Nova Scotia spends $39M on electronic medical records push

The province has spent tens of millions of dollars encouraging physicians to use electronic medical record (EMR) systems, but some doctors must still resort to fax machines because the government-approved systems don't talk to each other.

The practice of faxing sensitive records came to a head last week when Bedford spa owner Lisa Belanger spoke out about her decade-long effort to stop errant mental health reports from being sent to her business.

The faxes were from family doctors to a mental health referral service in her area, an office with a fax number one digit off Belanger's. 

Since 2008, the province has spent $39 million in incentives to eligible physicians who have adopted an EMR system, according to Health Department spokesman Tony Kiritsis.

That includes a one-time payment of $5,300 to each doctor to help offset costs, and annual payments of $2,000 for those who participate in EMR-related education. There are also yearly payments — averaging $5,600 in 2014-2015 — based on how much the physician uses EMR.

The department has approved three EMR systems, and about 70 per cent of family physicians and 39 per cent of community-based specialists are deploying one of the systems.

Why do the faxes continue?

The money is well spent, according to Dr. Mike Fleming, who has been using one of the EMR systems in his practice for 10 years. He said Nova Scotia is one of the most advanced provinces in Canada in this regard.

But part of the problem with the existing situation, he said, is the three approved systems don't communicate with each other. It means two doctors with two different systems can't exchange information like they should.

"You leave your system, send [the document] by fax, they get it by fax and then put into their system," Fleming said. "I don't think they've worked that out anywhere across the country where there's more than one vendor."

There is still the possibility of human error with EMRs, but it is significantly less, he said.

"Even with EMR it would be faxing information, but differently, in the sense you pick a number out of memory instead of keying in a number every time," he said.

No timeframe

Christine Grimm, senior executive director for investment and decision support with the Department of Health, said a provincial system implemented in 2004 didn't meet all needs, and additional systems were approved.

She doubts there will ever be only one system, but said there needs to be a "streamlined approach." 

"What we need to do is make sure what systems we need in the future to connect with each other so we can get that flow of information," she said.

The province started work on an EMR strategy last year. Once it's complete, Grimm said it will be in place for five years.

In July 2015, the Department of Health and Wellness stopped allowing additional doctors to use EMRs in provincial hospitals over concerns they weren't being used consistently.

That is still in place.

The province wants to eventually house every person's medical record in a system that's accessible to all doctors, but there is no timeframe or cost attached to the measure.