Thank you very much for this opportunity.
As the father of three teenage girls, it's going to be an experience to have people listen politely and not interrupt for 10 minutes. I'm going to enjoy this.
My grandfather was born in Montreal and lived in a small town just outside Montreal called Chambly. One of his early chores was to harness the horses and hitch them to the wagon to take his father to the train station. He disliked horses very much so when the car came out he was one of the early adopters. Early adopters transformed the way transportation happened. We're at the same stage now in our development of electronic health records and e-technologies.
If you go to the States the CDC, the Centers for Disease Control and Prevention, this last year said that about 50% to 55% of physicians are now using electronic health records in the United States. In Canada the Canadian Medical Association estimated that somewhere around 39% of our physicians are using electronic health records.
It's clear to me that with graduating 2,000 physicians per year we've passed the tipping point. Those graduating physicians are not going to start using paper charts and move backwards. They are moving forward quickly. I think we will see a massive shift to electronic health technologies in this country over the next three to five years. That's one of the key messages here; it's happening and we're there in terms of adoption.
One of the keys is that we haven't got toward meaningful use. What I mean by meaningful use is value added. If my grandfather only used his car to take his father to the train station and back, we wouldn't really have seen any development. If we're simply using our electronic health records to replace the paper chart, we're not getting anywhere. We're maybe slightly improving our efficiency but we're really not taking full advantage. That is really where we are now, that is, to drive the meaningful use. That's what I'd like to talk about a little: what we're trying to accomplish.
McMaster University is probably well known as being one of the innovators. We developed an electronic health record called OSCAR about 12 years ago. OSCAR is now one of the leading EMRs in the country. Approximately 2,000 family physicians are using it across the country with about three million Canadian citizens being registered with OSCAR and being supported on that. However, it's an electronic health record and that doesn't meet all the needs of our Canadian public. What we really need to see is the development of tools within the electronic health record that facilitate and promote care. We've been working with our colleagues and OSCAR has been developed across the country. It's now at McGill in the department of family medicine. It's at Queen's University, McMaster, and also at UBC.
This product is now starting to mature to the point where we're starting to see more and more, I will call them apps or add-ons to this product. For example, we are seeing an increasing number of patients with chronic kidney disease in this country who require renal dialysis. Renal dialysis, hemodialysis, and peritoneal dialysis are considered an onslaught and are extremely expensive. We know we can prevent large numbers of patients from moving down the slope to needing dialysis. Part of the challenge is identifying those patients early.
One of the things we've done is we've partnered with the Kidney Foundation of Canada and the Ontario Renal Network to start to develop what we would call an app that goes on to the electronic health record and identifies those patients early. As we start to see if they have an increase in blood pressure, if they have certain ethnic backgrounds, if they're aboriginal or South Asian, or if their glomerular filtration rate or their kidney function starts to deteriorate, it sends a signal to the clinician that says this is a patient whom you might need to pay more attention to.
As a result of that, we can now start to see changes in how we manage. One of the challenges with a paper record, frankly, is if it's sitting in the back of the paper record, nobody is triggering to the clinician that you need to pay more attention to that patient and perhaps intervene early to stop the progression.
This product is being trialled. It's now ready to go. I think one of the important aspects of one of the messages I'd like to give is that this is an open-source solution. Although it's been developed on our electronic health record, it will be made and is going to be made available to any electronic health record in the country. It would be something that would be an add-on, and we give it away. It's not a matter that there's a cost for it.
Another example is our BORN initiative, the Better Outcomes Registry and Network for perinatal and pregnant women. One of the keys here is that when you're a patient and you're receiving prenatal care from your obstetrician, your family doctor, or your midwife, that data resides on the clinician's chart. It doesn't necessarily get shared. In partnership with Ontario, as well as what was formerly called the B.C. reproductive care program—it has a new term, I'm sorry; it's in my speaking notes—the idea is to identify women and get their information onto a registry such that no matter what hospital they show up at, no matter which specialist takes care of them, their information is immediately accessible to the clinicians. That's going to lead to improved care, and less duplication of investigations.
We've also partnered with the Better Outcomes Registry to start doing prompts, again for the clinicians. When I was seeing patients this past Monday, up came a prompt that said to me the patient is 34 weeks pregnant, she has not received a certain investigation, she is already at risk because of her maternal age, because of her maternal weight, and it suggested that perhaps I should have done or should be doing a particular glucose screening. That fundamentally right there starts to change the whole dynamics of patient care because we're triggering early the information for how we're going to care for those patients.
We've also developed a program called MyDrugRef, which in a nutshell is a social networking site to try to improve how we provide care to our patients to stop the drug-to-drug interactions and to start to incorporate best practices. As a family doctor working in isolation in my office, I don't necessarily have access to a number of specialists and a number of other individuals. This is a way of having instant access to a whole variety of information. We think that's going to change how we practise over the next few years.
We've also been involved with the development of a personal health record. We've called it MyOSCAR for now, but really this is a personal health record that should be broadly available. I want to differentiate between a portal and a personal health record. A portal is a window into the physician's electronic health record. Our vision is that we develop a personal health record that you, the patient, own. It has a number of features.
Initially, we have online booking for the patient. I booked my plane ticket to come here online. Why can't I book my doctor's appointment online? Why do I have to wait? We have now instituted that and it's up and running so that patients can actually book online easily.
There's secure messaging between the clinician and the patient. My patients can send me a message over the Internet, not e-mail but secure messaging, so that I can interact with them. That could be my nurse, or one of the nurses in the unit, a dietician, a social worker, whoever is the most appropriate person.
The other thing is document transfer. When I looked online today at my patient profiles, I received the cholesterol, the laboratory results, the sugar test, etc. I acknowledged that electronically. It gets filed into my electronic medical record, but it also was sent to my patient today so that they saw it online, in their own personal health record, along with a comment from me, “Great work. Keep it up, Joe. You'd better come in and see me. We need to talk about your exercise”, or whatever it is.
It's that starting to put the care of our patients in the patient's hands, which is where it probably belongs in the first place. Through Health Canada or the Federal Economic Development Agency for Southern Ontario, we've been part of a partnership with York University and NexJ and are starting to develop a series of apps so that patients can take care of their own health themselves. It generates that sort of care for themselves.
My next point is that telemedicine—