A Guide to Canadian Primary Care's Electronic Medical Record
Healthcare providers have been using electronic medical records (EMRs) for decades as digital versions of paper-based medical records. By using an electronic medical record, doctors, nurses, and other healthcare professionals can securely store and access patient information, including their medical history, diagnoses, medications, and test results.
It has become increasingly common for primary care providers in Canada to use electronic medical records to improve the quality and efficiency of their patient care. The use of electronic medical records (EMRs) allows primary care providers to access a patient's medical history in real time, allowing them to make informed decisions about their care. EMRs also facilitate the coordination of care between healthcare professionals, which is particularly important in the context of primary care, where patients may visit several doctors and specialists for a variety of health conditions.
EMRs have proven to be beneficial for Canadian primary care clinics in improving patient outcomes, improving the patient experience, and streamlining their daily operations.
The purpose of this blog post is to provide an overview of the adoption and use of EMRs in Canadian primary care.
What is an EMR?
Electronic Medical Records (EMR) are digital versions of paper charts in clinician offices, clinics, and hospitals. EMRs contain notes and information collected by and for the clinicians in that office, clinic, or hospital and are mostly used by providers for diagnosis and treatment. EMRs are maintained by a single provider.
Electronic Health Records (EHR) are digital health information records that include a patient’s medical history, diagnoses, medications, treatment plans, immunization dates, allergies, radiology images, and laboratory and test results. EHRs are designed to be shared across healthcare settings, such as hospitals and clinics. EHRs contain information from all clinicians involved in a patient’s care; all authorized clinicians can access the record.
The main difference between EMRs and EHRs is that EHRs are maintained by multiple providers, while EMRs are maintained only by one provider. This means that an EHR contains more information than an EMR. Providers mainly use an EMR for diagnosis and treatment. Another difference is that EHRs are designed to be interoperable, while EMRs are not. Interoperability means that different systems can share and use data with each other. This is important because it allows providers access to a patient’s complete medical history even if they see multiple providers.
Procuring an EMR requires careful consideration of the needs of the practice or hospital. The following factors should be considered when procuring an EMR: cost, ease of use, interoperability with other systems, security features, and training requirements for staff.
Overview of EMR Adoption in Canada
More than 87% of Canadian primary care physicians are using an Electronic Medical Record (EMR) to store patient records as part of their daily practice. Even though most hospitals and large organizations have moved to more advanced and modern EMRs like Epic, Cerner, and Meditech recently, most clinics and medical practices still use old, outdated software.
There are, however, several factors contributing to the growth of EMRs in Canadian primary care. For example, finance and support from the government and other stakeholders have been key drivers of the revolution. The Canadian federal government provides grants and other incentives to encourage primary care providers to adopt EMRs. Furthermore, many primary care clinics and organizations are investing in EMRs due to their benefits.
Another factor contributing to EMR growth in primary care is the development of user-friendly, cheap EMR systems. Before EMRs became more widely adopted, primary care providers were wary due to concerns about their complexity and cost.
The costs of implementing a modern EMR are high, and many clinics and practices opt to stay with what they are already using, despite numerous reports that many traditional EMR methods contribute to physician burnout.
Listed below are the major Canadian electronic medical record companies and their operating systems. Over 95% of primary care EMRs in healthcare are operated by these three software companies; Telus Health, WELL Health, and QHR Technologies.
In essence, these companies acquire and manage a large number of electronic medical records (EMRs) used in primary care. As an example:
Telus Health: Telus Health is a division of Telus Corporation, one of Canada's largest telecommunications companies. Telus Health operates the largest number of electronic medical record (EMR) systems in Canada. They provide various EMR solutions, including CHR (Input Health), PS Suite, Med Access, Medesync, and Wolf. With over 40,000 physicians using their EMRs, Telus Health has a significant presence in Canadian primary care. They focus on offering interoperable EMRs that integrate with other technologies and provide ongoing improvements and maintenance.
WELL Health: WELL Health is a technology company that specializes in digital health solutions. They operate several EMR systems in Canadian primary care, including Oscar Pro, Intra Health, Juno, and Aware MD. WELL Health aims to provide user-friendly and innovative EMR solutions. They have a large customer base, serving more than 23,000 physicians. WELL Health also focuses on integration and extendibility, offering an integration layer through their Apps.health store, where physicians can choose additional solutions to enhance their EMR functionality.
