Hybrid health records; combining paper and digital medical charting
Today we had our training in the new, read-only hospital records system. We use something called PowerChart which is employed in almost all of the hospitals run by the Vancouver Island Health Authority (VIHA). Various sub-programs are used to input pathology info, lab values, medical imaging reports and transcribed patient encounters. We are still meant to do phone dictations to the typing pool, but they’ll appear in the chart. We hand write orders, but they are faxed to someone in the magical basement who enters them into the system (or maybe the unit clerk does it). ER triage forms are included in the system. I’m not sure how much will be in paper format, but for now, we are to have both the electronic and paper charts open in front of us when doing any record perusal.
The ‘hybrid’ system exists because we are transitioning from paper to pure digital charts. Unfortunately, I’ve seen this elsewhere, and I have yet to encounter a service that is 100% digital. The St. Paul’s Hospital Emergency Department, in Vancouver, is getting close. But doctors and nurses still use paper forms for triage & notes, even if they are scanned in eventually.
Tomorrow or Monday, I’ll find out what my Family Practice preceptors’ clinic is using. Most that I’ve encountered in the past use some blend of paper histories and progress notes with digital labs, consults, and radiology. This isn’t uncommon across the country; according to the CBC, Canada is still pretty retro when it comes to the format of medical records. Digitizing can be an expensive and cumbersome process, though the government of British Columbia has started to inject funding into the area. There are so many companies manufacturing Electronic Medical Records software; partly, this is because they are trying to build the ‘perfect’ system (many of these are physician-created) and partly, they can make good money doing so. Competition and capitalism allow for consumer choice, but I’ve got to say that here is one place where I would really love a national, standardized system. It would need a lot of health-care provider input and would have to be adequately customizable to make it acceptable to most people. But I can fathom it. Maybe we’ll get there in my lifetime.