RESUMO
Timely access to care is a persistent challenge for health care systems. Providing the right care to the right patient at the right time is important to reduce inappropriate use and improve the performance of healthcare services. The complexity of accessing primary care contributes to the high usage of emergency rooms for not-urgent conditions. Many digital tools try to offer a better access to care for patients and reduce ER overuse. This environmental scan of the digital tools available in Quebec identifies those digital tools and some of their limitations. The results reveal the complexity of mobilizing digital tools in the healthcare sector and highlight the need for all stakeholders to work together to enhance access to care.
Assuntos
Atenção à Saúde , Atenção Primária à Saúde , Serviço Hospitalar de Emergência , Humanos , QuebequeRESUMO
PURPOSE: We analyzed the intermediate and longer term changes in patients' waiting times following the implementation of an electronic medical record (EMR) dedicated to ambulatory treatment in both medical and radiation oncology. METHODS AND MATERIALS: A pre-post study design was developed to assess improvements in patients' waiting times, defined as the number of days between key steps in patient management preceding the first treatment. The postperiod began 1 year after the EMR go-live to allow for a preliminary period of adjustment to the new EMR. The EMR under study was closely integrated into the clinicians' workflow, being designed as a care pathway information system to provide real-time support to the coordination of the entirety of care processes involving all the care personnel. RESULTS: The large majority of the waiting-time indicators decreased over time, with decreases ranging from 2 to 28 days. However, an important time lag was necessary to see an improvement, to the extent that better access was only observed in the final months of the postperiod. CONCLUSION: The study highlights the potential to design EMR applications that capitalize on tight workflow integration, both in medical and radiation oncology, to deal with the fundamentally collaborative nature of cancer care delivery.