Better access to electronic health information key to improving health systems

Source
Canada Health Infoway. Survey question: “Have you ever accessed this digitally enabled health service at anytime in the past? Access your own personal health information electronically.” Custom tabulation based on 2022 Canadian Digital Health Survey: What Canadians Think. 2023.
 

Canadians need health systems that run on the best available information systems and digital tools.

Digital access to the health care system is important to Canadians. 4 out of 5 would like to access their health information electronically — whether that’s to book appointments, get in touch with their nurses and physicians or get test results. More than 80% of Canadians who have gone online to see their health information felt more informed and better able to manage their health. And some patients even say they were able to avoid a visit with their regular health care provider or to an emergency department because they could see their health information online.Reference4

I’ve been using digital health for about a year and primarily I use it to update information for my daughters, connect with service providers, and stay up to date on immunizations and ask questions. So being able to email a nurse at my local health centre, … being able to ask questions and figure out … should I be more concerned about something… I find it really helpful. — Toni Williams, British Columbia, a mother who accesses her family’s health information online through Canada Health Infoway’s Closing the Circle of Care Project Reference5

Notes
n/a: Not available.

Results for P.E.I. and the territories are not available due to small sample sizes. Quebec is not participating in the joint reporting exercise stemming from A Common Statement of Principles on Shared Health Priorities. Therefore, results are not available for Quebec.

Although weighting methods were applied to the survey, it is important to note that with the exclusion of Quebec the results do not reflect a nationally representative sample. Caution should be used when interpreting this data and when comparing results among provinces.

Source
Canada Health Infoway. Survey question: “Have you ever accessed this digitally enabled health service at anytime in the past? Access your own personal health information electronically.” Custom tabulation based on 2022 Canadian Digital Health Survey: What Canadians Think. 2023.
 

Electronic access increases with age and is higher among those with a family physician. But Canadians say some types of information are easier to get than others. For example, results for lab and diagnostic tests are more available than a list of medications.Reference4

Sources
Canadian Medical Association and Canada Health Infoway. Survey question: “Please indicate which of the following aspects of clinical care communication between providers occurs electronically directly from/to your practice system (not via fax). Exchange of patient clinical summaries with doctors outside practice.” Custom tabulation based on 2021 National Survey of Canadian Physicians. 2023.
 

Sharing information from their patients’ electronic records with other physicians is more common for doctors who work in hospitals than for those who work in the community. (Three-quarters of Canadian physicians receive lab tests and diagnostic results electronically.)Reference6

Other types of health care providers also have low rates of exchanging information electronically. In 2022, just over half of Canadian pharmacists reported sharing patient information electronically,Reference7 and in 2020, slightly less than a third of nurses said they did.Reference8

Notes
n/a: Not available.

Results for the territories are not available due to small sample sizes. Quebec is not participating in the joint reporting exercise stemming from A Common Statement of Principles on Shared Health Priorities. Therefore, results are not available for Quebec. Results for the Atlantic provinces have been combined due to small sample sizes.

Although weighting methods were applied to the survey, it is important to note that with the exclusion of Quebec the results do not reflect a nationally representative sample. Caution should be used when interpreting this data and when comparing results among provinces.

Sources
Canadian Medical Association and Canada Health Infoway. Survey question: “Please indicate which of the following aspects of clinical care communication between providers occurs electronically directly from/to your practice system (not via fax). Exchange of patient clinical summaries with doctors outside practice.” Custom tabulation based on 2021 National Survey of Canadian Physicians. 2023.
 

The low level of electronic communication in Canada’s health systems is a concern because it may be putting patients at risk. Safe, effective care depends on providers at every level having all the information they need to treat a patient. A 2022 survey of doctors, nurses and other health care workers found the number one barrier to sharing patient information between providers is a lack of common technical standards for exchanging information.Reference3

International surveys show the percentage of Canadian primary care physicians who can share summaries of patient information electronically with other doctors is increasing (to 38% in 2022 from 25% in 2019) but is still below the average of other developed countries (67% in 2022).Reference9

Modern information systems are also key tools for understanding trends in illnesses and broader population health, as well as which treatments do or don’t work. They will also be essential for managing another health care crisis such as the COVID-19 pandemic.

I was on call last week and I’m looking at laboratory reports, at X-rays, I’m talking to a specialist. I’m talking to the family or the patient. I’m gathering all this information and then crafting an approach to care. If I’m missing some of that information, or it is inaccessible, or I do not know it exists because it’s on a different platform, the likelihood of my making an error increases.— Dr. Ewan Affleck, Senior Medical Advisor for Health Informatics, College of Physicians and Surgeons of Alberta; Chair, Alberta Virtual Care Coordinating Body; Acute Care Physician, Northwest Territories

It will be important to understand barriers that can hinder access to electronic health information.

For example, electronic tools depend on pan-Canadian high-speed internet, which remains a challenge in many parts of the country. People who live in rural or remote areas or who have lower incomes may be less likely to have the internet they need to use online health tools.

It would be useful to collect information on how access to electronic health information varies according to age group, sex, income level and language and, if there are differences, how to address them.

As well, patients may need information to be translated into other languages, and people with disabilities will need software or other devices to access their electronic records.

Another issue is the need to help patients understand the technical language of health care so they can use the information in their electronic records to manage their health.

More information is needed to understand how better sharing of health information impacts wait times for patients, health outcomes, and patient and provider care experiences.

• Virtual care in Canada
• Commonwealth Fund survey, 2022
• Dr. Ewan Affleck — Virtual Care in Canada (podcast episode)