Paperless Healthcare Records in Canada

Paperless healthcare records are becoming a staple of the Canadian healthcare system as it strives to implement paperless initiatives. While Electronic Health Records and Electronic Medical Records are the main solutions in hospitals in the US, smaller healthcare professions, such as Contract Nursing and Assisted Living, are upping their game toward paperless initiatives. This is evidenced by the ever-increasing calls to increase efficiency.


Progress Has Been More Than a Decade in the Making

All the way back in 2005, the president of Canada Health Infoway, Richard Alvarez, laid out the ways in which he believed progress would come on Electronic Medical Records (EMR) and Electronic Health Records (EHR). He pointed to England’s Program for IT and stated that their goal was to have EHRs for the entire Canadian healthcare system by 2010. Sadly, by the time 2011 rolled around they scrapped the idea, even after having spent $20 billion in Canadian dollars.

In 2014 Jeremy Hunt, the Health Minister, challenged the National Health Service to go totally paperless by 2018. While this is a great idea and can have many benefits, including cutting down on costs and errors, the question remains: Has anything really changed since their last failed attempt?


The Problems with the Initial Plan

In order to determine if the current plan will really work, it’s important to first look at why it didn’t work the first time. There are many theories but the 3 most common are:

  • The motivation for implementation came from the top, but projects like these are typically much more successful if a bottom-up approach is followed.
  • The government didn’t properly engage with the right stakeholders. As a result, there was hostility and the workforce was unwilling and/or unable to meet the expectations they were expected to meet. There were technical difficulties, and too little time and attention was focused on the divide, both culturally and geographically, in the country.
  • IT contracts were awarded before the actual scope of the total project was understood. As a result, vendors withdrew—one even walked away from a £2 billion contract.


A Case Study of the Real Effects of Paperless Healthcare Records

The best way to really understand the challenges of having a non-paperless hospital administration is to consider the case of Martin Penninga. He is the former manager of a family practice located in Red Deer, Alberta. After managing it for 3 years, he realized that there were significant inefficiencies due to the paper-based system. In fact, he estimated that they were losing up to $6,000 a month as a result.

It may seem like, as the manager, it would be easy for him to implement a paperless system. That was not the case. He created a 70-page business plan, in which he recommended that the 100,000+ paper records (which took up a full third of the building) were converted into EMRs. His idea was that doing so would free up room to boost both patient flow and revenue.

The numbers are truly staggering: Up to 12% of the clinic’s annual staff budget was used for managing paper records. He wanted to have a totally paperless clinic, which would allow them to cut down on administration costs. However, his plan was stalled by the 13 doctors who owned the practice.

Penninga says the problems were really even more complicated than that. They wanted to bring new doctors in, but didn’t have space—thanks to the many paper records—and with their overhead rates as high as 40% of their billing revenue per doctor, they likely couldn’t have attracted new physicians anyway.

Costs were escalated even higher with staff expenses. Every doctor had a ratio of 1 ½ nursing staff to handle the administrative work. He noted that this was very expensive when compared to paperless doctor’s offices, assisted living facilities, and other Canadian healthcare offices.


Paperless Healthcare Records: The Results

Fortunately, this story does have a happy ending: Mr. Penninga left his practice to open Horizon. This was a truly paperless office that used a document management system. Their yearly revenue growth was an impressive 28.4%.

In fact, in just 8 months of existence, Horizon grew from 6 doctors to 12. Within a year, their annual gross revenue per doctor increased by $25,000 compared to the previous clinic he’d worked in. He estimates that they’ve saved over $6,500 per doctor in annual costs associated with paper documents: Another rational justification for the use of paperless healthcare records.

Being paperless has allowed his new office to be more efficient and has allowed doctors to see an incredible 7,000 patients per year. Compare that with just 5,800 per doctor at his previous clinic. In total, physician overhead rates are at a maximum of 30% of billing revenue. And it’s all thanks to an incredible document management system to facilitate paperless healthcare records.

Additionally, as Canada continues to become increasingly steeped in paperless healthcare administration, it will also open up the floodgates for managing the BYOD phenomenon with poise and confidence–a game in which the United States is still playing catch up to its Northern neighbor.