| Nov 22, 2007

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Feature Article - November 22, 2007

Rural Health Centres Switch to Thin Clientsby Jeff Green

Medical practitioners in Sydenham, Verona, Sharbot Lake, and Tamworth will not be weighing their patients before deciding whether to treat them, but they have decided to slim down their computer systems.

The four medical practices have been linked together as members of the Rural Kingston Family Health Organization for several years to better serve the needs of a diverse, rural population. Computerising the patient records at the clinics has been a priority, and the clinics have moved from paper to digital records. With technical advances that have recently come about, they are now storing all of their patient information through a secure link with the IT department at KGH.


In place of computer servers in each of the clinics, all of the computers in the clinics have been turned into ‘thin clients’, with all software and data storage being based in Kingston.

"The system has been up for about two months, and although there have been glitches, it is working well," said Doctor Laurel Dempsey of the Verona Clinic.

The new system takes the pressure off each individual computer system, and is a first step in a process of developing patient records that can be easily accessed by different practitioners. The ultimate goal is for each patient in the province to have an electronic file that can be accessed, in an appropriate manner, by any trauma centre or specialist that the patient interacts with.

But there is a very long way to go.

For example, if a patient is referred by Doctor Dempsey to KGH for an ankle x-ray, this would be noted in her electronic patient record by Doctor Dempsey. The x-ray at KGH would be sent digitally to a radiologist at the hospital for analysis, and the radiologist would enter their analysis into a computer. But then, the radiologist would also have sent a paper copy of their analysis, by mail or courier, back to Doctor Dempsey. Doctor Dempsey would read the information, and enter a portion of it into the electronic patient record, which itself is stored back at KGH. Although the patient file is stored at KGH, none of the practitioners at the hospital have access to it

The logical next step would be to eliminate the paper trail, and to have the digital x-ray as part of the patient record as well.

"We are hooked into the Kari-Net system, the internal email system of the hospital," Doctor Dempsey said "and sometime soon we hope to be getting the x-ray results and analysis via email. Then we will be able to insert all the information in the electronic patient file."

In a media release from KGH announcing the new system that came out this week, the potential for improved communication with the rural clinics was highlighted. “The value of the partnership will increase over time as health-care systems across the country move increasingly toward electronic documentation of patient records. The infrastructure established by this partnership between the Rural Kingston Family Health Organization and KGH means that two-way access to patient information will be available for all in the not-too-distant future, allowing health care professionals to provide the highest quality of care with greater efficiency,” the release said.

While the infrastructure is now available for this to happen, at least within the local health region, if not province-wide, it will still take a quite a bit of money to get there.

"Patient records are not necessarily much more complicated than banking information," said Doctor Dempsey, "and the banks have developed a secure electronic data system. The difference is that banking customers pay to set up the system, and to maintain it."

Funding the health care system as a whole is an ongoing issue, and electronic records are not a priority item.

Kingston General Hospital recently alerted the media to its need for $13.5 million in extra funding this year to deal with crumbling physical infrastructure and an increased patient load. This coincided with the recent provincial election.

Paul Huras, the top administrator with the Southeast Ontario Local Health Integration Network, the funding body for the hospital, expressed his displeasure with KGH’s media campaign, which he said was “detrimental” to the reputation of the hospital, according to an article in the Kingston Whig Standard.

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