Case Studies
Gulf Island Catches High Tech New Wave
April 2009
Gabriola Medical Clinic's completion rates for diabetes and hypertension tests are well above the average results in the province, due to advanced EMR features
They switched from paper to electronic medical records four years ago so today they use their EMR to full capacity, including an amazing job with their chronic disease management (CDM). The proof? Recent run chart reports show that the indicators for the Gabriola clinic's patients are way ahead of the average results obtained by other clinics across the province.
For example, for diabetes and hypertension: in April 2009 the clinic's completion rate for A1c (the blood test used for diabetic control) was 74% compared to an average of 21% obtained by other B.C. clinics. The completion rate for BP (blood pressure) recorded in charts over the same period of time was 86% in Gabriola, compared to 29%, the average outcome of other medical clinics. The data came from the CDM Toolkit, hosted by the Ministry of Health Services on a secure website and used by physicians to review their indicators and compare themselves to other clinics in the province.
"Meeting these targets in our diabetic and hypertensive patients is a good indicator of the quality of CDM care a physician is providing (...) We have achieved these great outcome results by the development of CDM registries and planned recall," Kay Holt, the clinic's registered nurse, explains.
"The reminder system to schedule appointments with the physician improves the management of our chronic disease patients because they don't always make regular appointments and only come to the clinic when an acute health problem arises. The planned recall also helps with referrals to specialists and with arranging lab tests."
The 3,500 patients of the clinic in Gabriola fully enjoy the benefits of the electronic system.
"We currently create print-outs of flow sheets and medical summaries as documents to share with patients," Kay says. "Patients with chronic conditions find this very useful and we encourage them to carry their medical summary when traveling or visiting other health professionals. This summary contains relevant investigations, lab data, and targets we aim for."
Dr. Mel Petreman, one of PITO's Local Physician Champions, and Shelly McNeil, Local Relationship Manager, have both been very supportive, visiting our office and offering feedback." she adds. "Without PITO funding and support, we would have struggled to fund an upgrade."
Billing the CDM incentive fees appropriately even helped fund a registered nurse position last year; a third family physician is due to start in July.
The transition period from paper to electronic was not easy, Dr. Francois Bosman, the clinic's lead physician, acknowledges. The staff needed technical training and it took about a year before the physicians felt confident to see their patients without paper charts.
"If I were to start all over again, I would get myself much more educated to be able to realize the benefits of the system earlier," Dr. Bosman says. "There is a lot that you can do with an EMR system such as developing your own templates, making referrals with full summaries and even accessing records from home if you have to."
But Dr. Bosman believes that one of the greatest EMR benefits is the ability to hand out the medical summaries to CDM patients to use when they see another doctor or they have to go to the hospital or, best of all, so they can see how much their health has improved or to use them when they see another doctor or they have to go to the hospital.
"We are very grateful to PITO for the financial and technical support we have received," Dr. Bosman says.