Canada's lag in adopting electronic health records is getting ridiculous

Except in Alberta.

Last summer, I decided to switch doctors. My existing physician was getting a little long in the tooth and my visits to him were taking longer and longer, at times hitting two hours for routine issues like a cough. On some occasions, I’d sit across the desk from him wondering if he’d nodded off.

After asking around for recommendations, I landed myself a new doctor. I’m with him now and I’m quite happy. Visits are short and to the point and so far, he seems to have cured whatever ailments I’ve come to him with.

During the transition, I got a letter in the mail from the old doctor’s office informing me that he required $47 to transfer my medical records to the new practitioner. Now, $47 isn’t a lot of money, but I took it as blatant extortion. There is perhaps nothing more personal than your own medical records, so to have someone ask for anything more than pocket change to cover photo-copying and mail costs is an outrage.

I was of half a mind to start a legal proceeding against the doctor since, in Ontario, the Personal Health Information Protection Act gives individuals the right to their own information. Privacy commissioners in this province and in Newfoundland have indeed ruled in favour of people who have been levied such excessive fees. The Newfoundland commissioner, for example, found that people should be charged no more than $25 for a record of up to 50 pages, with each additional page costing a maximum of 25 cents.

In the end, I decided that since I don’t really have any major health issues—knock on wood—I’d drop the issue and start from scratch with my new doctor. Hopefully, this won’t come back to haunt me.

The solution to the situation is mind-numbingly simple: electronic health records. If my old doctor had simply typed his notes into a computer each time I visited, transferring the data would have been as easy—and as cheap—as pressing “send.”

I wasn’t very surprised, then, to learn that it wasn’t just my ancient doctor—Canada in general is way behind in adopting electronic health records.

According to a new survey from technology services firm Accenture, only 5% of Canadian doctors allow patients to have electronic access to their medical summary or chart. That’s the lowest percentage in the survey of 3,700 physicians in eight countries: Australia, Canada, England, France, Germany, Singapore, Spain and the United States. Only 7% of Canadian doctors give patients access to their own or family member’s test results on a secure website.

Moreover, “less than a third of physicians (29%) believe a patient should have full access to his or her own record, 57% believe patients should have limited access and 14% say patients should have no access.”

Sanjay Cherian, Accenture’s health industry lead in Canada, says the problem is two-fold: incorporating electronic records happens both from a bottom-up perspective, where individuals doctors are trying out new technologies, and from the top-down, with institutions motivating change. “Cultural differences” on these issues are the reason why Canada is behind other countries, he says.

Accenture sells products in this area so it’s important to take the results with a grain of salt, but the lag has otherwise been well documented.

Fortunately, some provinces in Canada are doing better than others. I spoke with Calgary physician John Fernandes last year and he said Alberta’s Netcare EHR was “the single best electronic health record system on the planet.” It does indeed seem to be getting a lot of use from patients in that province.

There’s little excuse for why a country that touts such a great healthcare system is lagging in this area. It’s also unacceptable that some physicians are actually still opposed to giving patients access to their own information, or worse, charging for it.