Engaging With You on Digital Health

Digital health plays a vital role in how doctors deliver health care today and into the future. As the Ministry of Health moves forward on its provincial Digital Health Strategy, advocating for physician influence in shaping digital health planning is a priority for Doctors of BC.

We are committed to engaging with you to ensure the physician voice is reflected throughout the process, and that any proposed digital health solutions align with your needs without creating more work or adding to existing burdens.

Hearing from a broad range of physician voices—from all practice types, geographic locations, and specialties—is crucial to steering these efforts, as it will help deepen our understanding of perspectives across the profession and guide how we advocate for you as work in this area progresses.

Doctors of BC is planning a number of ongoing member engagement opportunities over the coming months. Check here often for the full list of current and upcoming opportunities.

Doctors are engaged to provide clinical feedback on a wide range of projects focused on enabling a connected health system:

• Initiatives work towards system-wide interoperability of EMRs, clinical systems, and other digital health technologies
• Initiatives seek to support quality patient-centered care and reduce physician burden

Additionally, Doctors of BC continues to work with health care partners to inform, guide, and influence work underway to develop and implement other digital health solutions in BC. Further information can be found below.

The Digital Referrals and Orders program (DRO) is a provincial platform that enables care teams to electronically exchange, track, and manage referrals, medical order requisitions, and consults (advice requests) in a more effective and efficient way.

Through various member engagements, Doctors of BC is committed to ensuring the physician voice is elevated and reflected throughout the development and implementation of the PHSA-led DRO program. This has included defining clinical needs and data sharing requirements for the provincial Request-for-Proposal (RFP) issued in 2022 and sharing member feedback during PHSA’s selection of the OceanMD vendor, to current ongoing design and implementation aspects of the DRO platform.

Benefits of the program include:

• Care teams use an interactive visual Healthmap to search for providers and clinics by keyword, locations, and health service offering.
• Clinics auto-populate data and attachments directly from integrated clinical systems into their referral, order, and consult requests to streamline data entry and reduce administrative burdens.
• Clinics receive and send patient messages, pre-appointment questionnaires, and appointment reminders to improve communication and transparency.
• Patients and their referring providers receive real-time updates about the status of their referrals throughout the process.

If you are interested in implementing OceanMD in your clinic or participating in other engagement opportunities related to DRO, please contact DRO.program@phsa.ca.

Implementation timeline and additional information

Initial implementation of OceanMD began in the Lower Mainland in Spring 2024 with the distribution of eReferrals to care providers that use the OceanMD web portal and/or the following integrated EMRs:

• QHR Accuro
• TELUS Med Access
• WELL Health OSCAR Pro

The Digital Referrals and Orders team is also actively working on adding more clinical system integrations and eOrders for medical imaging requisitions at select sites in 2024. The implementation of eOrders for lab requisitions and eConsults (advice requests) will occur in a future phase of the project.

Further information on the DRO program, including patient benefits and a link to a short video, can be found in these resources:

• DRO Family Practice Overview
• DRO Specialist Overview

Health Gateway is a provincial patient portal that provides patients with access to their health records for health care received anywhere in the province. BC patients can use the Health Gateway website to access their health records including lab results, health visits billed to BC MSP, medication history, specific diagnostic imaging reports, immunization records and schedule, plus more.

New features are added regularly, and input from patients, physicians, and other clinicians and providers helps to inform future expansion of information currently under consideration by the Health Gateway team.

Doctors of BC is continuing to support PHSA’s exploration of provincial solutions to the issue of reports distribution, which is understood as a significant burden to physicians with impacts on patient care. Consultation with physicians through engagement events and working groups began in 2021 to better understand the interconnected challenges physicians experience related to reports distribution. The themes and needs were validated in an all-members survey in 2023. The below list outlines the validated list of requirements provided by physicians:

1. Reports are sent electronically to the right providers, at the right locations; based on a comprehensive, reliable list of providers and locations that is up-to-date; including electronic distribution of community specialist reports.
2. Easy on-demand access to clinical information e.g., single sign on, keyword search, downloadable reports
3. Ability to self-manage report distribution e.g., where I want reports sent to and how, full/partial report or notification, partial/pending lab results, what circle of care reports I receive.
4. Ability to distribute reports based on patient’s known Circle of Care (with ability to select/deselect individuals from list)
5. Ability for report authors to distinguish between which recipients have actions and which are FYI, as well who needs to do what.
6. Improved EMR user experience e.g., support for PDF search, incoming reports match referral/order, ability to forward/share reports, standardized report structure/content including images, tables and graphics
7. Improved patient experience/interaction i.e., patients can forward/upload photos and reports to provider, consistent policy/approach regarding timelines for patient access to reports.

Engagement work continues to support the exploration of interim and broader provincial solutions to these challenges. If you are interested in participating in any discussions around this, please contact us.

