Spring 2004

I n f o r m a t i o n   T e c h n o l o g y
EMR — not just another acronym
Doctor leading EMR initiative
Dr. Gerard Farrell is the NLMA’s point person on the Electronic Medical Record (EMR) project. Dr. Farrell is working with Unisys Canada on the design and implementation of an EMR for the physicians of the province.
There is a concept we need to begin to understanding now, as it will be the fundamental building block of what is to come.


     Over the last little while, the NLMA has made it clear that technology in the medical context is a priority for the foreseeable future. Many of you are probably wondering what this means in the context of how you go about taking care of patients every day. While we are still early in the discussion phase of how technology will be applied in a practice setting, there is a concept we need to begin to understand now, as it will be the fundamental building block of what is to come. That concept goes by the name Electronic Medical Record or EMR.
     An EMR is like an expert — many more claim to be one than actually live up to the claim. Many companies claim what they are selling is an EMR. One of the problems is that companies differ on what they mean by the term. It’s as if automobile manufacturers couldn’t agree on what a car looked like or how it functioned.
     To explain what the NLMA means by an EMR, let’s use as our example the World Wide Web. When you want to surf the web, you start a browser, probably Internet Explorer. The browser takes you to your home page. Where you go from there is up to you. You can choose from a list of favorite sites you visit often. If something on one of the pages interests you, you click on the link provided and the browser (and the network) sorts out getting you to the computer that has that information and getting the information onto your screen. You don’t have to think about how it happens, it just does.
     The NLMA EMR (and no, it won’t be called that) will work in the same fashion regarding information you need to take care of your patients. The difference is that we have to wait for the government and the Newfoundland and Labrador Centre for Health Information (NLCHI) to build certain aspects of the network we need.
     Our plan will be to roll out the NLMA EMR in stages. That means that in version one of the EMR, key functions that will be highlighted will be electronic prescribing, billing (MCP and others), and electronic recording of clinic notes. In version one, because of federal privacy legislation concerns, it is possible that the physician will only have access to their own notes on their own patients, but the intention is to expand this function when the interpretation of the legislation allows.
     The NLMA EMR is not a replacement for Meditech. Certainly, the ability to browse from your record on a given individual directly to the X-ray report or lab result within Meditech (without having to use another program, log in, find the patient and then find the result) is something that we want to work towards. We hope to work with NLCHI and the institutions to establish this capacity. The NLMA EMR is also not a replacement for NLCHI’s Pharmacy Network. Rather, it is simply our way of getting the prescribing information to the Pharmacy Network. Think of it as a health information browser.
     Once we are through the early discussion phase, member input will be sought to determine how the NLMA EMR will function beyond these general statements. This project should not be any one person’s project, since all of us will end up using the application that results from this work.

     Dr. Gerard Farrell chairs the NLMA’s Health ICT Policy Committee and is the lead physician on the NLMA’s EMR Project.


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