Creating circles of care for Vancouver’s youth population

Dr. Steve Mathias is seeing an overall scattered approach to accessing health services in the young patients he treats at the Inner City Youth Program out of St. Paul’s Hospital. Without education on how to use health services, young adults can end up with many contact points throughout the health system, from mental health to primary care to substance use treatment. A shared Electronic Medical Record (EMR) that encompasses primary care in addition to hospitals and the provincial lab system supports better patient care.

“The EMR gives opportunity to see a patient’s spectrum of health issues and corresponding provision of care. A medical doctor can quickly lasso what a patient is doing for care — what services are being used, and if those choices are the most effective,” says Dr. Mathias.  “Access to a patient’s full chart also cuts down on repeated lab work and allows physicians to support each other’s treatment plans.”

EMRs aren’t new in the healthcare system, but their capability to move beyond simple electronic charting and become an essential tool for health care management is still under development. The VCH EMR provides a clinical care management system — from writing prescriptions, to receiving test results, to sharing multi-disciplinary documentation.

“Our EMR needs to be dynamic and responsive because our clinicians are constantly working to improve the quality of their clinical care — it’s our job to keep up with them and give them the tools they need. Our EMR team has worked hard to create a culture of ‘yes’ — when clinicians contact us with ideas for changes and improvements we try to say yes as much as possible, and deliver as quickly as possible,” says Dr. Stan deVlaming, Associate Chief Medical Information Officer for VCH Primary and Community Care. “I don’t expect us to ever have a ‘finished product’ that we just roll out when needed — every clinic/team that we have engaged sees how a powerful EMR can improve their care, and soon they have ideas for taking their care to the next level.”

Dr. deVlaming is leading the ongoing implementation of the EMR system across VCH, providing a valuable clinical perspective to the project. The recent addition of community health care is of huge benefit as patients move between Community Health Centres, emergency departments and other specialized programs such as addiction services. All team members, including physicians, psychiatrists, nurses and allied health staff access and contribute to the same EMR.

A recently introduced new feature for the VCH-PHC EMR is a portal that gives clinicians one-click access to the all of their patients’ information that is available on the Provincial eHealth Viewer called “CareConnect,” which contains radiology reports, lab reports, hospital visits, as well as documents like consultation reports and discharge summaries. The information flows both ways, as other CareConnect users, such as clinicians in emergency departments, can also access a real-time summary of a patient’s VCH-PHC EMR record, another recent improvement completed by the EMR and CareConnect teams.

Dr. Mathias aptly refers to the CareConnect summary as the “record of truth.” For clinicians, a system that provides a single patient record is a powerful truth for care and treatment, and ultimately, best possible patient outcomes.

For more information about electronic medical records: http://www.vch.ca/your-stay/your-privacy/health-record-requests