Electronic Health Records (EHRs)
Prince Edward Island is working with federal and provincial governments, as well as other stakeholders to implement and evolve integrated Electronic Health Records (EHR) across the province.
An EHR is a secure, integrated and comprehensive view of a person’s health information generated by their interactions with the health care system. This information is available to authorized healthcare providers when and where they need it, increasing the quality and safety of care received by every Islander accessing the health system.
This important initiative supports Health PEI’s goal of "One Island Health System", as well as the long-term sustainability of health care delivery on Prince Edward Island.
What's in an Electronic Health Record?
EHRs contain information relating to your health and care history including:
- Hospital, clinic and physician office visits;
- Laboratory and diagnostic imaging results (e.g. blood work, X-rays); and
- Allergies and medication history.
How secure are EHRs?
EHRs adhere to national and provincial privacy laws and use the latest security technologies to prevent unauthorized access to health information. EHR systems are more secure than paper-based systems because they allow only authorized users to see your information and they provide a detailed history of the health care providers that have viewed your record.
Why is the province implementing EHRs?
Sharing of health information is critical to providing responsive and sustainable care. Information must be accurate and accessible, whenever and wherever health care providers need it. Through EHRs, the province is focusing on appropriate, secure sharing of information to better inform decision-making and improve health outcomes.
What benefits do EHRs bring to Islanders?
EHRs help to provide more seamless care and improve the speed and quality of care provided to Islanders. Improvements resulting from EHRs include reduced wait times, fewer duplicate tests, improved access to services, better management of chronic conditions and enhanced patient safety.
What progress has been made toward implementing EHRs?
Prince Edward Island is among the leading jurisdictions with regard to EHR deployment and adoption in Canada. Most of PEI's EHR components are already in place and planned investments in the coming years will ensure PEI remains in a strong position to deliver integrated, high-quality care for Islanders.
What are the parts of the EHR?
The major installed components of the province’s EHR are:
- Clinical Information System (CIS) – The cornerstone of the province’s EHR, the CIS provides seamless, real-time exchange of clinical information between all Island hospitals. It was launched in 2008 and was completed in March 2011.
- Computerized Provider Order Entry (CPOE) – A robust order management system which allows clinicians to electronically process various types of orders. Electronic ordering has been implemented province-wide for laboratory, diagnostic imaging and allied health consult orders. CPOE enables faster, more efficient, and safer care for Islanders.
- Drug Information System (DIS) – The first of its kind in Canada, our province’s DIS contains information relating to medications prescribed for Islanders and provides Island pharmacists and other authorized health care providers with province-wide access to medication profiles.
- Picture Archive and Communication System (PACS) – PACS enables the digital capture, storage and distribution of medical images. A diagnostic image such as an x-ray can be captured and shared in real-time with authorized health care providers across the province.
- Radiology Information System (RIS) – RIS manages all diagnostic imaging-related patient information across PEI. An x-ray taken at one of our community hospitals, for example, can be interpreted by a radiologist either locally or remotely and as soon as she/he finishes the report, it is immediately available electronically to all authorized healthcare providers across PEI.
- Client Registry (CR) – CR serves as the definitive source of patient/client demographic and administrative information. CR shares this information with other components of the EHR as needed.
What are some of our experiences so far?
A provincial EHR solution is a collection of systems which need to work together in support of our various groups of clinicians. As all jurisdictions across Canada have experienced, these implementations are complex and it takes time to fully understand and work through the related details. While we have experienced many challenges along the way, our dedicated clinicians and staff have continuously worked together to resolve issues as they have been identified.
In 2010, the Auditor General made several recommendations to improve future EHR efforts and all recommendations have since been addressed. As more EHR components are implemented, we are seeing improved sharing of information across the health care system. We are also seeing that improved access to better information is leading to more effective use of available resources and safer, higher-quality care for Islanders.
How much has EHR cost Islanders?
The province has invested $28.9 million in its EHR systems. The Clinical Information System project was completed in June 2014 at a total cost of $41.3 million, but the net cost to Islanders was $25.1 million due to offsetting revenue from other sources including Canada Health Infoway, the Federal Medical Equipment Fund and the province’s hospital foundations.
Additional costs to the overall EHR:
- Clinical Information System (CIS): $25.1 million
- Picture Archiving and Communication (PACS): $1.5 million
- Drug Information System (DIS): $1.2 million
- Radiology Information System (RIS): $854,000
- Client Registry (CR): $203,000
- Total (as of March 31, 2014): $28.9 million
To put this spending in perspective, PEI’s EHR investments to date are approximately 0.75% of the annual Health operating budget over the corresponding period. On average, Canadian health care providers typically spend the equivalent of 1.5% of their operating budgets on these types of investments*.
(*Source: Snowdon, A., & Shell, J. L. (2010). Innovation Takes Leadership: Opportunities and Challenges for the Canada's Health Care System. Ivey - Centre for Health Innovation and Leadership.)
What's next for EHR?
Our first priority is to capitalize on the significant EHR investments that Prince Edward Island has already put in place. Efforts are underway to continually improve the usability and utilization of our EHR and ensure we take advantage of the many benefits these systems provide.
Over time, new components and functionality will continue to be added to our core EHR systems. The major EHR investments still to come include:
- Selection and implementation of an integrated provincial Electronic Medical Record (EMR) solution. This will give clinicians in non-acute (ambulatory care and physician office) settings the ability to manage their patient populations and connect to the extensive information contained in our overall EHR. This will replace paper filing systems with electronic records, which can be easily and securely accessed throughout the health care system. EMRs enable safer care because clinicians have a complete picture of a patient’s history that combines local information – like visit history and clinician notes – with other information from across the EHR such as allergies, diagnostic imaging and lab results.
- A way for Islanders to personally connect with their electronic health records. The specific solution has yet to be determined, but it could include a patient portal or website where patients could schedule their medical appointments, renew prescriptions and view elements of their personal health records.
How can I find out more about EHRs?
For more on the importance of standards within our province’s EHR: