Information exchange among physicians caring for the same patient in the community

In the November 4th issue, van Walraven et al.(1) present a timely article about the information gaps which impede continuity of care for Canadian patients. Both the article and the accompanying commentary(2) discuss the potential of electronic health records (EHRs) for facilitating provider-to-provider information sharing. This possibility is becoming a reality as the Canada Health Infoway works towards establishing interoperable EHRs for 50% of Canadians by 2010.(3)

The utilization of EHRs may also enhance provider-to-patient communication.(4) By making EHRs available to patients, either electronically or by print-out, this technology can improve patients’ understanding of their condition or treatment and can enrich the patient self-management approach that is becoming popular in contemporary primary care.(5) However, adoption of these methods requires a philosophical shift in the way that patient information is conceptualized. Traditionally, patient information has been under the ownership of the provider; sharing health records with the patient transfers much of this ownership into the hands of the patient. Although the Supreme Court ruled that patients have the right to access their full medical record,(6) a recent survey found that only 17.9% of Canadian hospital CEOs thought their staff would support partial patient access to EHRs, and only 3.6% thought that their staff would support full patient access to EHRs.(4)

Patient demand for self-care options necessitates a reconstruction of patient information management and use. The ageing of the population and the rise in chronic conditions have brought about an increase in the number of providers involved in a patient’s care.(3) Emerging technologies such as patient-accessible EHRs should be considered as a means of facilitating the transmission of information not only between providers but also between provider and patient in order to address gaps in the continuity of care.

References

1. Van Walraven C, Taljaard M, Bell CM, Etchells E, Zarnke K, Stiell IG et al. Information exchange among physicians caring for the same patient in the community. Can Med Assoc J 2008;179(10):1013-1018.

2. Reid RJ, Wagner EH. Strengthening primary care with better transfer of information. Can Med Assoc J 2008;179(10):987-988.

3. Canada Health Infoway. EHR 2015: Advancing Canada’s next generation of primary care. Available at: http://www.infoway- inforoute.ca/en/pdf/Vision_2015_Advancing_Canadas_next_generation_of_healthcare.pdf (Accessed November 7, 2008).

4. Urowitz S, Wiljer D, Apatu E, Eysenbach G, DeLenardo C, Harth T et al. Is Canada ready for patient accessible electronic health records? A national scan. BMC Med Inform Decis Mak 2008;8(33):DOI:10.1186/1472-6947-8 -33.

5. Leonard KJ, Wiljer D. Patients are destined to manage their care. Healthc Q 2007;10(3):76-78.

6. McInerney v. MacDonald. 2 S.C.R. 138, 1992. Available at: http://scc.lexum.umontreal.ca/en/1992/1992rcs2-138/1992rcs2-138.html (Accessed November 11, 2008).

Conflict of Interest:

None declared