, a real-time platform for personal health records is opening up our complex web of government and hospital health repositories to retrieve, encrypt and store health information in a readily accessible and shareable format.
“The future of health care is global, continuous, and longitudinal. The only way we make this sustainable is by letting individuals access and control their own health information,” says Huda Idrees, founder and CEO of Dot Health.
Beyond the benefits for patients, tech innovators have the potential to also make Canada’s EMR systems more effective for doctors and other health care providers by better organizing existing information. When services like eHealth Ontario began, their mandate was to consolidate existing medical records to ensure patient data was accessible to physicians across all medical facilities. While they have had limited success, cumbersome validation processes and poorly organized interfaces have made it cripplingly difficult for physicians to gain access to and find critical and relevant information amidst a sea of outdated records. As innovators like Dot Health interface with a growing number of existing EMRs, not only are they helping patients gain access to their own data, they are building solutions that enable health care providers to access the right information at the right time.
With so many potential benefits, it’s not surprising that other countries have moved full steam ahead toward a model of open and shared medical records. Sweden and Finland already allow patients full access to their medical records, and several other countries have implemented systems to allow patients more comprehensive access to test results. In studies like those conducted by the Commonwealth Fund, a globally respected health care think tank, these innovative countries routinely achieve better health outcomes at less cost than Canada.
Putting Canadians’ health information into the hands of patients rather than institutions and government will open the door to new, innovative industries and make it possible to provide more effective, transparent and sustainable care.
As Benjamin Franklin once wrote, “An investment in knowledge always pays the best interest.” When it comes to the knowledge hidden in our health records, Franklin’s words have never rung more true.
Dr. Brett Belchetz is a practicing emergency room physician in Toronto. He is also the CEO and co-founder at Maple (getmaple.ca), a telemedicine provider connecting Canadian patients and doctors for online medical visits and a senior fellow at the Fraser Institute.