To speed implementation of an electronic health record (EHR) system in Canada, e-health policy must be closely aligned with the major strategic direction of health care reform.
EHR must take a bottom-up approach to engage people from clinicians to administrators, states a study published in CMAJ (Canadian Medical Association Journal).
Canada Health Infoway has invested almost $1.6 billion towards 280 health information technology projects in the last decade, but Canada is far behind other Western countries in adopting electronic health records. "As of 2009, only 36% of Canadian physicians were using an electronic health record, as compared with more than 90% of physicians in Australia, the United Kingdom, New Zealand and the Netherlands," writes Dr. Robyn Tamblyn, Department of Medicine, McGill University and Research Institute of the McGill University Health Centre, with coauthors.
The study included structured interviews with 29 key stakeholders representing national and provincial organizations responsible for policy-setting and strategic planning for health information technology.
Successes of the Canada Health Infoway initiative include national standards, funding linked to performance benchmarks, patient registries and digital imaging. However, significant barriers to adoption were identified such as the lack of a national policy body, inadequate involvement of clinicians, disconnect between the business case and the needs of clinicians and the health care system, inflexibility and focus on national rather than regional collaboration to support clinical adoption.
"A key finding that emerged was the absence of an e-health policy to align the investment in information technology with the priorities of the health care system and of health care providers in order to accelerate adoption and achieve early return on the investment," write the authors.
"Canada needs to establish an e-health policy to guide the implementation of health information technologies to address the major strategic priorities of health care reform — improvements in patient safety, management of chronic diseases and sustainability of the health care system — and to promote the adoption of electronic health records and exchange of clinical data to address these challenges," conclude the authors. They recommend strong clinical and administrative leadership and the creation of a chief provincial clinical information office to help adoption.