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One of the major differences between Canada and the US in terms of the effecting change in the healthcare system is the power of the consumer. In the US, doctors and hospitals compete for patients, referrals and 'market share'. While this is not the Canadian way, what it does is create an environment in which the informed consumer (patient) carries significant weight in terms of influencing the behavior of medical practices and hospitals that serve them. The opposite is true in Canada. Family physicians have more patients than they can cope with (millions of patients are unable to find a family doctor) and specialists are in high demand with many having wait lists of month or even years. In the Canadian setting, the 'consumer' is less able to influence the behavior of the physician. When there are hundreds of patients waiting to get into a practice, why change?

With the advent of meaningful use requirements in the US, Health & Human Services (HHS) has upped the ante even further. In order for practices to achieve meaningful use, there are certain legislated patient oriented requirements that have to be met. In 2011, these are to provide patients with electronic copy of, or electronic access to, their health information and to provide clinical summaries for patients for each encounter.

While one might say that in Canada, many EMR systems allow the same sharing of information with patients, it is not required by law. As a result, EMR vendors may compete based on their ability to provide a personal health record or patient portal, but this capability is not universally required in order for medical practices to achieve certain incentives.

An article series in the Canadian Medical Association Journal (CMAJ) on patient charters explores the attempts in Canada to empower patients through provincial or national charters of rights. This is an interesting area with the potential influence provider behavior, but only if the change is required and not optional. The tension between policy and legislation.

"CMAJ - Scratch the surface of recent health care reform and you’ll likely find a commitment to “patient-centred care.” In some nations, the concept is even viewed as integral to a retooling of health care systems. But beyond a general promise to put patients at the heart of health care decision-making, most nations are still in the early stages of defining concrete parameters for the delivery of patient-centred care. At the front of the trend, countries such as Australia and the United Kingdom have enshrined the rights of patients in national charters, which outline what consumers can reasonably expect in terms of health care standards and accessibility. In some nations, charters have the force of law; in others, they are statements of health policy. Across the board, however, they serve the same function: to empower patients and serve as guidelines for the delivery of health care services..."

Click here to read the full article CMAJ: Patient charters: the provincial experience

What are your thoughts? Should we have a legislated patient charter of rights in Canada? If this were to occur, what do you think the impact would be to encourage adoption and use of EMR by physicians?

Click on the 'Comments' link below.

Read More: http://blog.canadianemr.ca/canadianemr/2010/08/cmaj-patient-charters-the-provincial-experience.html