Less needles for patients, shorter wait times and better diagnostic decisions are some of the results at St. Paul’s Hospital in Vancouver hopes to realize by using PathNet in the emergency room.
Vancouver company founded by two of the province’s major diagnostic laboratories, B.C. Biomedical and MDS Metro Laboratories, PathNet is an automated electronic system that makes lab results available to physicians.
Primarily, the system is designed to give family doctors the results from tests they’ve ordered for their patients. PathNet general manager Lindsay Allan said St. Paul’s is the first hospital ER to use the service, marking a new direction for the company. While a family doctor only has access to the results for their patients, the authorized ER physicians will be able to access the full database.
“If a patient comes into the ER and they don’t remember what lab they went to but they know they had blood work done, it’s extremely useful for the physician to do a quick check to see what’s there,” said Allan. “It helps guide them to select appropriate testing.”
Dr. Eric Grafstein, an associate research director at Providence Healthcare and an ER doctor at St. Paul’s, said there was a time when lab work was done in the hospitals and people visited the same ER. Now most lab testing is done in the community, and diverting patients to other hospitals makes patients harder to track. When a patient comes in there is pressure to find their history quickly.
“A common scenario would be to repeat the tests, but that can mean more pain for the patient, it takes more time, and it wastes resources,” said Grafstein. “You can try to call the lab or their doctor’s office to find the results but that’s often time-consuming, and if it’s after hours, people aren’t there.”
With PathNet, Grafstein said they can increase efficiency in the ER by having easy access to previous patient lab and pathology results. Outside of PathNet, Grafstein said they are also working with other local hospitals to access their information systems electronically.
“Health care information technology lags so far behind any other sector,” said Grafstein. “It’s only recently people have become aware that unless you can describe the processes you do, you can’t find the inefficiencies, and there are huge inefficiencies everywhere in healthcare.”
Grafstein said he’s a frequent user of PathNet, but it has been slow to catch on in the ER because it is currently set up outside of their legacy information system with a separate username and password. That will change in the coming months as they embed PathNet directly into their system.
As for the oft-cited privacy concerns around electronic medical records, Grafstein said a system like PathNet is actually more secure than faxing or calling the lab and asking for the records. With PathNet, there’s a record of who accessed the information and when.
“In the end, everything is a risk/benefit and I think the benefit of not having to be poked again or not having your care delayed is worth it,” said Grafstein.
PathNet’s Allan adds that the system is very secure, using a two-factor authentication process, and providing each user with a unique certificate. It originally was created in 1999 to be a more modern, standards-based delivery system and be ready for the privacy legislation that recently came into effect.
Physicians and other health care providers can access the servers over the Web using a secure network set up with Telus. PathNet can also transmit the data directly into a family physician’s practice management system, which Allan said accounts for less than 10 per cent of the doctors in the province.
The system is based on a sender-pay model, with the costs borne by the participating labs that post results. PathNet is adding extra services though, like a new results referral option, which for a nominal yearly fee lets a doctor avoid the hassle of bundling up records and sending them with the patient when referring them to a specialist.
“This allows the physician to type a referral letter within PathNet’s secure network and selectively attach one or more test results,” said Allan. “The specialist can then just pull the patient’s name up from their access-point and the information is there. It’s transmitted securely.”
PathNet is currently only operating B.C., transmitting over 200,000 to more than 3,200 doctors province-wide, but Allan said they have plans to expand beyond B.C. in the near future.