UK, Canada offer cautionary tales about EMR security

The problems and concerns people are having with EMRs are not exclusive to the U.S. Check the "Also Noted" section of today's newsletter and you'll see an item about a Royal College of Nursing survey from the UK, in which 49 percent of nurses say they think electronic medical records are less secure than paper records.

Fear of breaches is a universal worry. Apparently, lack of connectivity is, too. As the Canadian Press recently reported, nearly 5,500 physicians in Ontario now use EMRs, and more than 5 million of the province's 13 million residents now see doctors who have EMRs. But a planned interoperable network across Ontario is a long way away.

A provincial agency called eHealth Ontario is offering subsidies of $28,000 Canadian (about the same in U.S. dollars right now) over three years to each physician that switches to a suitable EMR system. It sounds awfully like the "meaningful use" incentive program here in the States, right down to the requirement that the software meet certain standards. What's missing is the interoperability from hospital to physician office outside of a few metro areas--Toronto not among them.

"[Taxpayers] are paying for physicians to put computers in their office, and this is a step that needs to be done," provincial lawmaker France Gelinas of the leftist New Democratic Party told the Canadian Press. "But that does not give physicians access to any new information to provide better quality care."

Another opposition member of the provincial Parliament had even harsher words. "Ontario's system of proceeding with an electronic health records system is a laughingstock internationally," said Christine Elliot of the Progressive Conservative party. "We are so far behind the other provinces."

At least there seems to be a spirit of competition among provinces to get their healthcare providers online. That also brings to mind the Surescripts state awards for e-prescribing, where Rhode Island and Massachusetts have been jockeying for the top spot among the states for at least the past five years.

All this is happening at the policy level. If only people on the front lines of care--like, say, the nurses in the UK--would start demanding better connectivity, interoperability and, of course, security, maybe networks would get built faster and better. Would it be too much to expect patients to expect the same? - Neil

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