QHR Technologies: QHR Technologies is another prominent player in the Canadian EMR market. They primarily operate the Accuro EMR system, which is used by around 20,000 physicians. QHR Technologies focuses on delivering EMR solutions that meet the needs of healthcare providers. While they may be less actively involved in improving and maintaining Accuro compared to other companies like Telus Health and WELL Health, they still provide a reliable EMR option for primary care providers.
Some of these EMRs were created through McMaster University's Oscar open-source project. Some of these EMRs are OSCAR Pro, Juno, Indivicare, and Avaros. Since most of these EMRs operate in the same manner, moving from one to another should be very straightforward if you are familiar with the other. There are primarily small adjustments to the user interface that account for the differences.
When it comes to deciding which EMR best suits your practice, you should take into account the following factors:
Key Factors to Consider When Choosing an EMR System
Selecting the right Electronic Medical Record (EMR) system is crucial for healthcare providers in Canadian primary care. Several factors should be taken into account when making this decision. This section will briefly outline the key considerations to help healthcare professionals choose an EMR system that best suits their practice. The factors include:
Web-based EMR vs. Desktop-based EMR
Choosing between a web-based (cloud-based) or a desktop-based EMR involves assessing the accessibility and convenience of accessing patient records from various locations.
Web-based EMR Vs. Desktop-based EMR
| Criteria | Web-based EMR | Desktop-based EMR |
|---|---|---|
Accessibility | Accessible from any location with an internet connection (home, hospital, mobile devices) | Limited accessibility, typically restricted to the device on which the EMR is installed |
Convenience | Convenient and flexible for practices with multiple locations or providers who need remote access | Requires physical presence in the office or access to the device with the installed EMR for record access |
Infrastructure | Relies on a secure internet connection and data servers | Requires local installation and may need additional hardware infrastructure |
Updates & Maintenance | System updates and maintenance handled by the EMR provider | Updates and maintenance need to be managed locally by the practice |
IT Requirements | Minimal IT infrastructure required, as most technical aspects are managed by the EMR provider | Practices need to manage and maintain their IT infrastructure, including hardware, backups, and security measures |
Cost | Often subscription-based, with regular fees for usage and support | Typically involves higher upfront costs for software licenses and infrastructure setup |
Scalability | Easily scalable for growing practices or those with multiple locations | Limited scalability and may require additional setup for expansion |
Internet Dependence | Reliant on a stable internet connection for access and functionality | Not dependent on internet connectivity for local access and operations |
Security | Data is stored on secure servers, with encryption and backup measures in place | Data security relies on local measures implemented by the practice |
Interoperability & Extendibility
Integrating other technologies easily with an EMR is a great way to extend its functionality. With their apps.health store, WELL Health is leading the way in providing an integration layer for other technologies. Similar to the Apple App Store for iPhone, the Apps.health store allows physicians to choose the solutions that they want to use to make their EMR more intelligent. Tali AI is one example of these apps. It is a voice assistant that helps physicians and clinicians input and find information by voice commands and is used in conjunction with EMRs to enhance their functionality.
Maintenance
Each of these companies has a different level of service based on which company maintains your EMR and where it ranks on its priority list. For example, Telus Health has developed a strategy to gradually move all of its physicians to a CHR (Input Health).
As a result, if you use one of their other EMRs (Med Access, for example), you won't receive as many bug fixes and feature enhancements as you would with CHR. It should be noted that QHR is less actively involved in improving and maintaining Accuro than WELL Health and Talus Health.
Therefore, if you are interested in an EMR that is continuously improving and integrates with other solutions, we suggest trying an EMR provided by Telus Health or WELL Health.
Certified EMRs
You can also talk to your local health authority for recommendations for certified EMRs for physicians in addition to all of the items mentioned above. For instance, OntarioMD reviews and validates EMRs for physicians on this list. This organization reviews and validates the EMRs of these organizations so that practices and physicians do not have to go through the process individually.
Final Thoughts
Ultimately, EMRs improve patient care and increase efficiency in the healthcare industry. There are still opportunities and challenges associated with the implementation of EMRs in Canada, but the adoption of these systems is growing.
Throughout this blog post, we have provided an overview of the guide and highlighted some key considerations. By implementing the right EMR, healthcare providers can better serve their patients and support the Canadian healthcare system as a whole.
Contact us if you would like to learn more about different EMRs in Canadian primary care, and their user cases.
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