A Web-based electronic medical record system that grants a holistic view of patient care history has been certified by OntarioMD Inc., a subsidiary of the Ontario Medical Association.
Physicians implementing Nightingale On Demand, from application service provider Nightingale Informatix Corp., can now apply for funding through the Ministry of Health and Long-Term Care (MOHLTC) and Ontario Medical Association Physician Information Technology Program.
The certification falls under Clinical Management System Specification 2.0.
Hosted systems like Nightingale On Demand offer several advantages to the health care industry. For one, physicians, who either operate alone or in small groups, can avoid the headache of owning and maintaining their own IT infrastructure, said Nightingale CEO Sam Chebib. “An ASP model allows them to outsource all of that effectively and be able to use a secure connection to access and update information,” he said.
But IT infrastructure challenges aside, Chebib said the Nightingale model is based on the concept of “one patient, one record” so that a number of health care providers can populate a single patient file rather than having disjointed records as in a client-server environment.
In the event that a drug is recalled, for instance, a physician with 2,000 patients has the obligation to filter through 2,000 records to ascertain who was given a prescription for the drug, and manually generate recall letters or make phone calls. But in mere seconds, said Chebib, an electronic system will generate a report, letters and e-mails.
David M. Kaplan, an assistant professor of family and community medicine at the University of Toronto, has been using Nightingale’s hosted system for five years in his practice, well before it was certified by OntarioMD. He’s now thrilled that he’ll receive the three years of funding for using the technology.
“Many benefits are due to the fact that…the data is not locked in the office,” said Kaplan of Nightingale On Demand. For instance, if a patient is in labour and a sample of blood work hasn't yet arrived at the hospital, a physician can connect to the system via the hospital network and retrieve the information, explained Kaplan.
Before electronic medical records, he recalled, health care providers relied on paper-based systems and manual workflows prone to error, to manage tasks like patient records, test results, X-ray requisitions, and purchasing supplies.
And from a peer collaboration standpoint, paper-based systems meant that “if you’re on vacation for a week, and one of your patients comes in to see one of your colleagues, it’s very difficult for them to read your handwriting,” said Kaplan.
The use of application service providers in medicine is becoming increasingly popular, said Chebib, and “there is no question that the quality of health care that is being delivered will be improved dramatically.”
But the lesser discussed benefits to using hosted electronic medical record software, he added, are monetary and operational. Health care providers can avoid redundancy and waste of resources if they have complete access to a patient’s history of care. And, if a physician can better capture services rendered for more accurate compensation, then that frees up time for more pro-active health care.
Besides Nightingale, Practice Solutions is in the process of being certified by OntarioMD as an ASP provider. It’s currently certified for the on-premise technology. The competitive request for proposal process was based on several criteria including whether the vendor would be in the marketplace for the long-term, said Brian Forster, CEO of OntarioMD. “It’s a painful process the first time so it’s important to choose the right system and the vendors that will be there to support it,” said Forster of the complexities of a typical system implementation. (Xwave is another ASP previously certified by OntarioMD.)
In fact, Forster foresees the health care industry moving to ASPs “over the next many years” given the simplicity of hosted systems and the fact that information and backup are major issues in medicine.
But while the benefits are clear, Kaplan acknowledged that some physicians “have an affinity for their charts,” having been used to a paper-based system. The implementation of new technology, he said, often requires a dramatic change in mindset.
But the health care industry has come a long way in its adoption of electronic medical record systems, said Chebib. “If you want to draw comparisons with the business world when it was pre-email and pre-PC… how we operate today, the efficiency we generate is immeasurable.”
