What is eDOCSNL?
eDOCSNL is the Provincial Electronic Medical Record (EMR) Program. Founded in 2015, the EMR Program exists to support providers with achieving increased clinical value leveraging the intelligent features of the EMR. The mature use of the solution will provide the province with information for health planning.
What is an EMR?
An EMR is a computer-based patient medical record specific to a provider’s practice. It includes patient information that may have been previously stored and recorded in paper files. It records patient demographics, medical and drug history, and clinical information such as laboratory results and findings from diagnostic imaging. It also manages activities such as billing and scheduling. Using the intelligent features of the software, EMR can support patient care with clinical decision support, care plans and individualized patient goals. The information collected in the EMR can provide valuable practice management insight through provider dashboards and reports.
What are the benefits of an EMR?
- Fewer errors compared to paper records.
- Better and quicker care
- Track results and data over time.
- Improve treatment and diagnosis.
- Identify patients who require screenings and preventive care.
- Better patient health data security and privacy.
- Supports data-based decisions.
- Receive follow-up support like reminders, weblinks and self-care suggestions.
- Save Space: Clinics do not need to store, manage, and retrieve paper records, thus saving space.
- Optimize Workflows: EMR help optimize workflows, keep track of patients, and manage patients who visit the medical facility.
- Lower Operational Costs: They reduce operational costs by keeping records in one place.
- View Health Information from other sources: Clinics can receive data from facilities (e.g. labs, DI) and interface with provincial health systems.
- Scalable: They help customize and scale patient records.
- Enables Outreach: Clinics can gather patient data and analyze it. This accessibility helps providers reach discrete populations, improving overall health.
- Reminders: EMR have communication capabilities that let clinics send reminders and alerts.
- Documentation: They reduce errors during documentation, improving care.
- Supports Research: Documenting patient records digitally supports research, and users can monitor patients for better care quality.
- Checks Conflicting Treatments: They have safeguards that prevent treatments that may conflict with each other.
- Communication Between Staff: They track messages between staff and other clinicians.
- Avoid Duplicate Tests: Without timely access to test results, physicians may have to order repeat tests. Keeping physicians up to date on previous tests reduces the need for repeats. It is especially important when tests are expensive, uncomfortable, and invasive.
What information does an EMR contain?
Participating in eDOCSNL will allow physicians to record the information gathered during a patient’s visit in the EMR. This includes information such as a person’s weight, blood pressure and clinical notes that would have previously been hand-written and stored in a file folder in a doctor’s office. eDOCSNL allows physicians to access information about a patient’s complete health record through integration with clinical data stored within HEALTHeNL, the provincial electronic health record. The EMR can leverage this information to support clinical decision making using clinical decision support alerts, individualized patient goals and care plans. The EMR also directly receives information from facilities, including labs, Medical Imaging and clinical documents.
How do I advance my EMR use?
The vision of eDOCSNL is to advance the meaningful use of the EMR. eDOCSNL staff will gladly assist you with identifying opportunities to improve your practice by leveraging the clinical value features of the EMR. Please submit a request for assistance through firstname.lastname@example.org
In addition, the program has introduced the Practice 360 initiative which is focused on the seamless integration of guidelines into the EMR at point of care. This initiative is designed to advance mature use of the EMR while providing value and efficiency for providers. To learn more, click here.
What is Practice 360?
Practice 360 is an ongoing eDOCSNL initiative designed to increase clinical value and practice efficiencies in the EMR for providers in Newfoundland and Labrador. The initiative will not only support guidelines-based care of chronic disease and national screening and preventive care strategies but also provide tools to better understand your practice. The EMR tools deployed through the initiative will be accompanied by training materials and media to ensure users are familiar with how to access and use them most effectively.
Practice 360 aligns with the eDOCSNL Strategic Plan by leveraging the intelligent and standardized features of the EMR to support and evaluate guidelines based and preventive care, presenting providers with the information they need for best practice decision making. Data provided by the EMR through the Practice 360 tools will enable the evaluation and refinement of guidelines and supports health system changes that will benefit all Newfoundlanders and Labradorians.
I am a specialist, is the EMR designed to meet my unique workflow needs?
EDOCSNL implementation projects are designed to meet the needs of individuals users. We have deployed to dozens of specialists across the province including ENT, Neurology, Ophthalmology, Dermatology, Respirology, Gastroenterology and more. There are other specialty services in the queue to come into the program. Please contact us, we are happy to explore how an EMR implementation can support your clinical and business needs.
What does it cost to use eDOCSNL in a clinic?
Fee for service providers pay a subscription fee of $200/month. The program is heavily subsidized by the Provincial Government so that providers who are part of the publicly funded Provincial health care system pay no deployment or ongoing support fees. There are additional enhancements and third-party add-ons that may have cost in addition to the basic monthly subscription fees (e.g., eFax, virtual video visits). These are not covered by eDOCSNL and will have to be paid directly to Telus.
When will I receive an invoice?
Invoices will be issued at the beginning of each fiscal for subscribers. We will work with you for a payment arrangement that suits your needs. Financial statements can be provided on request.
How can I pay my bill?
