Most
businesses encourage clients to electronically access their own
information because consumers value the efficiency and convenience of
electronic access.
Unfortunately,
the Nova Scotia Department of Health (DOH) has a different idea. It has
been a successful barrier preventing most Nova Scotians from retrieving
and using their own health information.
Few
Nova Scotians have access to their own health records or timely,
unimpeded, access to the results of recent tests. Most Nova Scotians
can’t communicate with doctors by phone or email.
The
DOH claims it wants to simplify care by encouraging people to
participate in their own care and have access to their own information.
However, only a select few Nova Scotians, privileged by DOH policies,
can call and speak to doctors over the telephone and can access their
health information.
The
Department of Health unashamedly reports that after eight years of
effort, and at huge financial expense, only a tiny and select group of
30,000 patients cared for by 300 doctors have routine access to a health
information portal. The remaining 97 per cent of Nova Scotians are in
the second tier for health care, without access to a personal health
information portal or the ability to speak over the phone with their
doctors (if they have one).
MyHealthNS,
using McKesson’s Relay Health, has been an ongoing effort by the Nova
Scotia Department of Health to give all Nova Scotians access to some of
their health information. Unfortunately, it made a simple goal
complicated and became a barrier to Nova Scotia innovation. Not
surprisingly McKesson Canada is withdrawing from this failing venture.
In
the interest of putting most Nova Scotians at a similar disadvantage,
the Department of Health doesn’t allow anyone, including doctors and
nurses, to retrieve their laboratory results or other health information
from any system other than the cumbersome and doomed Relay Health
system approved by the DOH.
Nevertheless,
despite inadequate compensation for electronic communication, a few
doctors continue to encourage and support patients who want to use
ordinary email for their communications.
In
the normal world, forwarding an email is easy. The initial recipient of
an email report merely forwards the information to another recipient.
In the case of health information, the doctor can forward laboratory
reports or advice using any email system acceptable to the doctor and
patient.
Many
patients prefer to take the risk of insecure communication using common
email systems to gain safer and more efficient care. They prefer their
usual email systems partly because health department systems regularly
report privacy breaches.
Sadly,
the Relay Health project interfered with existing projects, including
ones by the Cooperative Council, that were designed to accomplish
similar goals and at no cost to government or patients.
One
electronic health record vendor whose product was used by many Nova
Scotia physicians reported that the Department of Health wouldn’t allow
it to put patients’ email addresses in doctors’ patient record systems.
The DOH insisted that clinicians only provide patients with access
through the cumbersome Relay Health system.
Rather
than taking five or 10 seconds to forward a report with a brief
comment, the Department of Health demanded that doctors take
substantially more time to use Relay Health.
Every
year, some people are harmed, including dying, because a lab report was
ignored, mishandled or lost. When patients have access to their own
laboratory reports, they have the power to be active participants in
their care and prevent the consequences of lost reports.
There
are no rational reasons for the Nova Scotia Department of Health to
continue to act as a barrier to easy communication between doctors and
their patients.
Dr.
David Zitner, a retired family physician, was the founding director of
the graduate program in Health Informatics at Dalhousie University and
is Atlantic Institute for Market Studies (AIMS) senior health policy fellow.
