Medical record revolution

Queen’s professor leads project to track medical records online

Richard Birtwhistle is planning to implement an online system of electronic medical records across Canada.
Richard Birtwhistle is planning to implement an online system of electronic medical records across Canada.
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Queen’s University professor Richard Birtwhistle is leading a new project that will revolutionize how Canadian healthcare data is collected.

The project is called the Canadian Primary Care Sentinel Surveillance Network (CPCSSN). The $11.5 million network is the first tool in Canada to catalogue patient diagnoses and care across the country.

“This has been done in Europe in the U.K., but this type of data has never been available nationally in Canada before,” Birtwhistle said. Family care physicians with electronic medical records share their patient files with the database so other physicians can browse them to learn more about disease frequency, treatment possibilities and success rates.

“We can now collect information and use it to look at a national picture of chronic diseases in Canada at the primary care level,” he said. “We can also use information to give feedback to individual practitioners, so a doctor can reflect on that information and decide if they’re meeting standards to improve their practice.”

With one in three Canadians suffering from a chronic disease, and family physicians as a main point of contact, it’s important that they have access to this type of information.

So far, there are 140 family doctors participating in CPCSSN, but the Network plans to attract 600 to 1,000 within the next five years. By then, CPCSSN hopes to be able to provide researchers, physicians and policymakers alike with detailed information on the prevalence and progression of their five diseases of focus; chronic obstructive pulmonary disease, hypertension, diabetes, depression and osteoarthritis.

Birtwhistle said the main challenge is finding doctors with electronic files that can be
transferred to the database. “As a country we’ve lagged behind in having doctors use digital medical records,” he said. “Only 25 per cent of family doctors use electronic medical records but the tide is turning and this could change in the future.”

As more records go digital, it’s more important than ever that they’re well protected.

“We really wanted to extract information from these records in a way that patients remain unidentified. Issues of privacy have been brought up, but we’ve made sure information is as secure and private as it can be. A person’s name, address, health care number are not extracted. Instead we assign individual number to each person so we can track them over time and all information that is extracted travels in encrypted form.”

Birtwhistle said this information will be extracted every three months and has been extracted since 2008.

“In 2008, we were funded by the Public Health Agency of Canada to do a feasibility pilot, where we were able to collect information about people with chronic disease from family doctor records,” he said. “[Eventually, we’ll expand with] a central database for other types of primary research, where we can see the adverse effects of new drugs.”

Before all Canadian physicians enjoy the benefit of this type of database, they need to digitize their records. Cheryl Wein, a family doctor who practices out of Toronto, said the cost and initial time investment is the main barrier stopping family doctors from implementing electronic medical records.

“Electronic medical records are ideal and probably easier, but the implementation is hard. My own family doctor uses electronic medical records and finds them useful, but she has a full time clerk who has to scan files into the computer,” she said, adding that it’s also advantageous because electronic records link information about patient’s prescription records to pharmacies more efficiently. She said hospitals already use a lot of electronic records but it’s much harder to do in a smaller practice.

“We are a private business and not with a lot of resources,” she said. “We have to use our own money.”

Nevertheless, implementing electronic medical records will inevitably happen in today’s information age, she said.

“I don’t know how or when, but at some point everyone will be using them,” she said. “I’m just a little reluctant to make changes. It’s hard to change your whole system of doing things.”

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