Fall 2008

I N F O R M A T I O N   T E C H N O L O G Y
NL Peer-to-Peer Network initiative launched


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Drs. Gerard Farrell, Percy Crocker and Lisa Kieley

In September 2007, Canada Health Infoway launched the Clinician e-Health Support Network, a national peer-to-peer initiative that facilitates the sharing of e-health experiences among clinicians and their peers and integrate information technology into regular work processes to improve access, quality, and productivity.

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In September 2007, Canada Health Infoway launched the Clinician e-Health Support Network, a national peer-to-peer initiative that facilitates the sharing of e-health experiences among clinicians and their peers. Peer leaders include physicians, nurses, and pharmacists who will promote and support the adoption and integration of information technology into regular work processes to improve access, quality, and productivity. The Network also includes linkages to similar networks in other Canadian jurisdictions. The Newfoundland and Labrador Peer-to-Peer Network includes peer leaders from all three professions on one team and is uniquely structured to build on the primary health care renewal and electronic medical record (EMR) foundations that exist in our province by promoting and supporting the interdisciplinary use of EMR and related technologies.

The provincial Peer-to-Peer Network includes members of the Newfoundland and Labrador Medical Association as Physician Peer Leaders. Members will support their clinician colleagues who are contemplating the use of electronic health record solutions by providing individual demonstrations of electronic health records technology, ongoing support and mentoring, and assistance in goal setting and prioritizing, as well as offering on-site and remote support.

While recruitment is under way for an additional two Physician Peer Leaders, current members are Dr. Percy Crocker and Dr. Lisa Kieley, family physicians with the Newfoundland Drive Family Practice. Dr. Crocker and Dr. Kieley have been exposed to EMRs through a pilot project that provided two family practice groups with a state-of-the-art EMR suite. Dr. Gerard Farrell, Director of e-Health Research Unit and Faculty Member, Memorial University of Newfoundland (MUN) Faculty of Medicine, is the Physician Leader on the subcommittee that guides the provincial implementation of this national initiative.

Dr. Crocker has no doubt that the EMR is the future. While he recognizes that the shift to an EMR requires an initial investment, this is done with the expectation that there will be some cost savings when the transition is complete as a result of the system’s efficiencies. The first step is to transfer current paper based charts to the electronic system; the most important individual to decide on which information should be transferred in a private practice is the physician involved. Once the transfer is complete, the patient’s file pro-vides the basis for an informative, ready made consult letter that only requires a note stating the specific reason for the consult. There are also efficiencies regarding billings, as the physician assigns the appropriate diagnostic codes at the time of the patient visit and they are then automatically available for the front office staff to send to MCP.

“It is inconceivable to me that anyone starting a family practice clinic today would start with a paper system,” says Dr. Crocker. “It could be argued that physicians with only five to 10 years left in full time practice would be crazy to consider converting, but, hey, some of us at Newfoundland Drive Family Practice are in that category! It will be much more efficient and cheaper to store or transfer your patients’ files when you retire from your practice if it is in electronic format.”

Dr. Kieley noted that the transition to the EMR at Newfoundland Drive Family Practice didn’t always go smoothly.

“Our clinic went live in November 2006,” says Dr. Kieley. “Before we went live we thought we were well trained, both our support staff and our physicians. About two weeks into using the program we realized that the communication between the front office staff and the doctors was not going well and there was a loss of the normal flow of the office, for example, consults and investigations were not being booked. Once we realized the confusion, we met with our EMR program trainers, figured out the best way to do things for our clinic, and advised all the physicians of the same so that we were all consistent. This was something that we did not anticipate and I think having the opportunity to speak with another physician who went though this could have avoided this cri-sis.”

Historically, the support that physicians require when adopting new technology has come from the vendors themselves or from government officials.

“In the past, some physicians were intimidated when they considered buying an EMR; there was the whole issue of support,” says Dr. Farrell. “Who would they call when something went wrong? I think they'll find it reassuring that not only do they have some-one to call, but that it's a colleague, someone who is on the one hand here in the same province, and who is also part of a national network of such experts. What better resource is there than that?”

For more information on the Peer-to-Peer Network, please contact Tom Alteen, Project Manager, (709) 752-6048, at the Newfoundland and Labrador Centre for Health Information.

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