Cloud-computing and electronic medical records: We're missing the boat

When we finally get our electronic medical record (EMR) in Saskatoon Health Region, will it already be out-of-date?

Last Friday's Globe and Mail business section was buzzing with news about "cloud computing".  Apple's recent announcement of iCloud - while not the first cloud-based storage service - might, according to one analyst, do to that market what the iPod did previously to the MP3 player market.  iCloud will let you store data on remote servers and access it from anywhere you have internet access.  That means remote access to music, photos, video and documents.

How about your medical records?  Not so much.

Another article about cloud-computing focused on EMRs.   Bottom line: We're struggling.

Several years ago, in a blog far, far away, I pouted about the lack of a functional, province-wide EMR.  Since then, I have achieved on-line access to all x-rays done in Saskatchewan hospitals, except Regina.  Lab results ordered by one of our urologists, or copied to one of us, are sent electronically to our office EMR.  I usually get results on my inpatients even before the hospital ward receives them.  It also saves our staff the nuisance of manually assigning results to patient files.  I can also access patient pharmacy records, that is, if I can remember password #37.

There has been progress, but it's slow and local.  I have access to test results that I've ordered or another physician has thought to copy me on.  Otherwise, if I want x-ray reports, lab results and, most importantly, patients' medical history from another physician's office, I have to retrieve the information manually.  This usually involves me writing a letter, or my staff phoning a referring doctor's office.  It sometimes requires a follow-up request.  Then, if the information isn't forthcoming, we give up and repeat the test.

It's a frustrating waste of time and money.

An EMR that lived in the cloud would give me access (with appropriate permission) to all of a patient's records.  What's the roadblock?  According to the Globe and Mail piece: interoperability and security/privacy.

But, banks seem to have cracked this problem, and they deal with pretty important information.  Different industry, you say?  Well, Toronto's Sunnybrook has already put the power of an EMR into patients' hands with MyChart.

I hope that an EMR will arrive in Saskatoon Health Region in the near future.  But, if the data lives on local servers and isn't remotely available (to the patient, and any caregiver around the world who may be providing health services to them) then I fear our patients and staff will be saddled with an EMR that is DOA.