Canada's health-care system continues to lag behind many other countries because of our slow adoption of health information technology and electronic health records, contends a new report from the Health Council of Canada.
The report finds that even in today's wired world, most family doctors' offices in Canada use computers only for administrative duties, such as scheduling appointments and electronic billing.
But if more doctors used electronic medical records, the health system could better monitor national health data, such as how drugs are prescribed and used, says the report, entitled "Decisions, Decisions: Family Doctors as Gatekeepers to Prescription Drugs and Diagnostic Imaging in Canada."
The Health Care Council of Canada is an independent body created by federal and provincial governments to monitor the health system council and inform policy makers. It found that family doctors are not adhering to clinical practice guidelines – those guidelines that inform doctors about the best course of action and accepted standards for care.
Family doctors are increasingly treating patients with multiple health problems or chronic illnesses. The report authors say that as physicians face increasingly complex demands from their patients, they are writing more prescriptions and ordering more medical tests -- many of which are unnecessary.
Over the past 10 years, the number of prescriptions filled at community pharmacies has almost doubled -- from 272 million in 1999 to 483 million in 2009, the council found. The report also found that between 1990 and 2009, compared to 2003, there has been a 58 per cent increase in CT scans and a 100 per cent increase in the number of MRIs conducted.
"Family physicians act as 'gatekeepers' and play a key role in ensuring that our health care services such as drugs, diagnostics, and specialist services are being used appropriately," said Health Council of Canada CEO John G. Abbott in a statement.
"Given the host of factors that influence their decision-making, we can do more to assist family physicians in curbing the overuse of diagnostics and drugs, and make significant improvements in managing our health care system."
The problem of inappropriate prescribing and excessive medical testing will dramatically worsen as the population ages, the council says. Part of the solution, it says, is the increased use of electronic health systems, which would offer more comprehensive data on how drugs are prescribed and used.
Not only would electronic health records help to monitor current physician practices, they'd also help doctors ensure that they follow clinical practice guidelines.
"We can make up for this lack of information through additional research and the wider adoption of electronic health records by family physicians," stated Abbott.
"It is a critical foundation for safe and appropriate prescribing and medication management. It is essential that an electronic system [be] in place to efficiently assist physicians in following clinical practice guidelines, making the best decisions for their patients and for the sustainability of our health-care system."
