Dr. Laura McAdamDr. Eddy Lau

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Dr. Eddy Lau

Dr. Eddy Lau has been Chief of Paediatrics at St. Joseph's Health Centre since 2007. In addition to his on-call duties as a general paediatrician at SJHC, he runs a private practice near the hospital where he provides primary care and consulting services. Dr. Lau received his training at the University of Toronto, Queen's University in Kingston, Ontario and at SickKids. Additional clinical and academic roles include: Executive of the Canadian Paediatric Society(CPS), Section of Community Paediatrics; community paediatrics staff member of the Postgraduate Medical Education Committee for Paediatrics at the University of Toronto; Co-Director of Postgraduate Medical Education for Paediatrics at SJHC; and Member of the Continuing Professional Development Committee of the CPS. He has a particular interest in medical education and has received various awards from St. Joseph's Health Centre and Sick Kids Hospital/University of Toronto in both undergraduate and postgraduate teaching.

I usually work two full days as a general paediatrician in the hospital (St. Joseph's Health Centre) - I run a consultation clinic and am often on-call. Three days a week, I'm in my office at Village Park Paediatrics where I see children both for primary care and consultations.

From my perspective as a paediatrician, eCHN is quite comprehensive. I don't have to look at anything else to get most of the data I need. Also, I really like the interface - it's very easy, very user-friendly. I'll often actually log-in to eCHN to get information about patients from St. Joe's even though the hospital has its own system. If I'm in my private office and want to look up a patient's blood-work that has been done over time in three different places that are affiliated with eCHN, I can log-in and see all three tests from the separate sites in chronological order.

At Village Park Paediatrics, children sometimes are seen at other locations prior to a visit at my office. For example, it might be a child with pneumonia who was seen in a walk-in clinic two weeks ago and a few days later was taken to SickKids Emergency. When the parents bring the child in for follow-up with me, I try to get as much information from them as I can, but often it's hard for them to remember important details like the name of the clinic or doctors they saw, or what kind of tests were done or medications given. I can easily go to the eCHN Portal and pull up the patient's chart. I can actually see everything about the SickKids Emergency visit - the initial notes from the Emergency doctor, the diagnosis and the discharge sheet - so it's all very helpful. It lessens the burden on the parents and helps to direct what I do in the follow-up visit.

Also, if the child has had any lab tests done at the walk-in Clinic, I can now see some of the results on eCHN via OLIS (Ontario Laboratories Information System). Having the lab results is a huge benefit. It saves me from redoing any test I might feel is necessary and maybe delaying diagnosis or management. I can modify and manage the treatment based on what has already been done.

When I'm on call at St. Joe's, I will often get called to the Emergency Department. Sometimes the patients that show up are very complex – they may be complex SickKids patients. The parents may tell us the child has developmental delays, has specific needs for feeding, is allergic to certain medicines and so forth. They may have a good idea of some of the clinical history but the child has likely been seen by multiple specialists at SickKids so it would be a daunting task to get all the details from interviewing the parents.

Children with chronic illnesses usually have ongoing treatment plans and laboratory tests. These pieces of information may be invaluable during an evaluation of a patient. Accurate information makes it a lot easier to manage complex patients in a setting where we don't usually see them - it helps us make a better diagnosis and treatment plan. So having all the pieces of the puzzle clustered in such a way that you can easily look them up is really important.

For example, if a sickle-cell patient shows up in our emergency department, I won't have any idea of her baseline hemoglobin to determine how anemic she is. But I can check it on eCHN - and seeing how she is compared to her baseline can indicate the degree of illness such a child is experiencing. The ability to go to the source and access the raw data on eCHN makes a huge difference to the quality of care we can provide.

One of my biggest uses of eCHN, apart from checking data, is arranging referrals for children to SickKids. You used to have to log-in to the ARMS (Ambulatory Referral Management System) at SickKids separately but now you can do it directly through the e-Referral system on eCHN. So that's one less log-in you have to do.

Also, the system allows me to track referrals much better. When we used to do paper referrals, we'd tell the patents to let us know if they hadn't heard from the clinic by such-and-such a date. Often we would not know the status of the referral. Without a tracking system, the result could be poor communication with the family and increased anxiety on their part.

Now I make the referral and I can check its status. I know when it's been reviewed, I know when it's been accepted. I can tell when it's been booked and completed, just by looking on eCHN. This allows me to inform parents if a referral is being reviewed, booked, or needs redirection to somewhere else.
If I need to add information to the referral, it's a one-stop shop to add documents. I might want to write a note to the doctor at SickKids - "Oh, here's something else I noted that's relevant to this referral that you haven't seen yet." Or sometimes there's an additional test result that's just come back and I think it's important information for the consulting doctor to see - so I can add that easily.

Overall, it's a pretty seamless system that provides benefits both for me as a health care provider and for the families. I am able to make more efficient use of my time to help manage their care.