doctor on computerbaby boy

eCHN in the Media

Health Innovations: Children's Health Network

The Globe and Mail

André Picard

A decade ago, a small group of Ontario pediatricians decided their tiny charges could benefit from having better medical records.

What if, they wondered, they could get all the paper files into a computer and that file could someone be made available to doctors when and where they need it - in a hospital emergency room, a clinic, or doctor's office?

In 1999, it seemed like a pipe dream but in 2009, about 98 per cent of children who have been to a hospital in Ontario now have an electronic health record.

"Not many people believed we could do it," Andrew Szende, CEO of the electronic Child Health Network. "The government looked at this as an interesting experiment that was doomed to fail."

In reality, eCHN became a model of efficiency and effectiveness.

Not only is the system virtually universal - linking about 100 sites in the province that treat children, including children's hospitals, general hospitals, pediatricians and family physicians - but it was cheap.

The total cost of eCHN has only been about $60-million over a decade, good value in the digital age.

Mr. Szende said the key has been an incremental approach and placing the emphasis on integrating the computer equipment facilities already have rather than insisting they make expensive new investments.

"We have not tried to boil the ocean," he said. "We started small and we've been iterative and unrelenting."

The electronic health records are appreciated by parents - particularly those whose children have chronic health conditions and find themselves in the health system frequently - and with practitioners.

"The system is extremely useful and extremely necessary," said Mark Feldman, director of community pediatrics of the University of Toronto and a practising pediatrician.

"It's potentially lifesaving in the acute care setting."

Dr. Feldman - who stressed he has no stake in eCHN - said his enthusiasm is borne strictly of seeing it work. He also has grim memories of the system of paper records.

"In the old days - meaning 10 years ago - I had to call a hospital like Sick Kids, beg someone to walk down to the medical records room to find a kid's file and then call me back and read it, or fax it. The process would take hours.

"Today, I log into the computer and I have the information on my screen," Dr. Feldman said.

"You can't tell me that doesn't improve patient care."

While the system has improved care for Ontario children, another equally important contribution of eCHN is invisible to patients: a technical breakthrough.

"We were the first ones to figure out how to link up health information systems, how to build the interfaces," Mr. Szende said.

That is a huge issue because, as it stands, there are countless systems in place. Often, individual hospitals have different computer systems for patient records, diagnostic imaging and laboratory tests, and they are not linked in any way.

Mr. Szende said the success of eCHN is such that "it begs the question: 'If we can do it for kids, why can't we do it for everyone?'"

A new provincial agency, eHealth Ontario, has been charged with doing exactly that, creating electronic health records for all citizens by 2015, and ensuring safer, more cost-effective patient care along the way.