Dr. Laura McAdamDr. Eddy Lau

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Dr. Laura McAdam

Dr. McAdam works as a Paediatrician in the Child Development Program and Acquired Brian Injury Program at Holland Bloorview Kids Rehabilitation Hospital. Her clinical focus is with children who have Neuromuscular conditions and Acquired Brain Injuries. She received her training at Queen's University, the University of Toronto and the Alberta Children's Hospital in Calgary, followed by 2 years of Paediatric Neurology training at SickKids. Dr. McAdam is a past recipient of the Young Investigators Award from the annual meeting of the Child Neurology Society. She is involved in Neuromuscular clinical research and has recently won an award at the World Muscle Society meeting. She also has an interest in medical education and is responsible for a Summer Medical student scholarship program at Holland Bloorview.

I work on an in-patient Brain Injury Rehabilitation ward and in an out-patient Neuromuscular Clinic. I follow children with brain injuries and children with neuromuscular conditions, such as Duchenne Muscular Dystrophy.

I use eCHN every day, usually multiple times a day. For new admissions to the ward, it's quick access to the information from SickKids or other referring hospitals, as well as information about other medical issues they may have had prior to their brain injury. It allows for accurate and timely information which is very, very helpful and families often comment that they appreciate the information I already have about what happened in acute care. In Neuromuscular Clinic frequently we'll just receive a brief referral letter - so through eCHN I have access to the consultant's notes, other assessments as well as what kind of work-up has been initiated. eCHN helps facilitate transfer of information that is essential for clinical care.

A lot of the children that I follow have a complicated medical course so to have access to their information, to pull the whole picture together and know all those extra pieces is beneficial for myself as a physician but also for the families. eCHN also leads to better coordinated care and a more consistent history – and that's what I think parents prefer.

Depending on the patient, I rely on eCHN to find different information. For the children with a Brain Injury, I'll always look to see if they've had a recent scan or I'm looking specifically for their Neurosurgery or Neurology consult. Sometimes we don't get copies of consult letters so I'll check to see when was the last time they saw the neurosurgeon - were there any issues, have they had any shunt issues? - because all of that impacts their brain, their function and their development. So it's just helpful to have that information before I go in to see the family.

For children with Neuromuscular conditions, they may have different specialties following them so it might be Respirology, Genetics, Neurology or Cardiology. I'll go specifically to the sub-headings because these patients have had so many investigations – some of them have pages and pages and pages - I'll go specifically to Notes or else I'll go to specific tests and I'll know what I'm looking for.

Families aren't having to retell their stories so many times because we have reliable information about what has gone on. It's a big time-saver because you only have a certain amount of time to see the families and if you're spending 90% of it trying to get the past history, you won't be able to get to the details of what their current concerns are.

We use the diagnostic images on eCHN frequently. And I think it's also very helpful for the families. They may have seen the scans at SickKids but they wouldn't necessarily have had time to absorb that information so sometimes you can show them a couple of images just so they understand. And it makes it more real – because when they're in acute care, they're just worried about survival. They need time because they've had such changes in their life – nobody can process all that information at once. And then by the time they come here, that's when they really start to think about impact and they have a lot of questions, they want to learn about the brain.

I rely on eCHN and can't imagine trying to see patients without having access to it. I think families definitely have more confidence in you as a physician if you have a good understanding of their child and the issues they are facing.