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5 Reasons Why Canada Could Be a Hotbed for EHR innovation

Posted on June 4, 2016 I Written By

Colin Hung is the co-founder of the #hcldr (healthcare leadership) tweetchat one of the most popular and active healthcare social media communities on Twitter. Colin is a true believer in #HealthIT, social media and empowered patients. Colin speaks, tweets and blogs regularly about healthcare, technology, marketing and leadership. He currently leads the marketing efforts for @PatientPrompt, a Stericycle product. Colin’s Twitter handle is: @Colin_Hung

From June 5th to 8th thousands of Canadian HealthIT professionals, government representatives, hospital leaders and policy consultants will gather for the annual eHealth Conference (#eHealth2016) in Vancouver. This event is like HIMSS, but smaller and focused on Canada.

Full disclosure: I am Canadian, but I spend about 80% of my time focused on US Healthcare. I manage to stay informed about the happenings in my home country through the tweets and posts of people like Glenn Lanteigne @GlennLanteigne, Mark Casselman @markcasselman, Michael Martineau @eHealthMusings, Colleen Young @colleen_young and Pat Rich @pat_health

Ahead of the #eHealth2016 conference Pat Rich sent out this tweet:

This tweet got me thinking about the state of EHRs in my home country. After hours of catching up on the latest Canadian EHR news – a light bulb went off – Canada could be the ideal test bed for new EHR innovations.

Here’s 5 reasons why

Reason 1 – No Meaningful Use, MACRA or MIPS

Like the US, Canada did allocate government dollars to help encourage the adoption of EHRs by physician practices and healthcare institutions. However, the dollars given out to Canadians paled in comparison to the US $34B CMS program. In fact, in some provinces (like Quebec) the incentive payments were so insignificant that many choose not to fill out the paperwork to receive their funding.

As well, none of the incentive programs have attestation requirements similar to the US Meaningful Use criteria. Nor do Canadian programs have penalties for not adopting an EHR.

This combination of relatively low incentive dollars, lack of MU-style adherence programs and zero penalties means that EHR vendors in Canada are relatively free to pursue their own product roadmaps. There is less government and end-user pressure to build functionality simply to meet funding criteria. Instead, EHR vendors can focus more on what end-users really want (better user interfaces anyone?)

Reason 2 – PIPEDA vs HIPAA

Canada does have privacy legislation. It’s called PIPEDA and it places the onus on healthcare organizations to protect the personal identifiable health information of patients. At a high level the protections for health information under PIPEDA is similar to that of the US HIPAA laws.

The biggest difference, however, is in the attitude of healthcare providers towards PIPEDA vs HIPAA. In Canada PIPEDA is not thought of as a barrier to information sharing. Privacy is definitely a concern, but PIPEDA isn’t used as often as an excuse to prevent access to information.

Reason 3 – Single Payer

Each provincial government in Canada is the single payer for healthcare for its citizens. If you live in Ontario and you go to the hospital, the hospital bills the Ontario government for the care you received. There are no other payers involved, no co-pays, nothing.

For EHR vendors this makes payment processing and collection a lot simpler – giving them more time to focus on other areas of EHR functionality.

Reason 4 – Patient Identifiers

A beneficial consequence of the single-payer system is that every person in Canada has a unique patient identifier. Consolidating health information from multiple healthcare organizations is therefore much easier since every lab result, prescription, requisition and image has this unique identifier. It’s Canada’s built-in unique key.

Reason 5 – Sorry, eh.

Canadians by nature are very apologetic. We say “sorry” when people bump into us. We apologize when we feel we are inconveniencing someone else. It’s something in the water.

I’ve personally found Canadian end-users to be very tolerant and understanding of new technologies. It’s not in our nature to complain so things have to go REALLY wrong before we make it an issue. Admittedly I have a small sample size, but when I speak to HealthIT vendors doing business in Canada, I hear similar stories.

Conclusion

In combination, the 5 reasons above create an innovation-friendly environment for EHR vendors. Instead of having product functionality dictated by government legislation and financial incentives, vendors are free to incorporate real end-user feedback into their EHR platforms. They can push the usability envelop in a tolerant environment where privacy isn’t used as a blocker to progress.

Maybe I’m delusional, but I’m really hoping to see signs of EHR innovation at the upcoming #eHealth2016 conference. If you are an EHR vendor that’s doing business in Canada and you are doing something innovative with user experience or functionality I want to hear from you!

Random Thoughts: EMR Projects Decentralized; Problems Persist Despite ‘Solutions’

Posted on August 4, 2011 I Written By

Once in a while, I run out of Big Ideas to share and resort to a rundown of short items. This is one of those times. Often, though, that approach turns out to be more interesting than a well-thought-out commentary. (Thus, the popularity of Twitter, right?)

Speaking of Big Ideas, I’m thinking that the age of the massive EMR project may be coming to an end. You may have seen my piece in InformationWeek today about the reported end of the national EMR in England. London’s The Independent reported earlier this week that the Cameron government will announce next month that it will scrap the national strategy in favor of allowing local hospitals and trusts to make independent EMR purchasing and implementation decisions.

This news comes on the heels of a decision by the government of Ontario to give up on hopes for a single EMR for all of Canada’s most populous province.

On the other hand, here in the States, we’ve seen a lot of consolidation among healthcare providers, but I’m guessing that has more to do with administrative Accountable Care Organizations and the prospect of bundled payments than any desire to build a more unified EMR. Though, consolidation does make health information exchange somewhat easier, and that’s going to be key to earning “meaningful use” dollars beyond 2013.

On a somewhat similar note, doesn’t a headline like, “Positive Outlook for Small Practice EHR Adoption” sound like a no-brainer? I mean, isn’t that the segment of healthcare providers that historically has had the slowest adoption rates? More than anyone else, small practices—particularly small, primary care practices—are the intended target of the federal EHR incentive program. And most of the news from health IT vendors of late has been about how they are going after this long-neglected market, right? The innovation seems to be happening in ambulatory EMRs, as evidenced by DrChrono’s newly certified iPad EHR app, aimed squarely at independent physicians.

That said, vendors and publicists, please do not start inundating me with news about other EHRs getting certified. There are hundreds of certified products out there now, and I cannot and will not write about, oh, about 95 percent of them.

While you’re at it, please stop using the word “solution” as a synonym for “product” or “service.” Tech journalists hate this trite, lazy and, frankly, inaccurate term so much that I’ve been instructed by the editors of InformationWeek not to use it, except in direct quotes. In fact, I get reminded not to use it pretty much every time I’m forwarded a press release laden with news about someone’s “solution.” Solution to what? I’ve been seeing that term since I started covering health IT more than a decade ago, and I still don’t see much getting solved in healthcare. With all the “solutions” out there, you’d think that healthcare had been fixed by now.

I could get a whole lot more curmudgeonly on you, but I think I’ll stop now and await your comments.