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Chad Leaver



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    OS15 - Analytics Leads the Way (ID 10)

    • Event: e-Health 2019 Virtual Meeting
    • Type: Oral Session
    • Track: Executive
    • Presentations: 1
    • Coordinates: 5/28/2019, 10:00 AM - 11:00 AM, Pod 6
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      OS15.02 - Availability and Utilization of Virtual Care and e-Services in Canada (ID 436)

      Chad Leaver, Performance Analytics, Canada Health Infoway; Toronto/CA

      • Abstract
      • Slides

      Purpose/Objectives:
      Digital health technologies to support patient care at a distance (virtual visits) have long been available in Canada, largely through a broad suite of telehealth programs and service providers. Innovation in some international health systems has seen citizen utilization of virtual visits grow to over 50% of annual healthcare interactions. Canada?s digital health sector and healthcare marketplace are advancing availability and accessibility options for virtual visits, yet the current proportion of care in Canada that is virtual is not currently known.


      Methodology/Approach:
      We completed two national surveys between February and March 2018. The Canadian physician survey used a multi-method promotion and recruitment strategy with direct-distribution to over 45,000 primary care and specialist physicians in Canada currently listed in the Canadian Medical Directory (CMD). Physicians could complete the survey manually or online. A general population survey of Canadians was recruited from multiple online panel sources to ensure a representative sample of Canadians by age, sex, province; and rural and remote communities. Both surveys were administered in French and English and focused on access and utilization of virtual care and other e-services in Canada. We used descriptive and cross-tabular analyses to determine the current availability and use of virtual care and to estimate the proportion care in Canada that is currently virtual.


      Finding/Results:
      A total of 2,406 Canadians completed the general population survey; and 1,393 physicians: primary care (n=799); and specialists (n=594) completed the Canadian Physician Survey. Canadian?s interest in accessing virtual care and other e-services is trending positively with significant increases from 2016 for e-Rx renew, e-view, e-booking, e-visit (e-mail and messaging), and virtual visits (+4% to +8% increase). 6% of Canadians report they can currently visit with their health care provider virtually online by video, 3% of Canadians have done so in the past year. Men were more likely than women (5% vs. 2%); and younger Canadians (<35yrs) were more likely than older Canadians to have had a virtual visit in the past year. Virtual visit coordination was either patient initiated or coordinated by regular care provider/specialist clinics. Most virtual visits (53%) were conducted at a health care facility, with the remaining 47% in the patient?s home. For patient initiated virtual visits in the past year, 49% were of no charge to Canadians; the remaining 51% were charged a one-time (per visit) fee. Of the healthcare interactions reported by respondents to our survey 1.6% of these were virtual in 2018. Results from our physician survey highlight virtual care and e-services currently provided by physicians in Canada and key facilitators to advancing physician adoption and use.


      Conclusion/Implications/Recommendations:
      Canadians are increasingly interested in accessing virtual care and digitally enabled health services, yet currently only small percentage of Canadians say they can do so. We estimate that in 2018 1.6% of visits in Canada were virtual. Greater consultation to refine our methodology and assumptions informing this estimate and future trending is warranted. In order to realize the estimated health system value of virtual care, enabling citizen access, clinical practice integration and physician remuneration will be essential.


      140 Character Summary:
      Canadians are increasingly interested in virtual care. We estimate that in 2018 1.6% of healthcare visits in Canada were virtual face-to-face consultations.

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    RF03 - Patient Empowerment: It's about Time! (ID 45)

    • Event: e-Health 2019 Virtual Meeting
    • Type: Rapid Fire Session
    • Track: Clinical and Executive
    • Presentations: 1
    • Coordinates: 5/28/2019, 02:30 PM - 03:30 PM, Pod 8
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      RF03.01 - Advanced use of EMRs yields greater benefits: 2018 Canadian Physician Survey (ID 432)

      Chad Leaver, Performance Analytics, Canada Health Infoway; Toronto/CA

      • Abstract
      • Slides

      Purpose/Objectives:
      Clinicians, governments and the digital health sector have all made significant investments supporting adoption, use, and interoperability of Electronic Medical Records (EMRs) and associated digitally-enabled health services. We sought to update the current use and value of digital health technologies in practice by specialist and primary care and specialist physicians in Canada. The objective of this presentation is to highlight key insights from the 2018 Canadian Physician Survey while focusing on three main themes: advanced use of electronic medical records (EMR); use of functions related to medication management; and advanced use of consumer-facing e-services such as patient access to their own health information, e-visits, and e-booking of appointments.


      Methodology/Approach:
      A total of 1,393 physicians completed the survey: primary care physicians (PCPs) N=799; and specialists N=594. The survey was conducted in French and English using a multi-method promotion and recruitment strategy. A weighting methodology, developed by the Canadian Institute for Health Information (CIHI), was applied to all responses representing the (estimated total) 78,839 of eligible physicians in Canada. Weighted and unweighted results of the survey were compared; and comparison of the unweighted demographics to the 2018 Canadian Medical Association Masterfile physician profiles demonstrated no statistically significant differences between the 2018 CPS and the CMA Master file via Chi-Square test.


      Finding/Results:
      Use of EMRs is demonstrating significant efficiency benefits for physicians and the health system as evidenced by 82% of PCPs and 77% of specialists who stated that they provide more efficient care with electronic records. However, not all physicians are using EMRs in the same way or have access to the same functionality. While PCPs frequently access lab results (80%) and diagnostic images (74%), other functions such as ?generate lists of patients who are due or overdue for tests or preventive care? or ?electronically exchange patient clinical notes with any doctors outside your practice? are more rarely used. Use of more advanced clinical functions such as these is correlated with higher perceived efficiency and higher satisfaction with physician EMR systems than basic use (use of just 1 or 2 functionalities). A key finding is that 84% of highly optimized PCP EMR users (using 6 to 9 functionalities) are satisfied with their EMR, compared to only 49% of PCPs using 1-2 functionalities. Similar findings were observed when correlating use of medication management functions such as generating an electronic prescription with an EMR and use of electronic warnings for drug interactions and perceived efficiencies. Additional findings related to physicians? use of virtual care and consumer-facing e-services were also captured in the survey.


      Conclusion/Implications/Recommendations:
      A majority of primary care and specialist physicians use EMRs and have access to connected patient information from care settings outside their main practice. The methods of electronic access to clinical data from connected health information systems differs across jurisdictions and community-based and hospital care settings. Furthermore, there are various levels of integration with point-of-care EMRs such as viewers, in-context single sign-on, and direct data feeds. Altogether, these findings show growing adoption of digital health across physician practices.


      140 Character Summary:
      The 2018 Canadian Physician Survey maps use of EMRs in primary care and specialist practices. Advanced use is correlated with higher efficiency and satisfaction.

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