Friday, August 31, 2007

100% Paperless Healthcare and the EHR

Whether your hospital is in Toronto or 100 Mile House, Cape Breton or Restigouche—one thing’s for sure. No matter how “wired” your healthcare facility is, you’ll still find lots of paper forms and processes. Paper is endemic in Canadian hospitals and clinics, even in those with fairly robust enterprise information systems. Paper is still used for staff scheduling, HR processes, reporting, transfers, discharges, and all kinds of other workflow-related tasks. There are a number of valid reason why this is.

Many Healthcare Informatics (CIS/HIS) vendors could extend an existing (standards-based) platform to support a fully-automated, (fully paperless) digitized-workflow---but often the perceived aggravation, delays, and high costs associated with modification (and integration) simply doesn’t justify the effort, or more importantly, the required ROI.

Specialized software can solve some of the smaller problems, but adding additional applications in an already crowded and complex arena of applications (that don’t talk to one another) can further compound issues. The biggest problem with any paper-based workflow is that it is static, and therefore cannot be shared beyond the physical limitations of the department.

This directly impacts our goal of a Canada-wide electronic health record (EHR), as existing patient information cannot readily be made available when and where it is needed. Clinicians and administrators need access to this patient data to enable the most informed decisions around patient care (regardless of geographic location) and to optimize operational performance. Most would agree that significant improvements are required in the area of clinical information acquisition, storage, retrieval, sharing, and especially presentation. An important first step is simply to get all existing data into the hands of clinicians and other health care professionals, as informed decisions can help save money and—more importantly, help save patient lives. Ultimately any (and all) patient health records, whether in an Acute Care, clinic, laboratory or General Practitioner (GP) setting, will need to be available digitally in a standardized and regulated format.