Currently the payment methods available include paying by check or by Pre-Authorized Debit (PAD). Checks can be sent to:
70 O’leary Avenue
St John’s, NL
The PAD form can be found below. These can be submitted to: Accounts.Receivable@nlchi.nl.ca
I am interested in enrolling but would like more information. Who do I contact?
Please direct all inquiries to email@example.com. Program staff will be in touch with you to provide you with more information. Following your expression of interest, a program application to join the program can be found here.
What is included with my EMR?
Your enrollment in the program provides access to the EMR solution and linkages to other eHealth systems in Newfoundland and Labrador. This includes delivery of clinical results to your EMR, direct linkage to patient charts in HealtheNL, direct submission of bills to MCP and access to the Client Registry, the same demographic database used by MCP. The software solution provides you with access to clinical decision support features, care plans, individualized patient goals and practice management dashboards and reporting.
I am using another EMR system now, what is the process to change over?
Please direct all inquiries to firstname.lastname@example.org. Program staff will be in touch with you to provide you with more information. The Program and vendor will build a project plan to convert you to the new software, which will include a training and change management plan as well as a data extraction project to convert the information from your old software into the new solution.
How long does it take to get an EMR setup in my clinic?
This depends very much on resource availability at the time of your request, but generally takes weeks to months to arrange. To ensure success, the pre-implementation process is methodical and individualized. The longer the lead time between the request and implementation, the better we can meet your needs. We would suggest a minimum of three months’ notice for an implementation.
Who do I contact for technical support?
EMR support is provided by a combination of the vendor and the program and varies between practice settings. Please see the support resources page here.
Where can I find resources and training material?
There are many resources available on our website here and Telus has many support resources available in its online help features. In addition, the user community is also very self-supportive, and this can be accessed through the community portal functionality in the software. If you need help with resources or training material you cannot locate through one of these methods, please reach out to email@example.com.
Is there training available?
Yes. The vendor can provide formal training and eDOCSNL program staff can supplement this with additional training and on specific features, workflow optimization, mature use, and many other needs. Please reach out to us at firstname.lastname@example.org with all your training requests, we are here to assist you.
Changing Clinics / Locums
What should I do if I plan to retire or move?
Retiring from practice can be a daunting and confusing process, adding the EMR layer to this makes it even more complex. While there are professional and medicolegal elements to this transition into which we have limited insight, we can help you with making decisions regarding what to do with your EMR. Your first step in this process is filling out this Provider Termination Form. For more information on retiring from an EMR based practice, please review this document. For information related to moving from one clinic to another, refer to this document.
I am using an EMR in my current clinic but am planning to move. What should I do?
Please fill out this Provider Transfer Form and contact us at email@example.com for more information. There are some potential professional responsibilities involved in this as well including notifying the RHA of your move so they can update your address and, depending on the nature of your move, implications for custodianship of your patient records. For more information on this, we would advise you to contact your licensing body.
I am a locum; how do I get access to the clinic’s EMR?
The system administrator in the clinic can set this up and delegate an existing provider license within the EMR instance for your use. If you or the clinic need any help with this, please reach out to firstname.lastname@example.org.
What are eResults? What results can I review electronically?
EResults refers to the direct delivery of electronic results to your EMR. There are a few results that do not get delivered to any electronic system (e.g., ER visit records) but in theory any result that is delivered to HEALTHeNL could be delivered to your EMR. Most providers choose not to receive everything in their EMR but there is a minimum standard for results delivery that apply across all provider groups. For example, everyone receives the results on which they are designated as ordering provider. If you have questions about the results you receive or would like to receive more than the minimum standard, please contact us at email@example.com.
How can I get more information on eResults?
It is critical that Providers have a good knowledge of eResults as there are patient safety and medicolegal implications. For more information on eResults, please click here.
Are there virtual care technologies available through the EMR?
Yes, the EMR supports s number of virtual care methodologies including video visits directly from the EMR schedule, direct communication with patients through the patient portal extension and video visits from within the patient portal as well. The EMR can also be used to document visits that take place in other virtual care solutions, including the provincial Telehealth infrastructure.
Is eDOCSNL secure?
eDOCSNL uses TELUS Health’s Med Access, a robust EMR software. It was designed specifically for use over the Internet and is presented via a modern web browser.
TELUS also provides rigorous data management with back-up to professionally managed, redundant TELUS data centres so a physician does not have to worry about back-ups or disaster recovery.
Is patient information kept private? Who can access the information in my EMR?
Physicians can restrict access to a patient’s information to those who provide or assist in the patient’s care and treatment. All users require a password to access eDOCSNL and the system keeps a record of each time a profile is accessed, including when and by whom. Patients can request to see a copy of these records at any time.
As part of the eDOCSNL strategic plan, a subset of data elements will be extracted from provincial EMRs and sent to the NLCHI data warehouse. The EMR Management Committee has approved an Information Management Framework policy for the use and disclosure of EMR Data which specifies the data elements that can be disclosed, who they may be disclosed to, the purposes for which the data may be disclosed, and any appropriate limitations on use of data. Click here to access the Framework. The specific data elements (available here) have been reviewed and approved by the EMR Management Committee. This list will be expanded as more data elements are approved for extract from all EMR instances in Newfoundland and Labrador.