A patient summary is a standardized set of basic clinical data that includes the most important health and care related facts required to ensure safe and secure health care. It’s comprised of a standardized collection of patient information – the necessary minimum and sufficient data to inform a patient’s treatment at a point of care. Clinical uses of patient summaries may include:

• Medical emergencies
• Unfamiliar provider at the point of care
• Coordination/transitions of care

Patient summaries can help improve:

• Coordination of care and clinical workflow efficiencies
• Health outcomes and patient safety
• Patient and provider experiences
• Cross-jurisdictional patient flows

In early 2021, the Shared Care Committee (SCC) funded a Patient Summaries Pilot Project in the Victoria and the South Island regions. A key objective of the project was to improve communication between community- and hospital-based doctors in their shared care of in-hospital patients. The project successfully met this objective and PHSA is now pursuing the provincial development of a Patient Summary to support patient care.

To support the provincial development of Patient Summaries, Doctors of BC has supported physician involvement through an All-Member Engagement (January 2024) as well as an active Clinical Advisory Group (CAG) and numerous ad hoc provider meetings to support the fulsome development of requirements for a provincial patient summary. The first iteration of the solution is currently being sought and will be tested with physicians in clinic prior to an additional All-Member Engagement to be held in Spring 2025.

• Information on the provincial patient summaries project

Related work is underway at a national level through Canada Health Infoway’s Patient Summaries project. Recognizing the need to build on BC-based lessons and for physician input on digital health solutions, Doctors of BC advocated for and facilitated physician participation in key review stages of Health Infoway’s work.

For more information on the National Patient Summaries Project, visit Canada Health Infoway.

In collaboration with the Ministry of Health and other stakeholders, Doctors of BC’s Digital Health Strategy team is working towards enabling connection and communication across BC's health care system.

Recently, Doctors of BC completed an EMR Survey to understand our members' needs. Doctors of BC will use these findings to inform development of a provincial EMR Strategy. They will also guide our advocacy approach and our collaboration with provincial partners. We will continue to seek member input to understand BC doctors' evolving priorities, including seeking more information from them on central supports for EMR contract negotiations and pricing.

See the summaries of What we heard from members around EMR interoperability and vendor governance below.

Past engagements on interoperability and vendor governance: What you told us in the Informing Digital Health Strategy in BC – Phase 3

In April 2023, we conducted a survey seeking members’ input on potential approaches to shifting to fewer EMRs in BC and ways to ensure steps towards EMR consolidation align with your needs and perspectives. You told us that, as the Ministry focuses on how to move toward consolidation, as well as advances its work on collaborative governance of EMRs (as agreed upon in the 2022 Physician Master Agreement), you support using a collaborative structure to procure and manage EMR contracts. You identified the need for an EMR governance structure that is responsive and provides full access to records with quality data and shared your preference for exploring the use of a collaborative structure for EMR contract procurement and management, with the aim to support rising EMR costs and capping fees related to changing EMRs.

System Interoperability – Supporting a “connected health system”

Between Aug – Sept 2022, we sought members’ input on your clinical needs related to interoperability, including validating a list of clinical requirements that were to be included in a joint Ministry and Provincial Health Services Authority Request for Proposal for a digital solution(s) to support a “connected health system” in BC. Respondents told us they want a user-friendly connected health system, and their feedback centered around four main themes: patient experience, provider experience, administrative burden, and features and functionalities.

Informing Digital Health Strategy in BC – Phase 2

During April 2022, we conducted a survey seeking members’ input on EMRs and EMR vendors, as well as EMR functionality and information-sharing. The survey built upon past member engagement where EMR management, poor functionality, and lack of system interoperability were identified as significant burdens and primary concerns. Respondents confirmed they want simple, fulsome sharing of patient information across the province. Interoperability – and the consolidation of EMRs to aid in interoperability – was strongly supported; however, costs of EMRs, administrative burdens, and challenges associated with data portability continued to be significant concerns.

Informing Digital Health Strategy in BC – Phase 1

In June 2021, we gathered member feedback on optimizing the use of electronic medical records (EMRs), electronic health records (EHRs), and other digital health technologies to understand doctors’ priorities when it comes to enhancing how these systems work, and how to use them effectively in a post-pandemic environment. We also sought input on the Ministry of Health’s priorities related to enhancing functionality, information-sharing, and effective use of digital health technologies. Respondents told us that administrative burdens, poor functionality, and lack of system interoperability with EMRs and EHRs increases inefficiencies for doctors, leading to a decrease in quality of and access to care and an increase in physician burnout. Respondents also showed a strong desire to simplify and streamline EMR use and management to improve patient care and align with clinical workflows.

Hearing from a broad range of physician voices – from all practice types, geographic locations, and specialties – is crucial to steering these efforts, as it will help deepen our understanding of perspectives across the profession and further guide how we advocate for you as work in this area progresses.

If you are interested in getting involved or have any questions about digital health engagement opportunities or digital health, please contact us.

You can also learn more about our advocacy work in this area by visiting the Digital Health Strategy section of our website.