Alberta prepares to make patient record history

Alberta’s ability to build consensus among its health-care community was key to developing what will be Canada’s first electronic patient record, according to those who helped create it.

The EHR, a $59 million, five-year initiative

that lets authenticated health-care providers see and update, via the Internet, health information such as a patient’s allergies, prescriptions and lab tests, is slated for implementation in spring 2004. At that point, all the province’s health regions, one-third of its doctors’ offices and half of all pharmacies are expected to be using the system.

The project involves collaboration between the Alberta government, various health care organizations across the province, Alberta SuperNet, Canada Health InfoWay and IBM Canada Ltd.

The system will provide doctors with immediate access to potentially life-saving information in emergency situations, said Dr. Brendan Buntin, president of the Alberta Medical Association. Doctors can check a patient’s record, for example, to make sure he or she isn’t prescribing medication that conflicts or overlaps with existing prescriptions,

“”It’s a more efficient way of accessing information,”” said Bunting. “”It reaches across communities. We can quickly access information, particularly on an emergency basis.””

The system will contain a person directory that allows users to identify patients and update demographic information such as their phone number and address. A lab results component will allow physicians to view and sort test results, and a drugs and allergies area will let health-care providers access patient medication histories and allergies information.

Doctors will be able to access the system either over the Internet or by using the version that is integrated with the electronic medical records system many Alberta doctors now use in their own practices.

In addition to providing information to avoid conflicting prescriptions, the EHR is also expected to reduce the number of duplicate prescriptions handed out because pharmacies will now have access to the patient’s entire prescription history, said Bunting.

“”Let’s say a patient is getting medication for arthritis. Pharmacy one provides medication and then the patient goes to another doctor and to another pharmacy. (With the EHR) they won’t end up taking both meds for the same problem, and we do actually see that with a lot of people.””

B.C. has had such a system for its pharmacies many years. Called PharmaNet, the system provides pharmacists with access to a patient’s complete medication record.

“”I have accessed that over the phone and it’s very worthwhile because I was able to find out what meds a patient was getting in an emergency situation. It really helped us treat the patient,”” said Bunting.

According to Barry Burk, general manager, health-care industry at IBM Canada, Alberta was the first province to debut an EHR because it was able to bring all participants to the table in a way the other provinces and territories have not yet been able to do.

“”I think the thing Alberta did that is unique was the comprehensive vision,”” said Burk. “”Other jurisdictions have looked at . . . maybe the possibility of some sort of sharing of information among doctors, but in the case of Alberta … they had everybody at the table, so we were able to complete a much more comprehensive blueprint and therefore get the entire health system engaged.””

Ensuring the privacy and security of information was a major part of the project, he added.

“”First of all we worked very closely with the privacy and security experts in the health ministry, as well as the privacy commissioner in Alberta, so we really followed their lead,”” said Burk. “”From an application perspective we’ve got all the kinds of things you would expect, including user identification and user authentication, down to functional authorization.””

That means different people with different functions have different access to information, added Burk.

“”You can also protect information down to a field level, so if I didn’t want people to know I was on a drug for depression for example, I can have that masked so all the information would be available except the specific name of that drug.””

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