Centralized electronic health records benefit emergency medicine
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* Alex Hoechsmann

Citing British government reports that recommend abandoning their centralized electronic health records (EHRs) project, Paul Christopher Webster continues his assertion that Canada Health Infoway’s vision of a centralized national health database is “not feasible.”1,2 However, focusing on the failures of EHRs may lead people to believe that all enterprise digital health solutions are doomed to fail. Although a national top-down–driven EHR system may not work, electronic medical records (EMRs) may be a valuable part of the future of health care in Canada and may become a workable surrogate for an EHR system.

The Government of the Northwest Territories is working on adopting one EMR system for the territories. No matter where a patient goes within the territories, their primary health care data will be accessible to the treating physician or nurse. At the Stanton Territorial Hospital in Yellowknife, Northwest Territories, emergency department physicians use EMRs to view the patient charts of almost half the population of the Northwest Territories. Functioning as a viewing and messaging portal, EMRs allow emergency department physicians to coordinate care with the primary care providers of patients, thus avoiding unnecessary investigations and facilitating continuity of care.

Canada should continue to strive for enterprise health information solutions. A successful system would capture real-time data that follow patients across health services and contain all relevant patient-centric and aggregate data, and are shared across services, thus allowing for rapid communication among providers. In essence, a successful system would be an enterprise EMR.

## References

1.  Webster PC. Centralized, nationwide electronic health records schemes under assault. CMAJ 2011; 183:E1105–6.
    
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2.  Webster PC, Kondro W. Medical data debates: Big is better? Small is beautiful? CMAJ 2011; 183:539–40.
    
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