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I do a consulting practice here in Orillia, looking after everything from infants all the way up to teenagers with various problems. About half of my time is spent in hospital doing inpatient work and half my time is spent in my office. And I work together at this point with four other paediatricians who have a fairly large and busy paediatric practice.
Being a consultant, what we’re asked to do is to help deal with specific problems. Some of those problems can be quite complex and we certainly attempt to deal with as much of the problem as we can here. Other times, though, we’re going to need to tap into some of our Tertiary Referral Centres such as Sick Kids. And so some of those children will have to go down to Sick Kids, or wait and do telephone consultation.
Early on we were invited to participate (in eCHN) as one of the pilot projects with Sick Kids, ourselves and a couple of other institutions in Toronto. And to me the idea was really exciting because here we had an opportunity to in fact share data because kids go back and forth, data needs to flow back and forth. And to provide optimum care, you really need timely information. And unfortunately, one of the drawbacks to the system has been a lack of timely information.
I mean, a child might be down in Toronto and we might not get back information for two or three weeks or longer, for various reasons. And we’re supposed to see them in follow-up or in fact I’d sent them down for a consultation and we’ll see them back. And we don’t find out what’s happened, what’s gone on, what they did. I mean, parents are given certain amounts of information but they’ve been caught up in the system and their understanding of it, if you ask for very specific details like what did this test show, they may not know what the answer was.
The biggest frustration really was getting timely access to that information so you could work with it. If I really needed it then I’d have to go on the telephone and play telephone tag with somebody. Voice jail is a wonderful institution. Sometimes, in fact, the information wouldn’t come for various reasons. They’ll ask who your doctor is and if it goes to the family doctor, the family doctor gets written down, even though the referral may have come from myself. So you’re out of the loop. And some days you don’t even know that you’re out of the loop. And so, you know, to get away from that or to get around that - major advance, it’s great.
So here’s an opportunity that data could be entered in electronically in that institution, could be entered in electronically in our institution, could be shared and we could have access, immediate access to it. So the idea sounded great and we thought, fantastic, let’s participate in it, let’s go for it. So that’s how we started with it.
Does it improve quality of care? I would say yes, most definitely. And the reason for that is that information is now there. eCHN improves patient care on several fronts. One, I can see what’s been done elsewhere, so it avoids duplication of effort, duplication of testing. I can share information, things that I’ve done here, so hopefully it does the same in the other institutions. It also allows the families to see what’s happening, what’s going on. And one of the most powerful parts of it, I think, is I can draw, for example, x-rays - - and I can show the family, remember that test you had? This is what it is, this is what they’re talking about.
And it’s surprising how parents go, 'Oh!' I mean, they just don’t see it when they’re down there. And here’s an opportunity for them to see what it is we’re talking about. So, you know, that to me is a very powerful tool too—and it brings your patients on side, they’re part of, you know, this network of looking after their children.
I find it very friendly, I find it very easy to get on. Right now, for example, they have a reminder for me. I can track certain patients. So some of my more acute ones or ones I’m more interested in, I can tag them. I might get an email saying you’ve got some new information on these patients. So it’s really helpful and useful in that way
I do see eCHN as the way of the future - especially as we’re sharing medical care. Especially in the complex medical cases where you really do need to tap into various resources. You know, so if I have a child, for example, who has been involved with neurology and neurosurgery at Sick Kids, I’ve been seeing them here, they have rehab say at Bloorview, I mean those hospitals are all partners. So now at least we have a very comprehensive medical record for that patient.