Health system should get with the digital age

Quebec physicians shouldn’t still be using fax machines, pagers and paper, Adam Hofmann says.

The principal method of communication between doctors in Quebec is still the fax machine. Quebec is years behind other provinces in deploying health-care technology. We also still use pagers and paper in the digital, mobile age. When I started working as a doctor in Quebec, just under a decade ago, we were still faxing requests to pharmacists for patients’ medication lists. If you were working in the emergency department, you had to hope that the patient having a heart attack had the wherewithal to remember his or her pharmacist’s phone number. So if it was nighttime or a holiday, forget having your patient’s medication list, you had to wing it and hope they didn’t go into withdrawal or miss a dose of something important. After graduating, I worked as a doctor around the world, from Uganda to British Columbia, and from small communities in rural northern Ontario to teaching hospitals in Montreal. I had decided to spend the first few years of practice moonlighting — more formally known as locum tenens, literally “place-holding.” This type of practice allowed me as a then-beginner doctor to experience a variety of health-care settings on a temporary basis. This comparative exposure to different systems greatly shaped my perspective on how systems deploy technologies. For instance, when I worked in British Columbia, I admired the fact that they had the ability to download a patient’s medication list from a secure online database. When I saw a patient from Kelowna who fell ill while vacationing on Vancouver Island, I knew which medications they were on. This undoubtedly saved lives. When I was in rural northern Ontario and needed a hospital-to-hospital emergency transfer, or a piece of advice from a faraway specialist, there was a well-resourced and staffed call centre dedicated to making my task far easier. We also shared an interconnected electronic medical record across hundreds of kilometres. Paper charts were a thing of the past, unlike in present-day Quebec. To be sure, it has gotten better recently as the Quebec government has put into place an online system similar to the one in B.C. But, as it stands now, there are no, or few, full-scale, modern, electronic medical records deployed in Quebec. There is also little support for inter-hospital transfer and facilitating communications between disparate groups of doctors and health professionals. Our sick-care system needs innovation. Preventive medicine is the key to saving millions of lives, and technology can scale our efforts efficiently. As a health-tech entrepreneur, I developed a free app, Medmo, to help family doctors co-ordinate with specialists on-demand, without the clunky back and forth of a fax machine or pager. And I founded Preventia Clinics, a publicly funded, scientifically driven solution designed to keep patients well, at home, and out of hospital. We are part of a larger social movement called Mouvement Innovation Santé, and have begun making headlines in the French-language media on this pressing issue. There has been a grassroots call for change and innovation in the Quebec healthcare system. In a recent survey by Léger, a full 98 per cent of Quebecers feel the system needs to be improved. Similarly, the Montreal Economic Institute reports that approximately seven in 10 Quebecers surveyed are open to the idea of innovative private companies coming in to develop and deploy these new technologies and deliver health care — provided they are publicly funded — and successfully accomplish what the government has struggled to do for the past few decades. It’s long past time the Quebec government partnered with the passion and talent in their own province, and recognized the undeniable desire for change that the population is demanding. The new Quebec government has the opportunity to save more lives, at a lower cost to the taxpayer, by investing in technology. We are decades behind where we deserve to be.