When it comes to physicians using IT in their medical practice, Quebec is lagging behind the rest of Canada, according to a doctor in La Belle province who is championing the use of EMR software.
Dr. Jean-Francois Rancourt of The Montmagny Family Medicine Group, in Montmagny, Que., says he's been using EMR software (electronic medical records) from Purkinje Inc. for the past three years, but he's noticed only five per cent of Quebec clinics have gone the electronic route.
"It's really unfortunate, because the Quebec government provides a lot of subsidies. For example, ePrescriber, and electronic laboratory test results are available at no cost to physicians," says Rancourt.
"The biggest problem is that we don't have leaders who can convince their colleagues to use this...what we need in Canada is to inform physicians about the benefits of the electronic system, and to encourage them to use it."
In the Netherlands, 98 per cent of physicians use electronic systems in their practice, according to Rancourt.
"They (in Canada) have to convince physicians of two things: for the government to put money into the electronic system, and to have a legal obligation for physicians to work with it, like they do in the U.K."
Rancourt says that his goal with implementing the EMR software from Purkinje was to share information with his Family Medicine Group, which currently operates three clinics with 20 physicians.
The Family Medicine Group uses the Fujitsu fi-5120C scanner to scan paper documents into the Purkinje Dossier EMR software.
He says that change management is a barrier for physicians to embrace the EMR software. "The work of physicians is really hard to explain, but it's an art, a science - people don't want to change their habits.
"Just two doctors out of the 20 had some difficulty (adapting to the EMR) because they're obsessive-compulsive people and they're used to doing things in a very specific way," he says. "But they see when they have their lab results electronically, in five minutes, how good it is."
He notes that Western Canada seems to be leading the pack when it comes to IT implementation by physicians. "In Western Canada, it's about 20 per cent of clinics that work with an electronic system," says Rancourt. "In Alberta, they reimburse physicians for every time that they use the ePrescriber that is linked with the province's database."
This is echoed by Purkinje's director of product management, Stephen Lafferty. "We're seeing interest increase in both Quebec and Ontario, which are our main markets, but I would say the province that has the most penetration is Alberta because they have the best subsidy program."
He adds that they're starting to see a lot of interest in EMR software from Local Health Integration Networks (LHINs).
"The goal is that within the next five to 10 years that we start to see something like what they have in New Brunswick, which is called 'One Patient, One Record,'" says Lafferty. "That's what's going to happen across Canada, so that if you have a car accident in Alberta, but you live in Quebec, they'll have access to information about you on your chart."
And it isn't only Quebec and Alberta that are subsidizing physicians for using IT in their practices. Dr. Stephen Chris, a former Toronto-based family physician, is also currently chairman of the board of Ontario MD, a subsidiary of the Ontario Medical Association (OMA).
Ontario MD manages a fund established by the Government of Ontario to promote the use of IT, in particular electronic medical records and secure e-mail communications for physicians, says Chris.
"We subsidize family physicians who are purchasing approved EMR systems, or what we call CMS (clinical management systems)," he says. "We validate the vendors, make sure their products meet minimum specifications, and give assistance to physicians in the process of implementing electronic medical records."
He adds that Ontario MD had enough money to subsidize just over 500 doctors, but they received over 2,000 applications.
"There's a tremendous appetite in the family physician community to move to an EMR environment, but it's expensive and very time-consuming to establish what you need and get it installed," says Chris.
Lafferty notes that while Purkinje's EMR software may be a little more difficult than most systems to learn, once it's up and running their physician clients are saving an average of 45 minutes a day.
"They don't have to bring charts home to complete them, and they're seeing more patients with the time that they're saving," he says. "We also do a workflow analysis for the clinic before we implement the software, and we suggest ways that they can be more efficient using the system."
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