Informatics, moving information and Connect Care

August 8, 2018

Hello Members,

In 2018, the Board of Directors approved a new AMA Policy Statement on Health Informatics. You can view it here, or listen to a podcast interview about it here. The policy’s purpose is to help guide the AMA through the increasingly complex provincial health information system. Today I wanted to update you on how the policy is helping us address two important questions:

  1. How will we maintain and improve the two-way flow of patient data between community-based physician practices and the rest of the health care system?
  2. What is Alberta Health Services’ Connect Care and how will your practice be affected?

When you hear about the provincial health information system, it can be hard to see all the various parts and how they relate. Massive investments and efforts are being made by government and AHS toward improving systems. As physicians, though, we may still ask: Are we doing all the right things so that patient information flows and is available when and where it is needed?

As per our policy, the AMA has been advocating for physician engagement and input in all the work being done. We need to ensure that informatics solutions deliver clinical value without getting in the way of what we do in our practices.

The AMA’s informatics policy reflects four themes. These cover a lot of territory, but recently we have applied the most energy to two of these in particular.

  1. Our physician leaders have been working with Alberta Health and others on the Community Information Integration (CII) project to improve two-way flow of information between community-based physician practices and the larger provincial system. As a result, we expect to see the following improvements for both acute and primary care over the next year or so:
    • The Central Patient Attachment Registry (CPAR) will be combined with CII to provide automatic upload capability of patient panel information from primary care offices. 
    • Community-based specialist practices will be able to send consult reports to Alberta Netcare from your electronic medical records. 
    • We’re optimistic that beginning in 2019, CII-enabled notifications about patient events (emergency room visits and hospital admissions and discharges) will be sent to the patient’s medical home. 
    • Also (hopefully in 2019), community EMRs will generate a standardized patient summary to Alberta Netcare, allowing other physicians to see a pertinent summary of the patient’s medical history.
  2. AHS’ Connect Care initiative is supported by a provincial clinical information system (CIS) that integrates information from across the continuum of care wherever AHS holds the legal record of care. Access to health information and related services in the provincial CIS will be available to community physicians via a provider portal. As an EMR, however, it will not be made available to most community practices in the foreseeable future, if at all. In keeping with our policy, we have been working with AHS and others, stressing the importance of building necessary bridges between Connect Care and EMRs used by community physicians.

One of our first priorities is to ensure that, with the transition to the new Connect Care platform, lab results, diagnostic imaging reports and hospital reports continue to be delivered electronically to community practices. AHS has committed to continuing e-delivery, and we are working with the EMR vendors and AHS to ensure a smooth transition between the old data sources and the new. At the same time, we are exploring with our partners at AHS how best to optimize the AHS patient portal.

We have made substantial progress with informatics, but a number of issues remain unresolved. For example, what is the future of Alberta Netcare and how will it relate to Connect Care? How will the patient portals being developed by AH and AHS interact and complement one another and how will we avoid confusion for Albertans and the provider community? With the introduction of new solutions and system capabilities, how will patients and providers be supported and what roles and responsibilities may result?

These are just a few of the areas where additional clarity is needed. Where, then, does the AMA go from here?

Our policy states that: “The AMA will work with all stakeholders to influence priorities and represent the interests of its members, and to ensure that all initiatives support the patient/physician relationship, and the ethical and professional duties and obligations that physicians have to their patients and to society at large.” In the months ahead, our actions will reflect this statement at the governance and leadership tables for the provincial health information system. We will also keep members informed about what happens next and invite your feedback.

On that note, please let me know your thoughts on this letter or any other issues on your mind. Thank you very much for your continued support – and a special thank you to our physician leaders who are providing expert advice and representation in the health informatics domain.

You can reach me in the usual three ways:

At your service,

Neil D.J. Cooper, MD, FRCPC, Dip. Sport Med.

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