Electronic medical records a big sell for incoming N.S. doctors

Nova Scotia doctors looking ahead to retirement may need to say goodbye to paper records and adopt an electronic medical records system to attract a replacement. 

Physician recruiters in the province say paper records are a deterrent for new grads and incoming doctors who want to use up-to-date records systems. 

But 10 per cent of primary care physicians in the province have yet to switch to digitized medical records.

Mindy LeBlanc, a physician recruitment consultant for Nova Scotia Health, said many incoming doctors want to work at offices with electronic record systems already in place — especially if they're stepping into a solo practice with a large patient list. 

"Most newer physicians are looking for the electronic medical records, which makes work a little bit easier for them, so it's all digitized and it's easy to access," LeBlanc said. 

Some established practices with retiring physicians may still have paper files, which can be an unwelcome sight for some doctors.

"Most physicians don't want to take on that responsibility of having to take all those paper files and input them into an electronic system. So that can be a challenge," she said. 

Learning curve 

Dr. Ken Murray has been a family physician in Neil's Harbour since 1972. 

His rural clinic transitioned to electronic medical records 23 years ago, thanks to a tech savvy colleague.

Murray still remembers the challenges that came with a new digital system.

"It was difficult at first, adapting, and all the entry required, putting in information from old charts and making medication lists current," he said. "Not being a skilled typist, that sort of added to the challenge."

Murray said electronic records are the norm now, and new physicians entering into practices expect such systems to be in place. 

"Overall, [it's] for the good. But it doesn't speed me up at all. I think I'm slower using electronic medical records than I was the old way, and others have told me the same," he said.

Murray understands why some solo practitioners late in their career may not be keen on switching to digital records. 

"I would not expect that physicians in the later part of their career, within 10 years of retirement, would necessarily want to do it … unless they had someone who was really going to take it on and oversee all the setup." 

Incentives available 

For more than five years, the province has been trying to adopt what it calls a one-patient, one-record system.

The Department of Health and Wellness declined to comment on the system, as it is "in the final phases of procurement."

The department said electronic medical record adoption is high in the province, with 90 per cent of primary care physicians using at least one of the two electronic options available — MedAccess and Accuro. 

In clinics affiliated with Nova Scotia Health, the use of electronic medical records is mandatory for primary care physicians. For private practices, it is optional.

There are some incentives to help doctors switch to electronic medical records.

The Nova Scotia physician master agreement is a funding contract between physicians and the provincial government. 

It has three funding incentives designed to encourage the adoption of electronic medical records: a one-time payment of $10,000 to physicians adopting the technology for the first time, an annual participation grant of $2,000, and an annual utilization grant, which varies based on doctors' survey responses.

A long way to go

While physicians in the province are much closer to being paperless, the president of Doctors Nova Scotia said there is still a long way to go for seamless integration between offices, hospitals, labs and pharmacies. 

"We still don't have great transfer of records even between one electronic medical record to another," said Dr. Leisha Hawker.

She said that lack of integration can cause communication delays, make the system less efficient, and increase the risk of errors or miscommunication.

Her association, which represents all physicians in the province, has made up-to-date e-health technology a top priority.

"Keeping up with technology is important for physician's satisfaction, but it's also important for recruitment and retention of our doctors, and we have such a shortage," said Hawker.