Backers behind Evidence2Practice tools wonder why most Ont. FPs aren’t using these EMR tools

Free EMR-integrated Evidence2Practice (E2P) tools that optimize care for Ontario patients with anxiety and major depression, heart failure, diabetes and COPD are currently being used by approximately 4,000 primary care providers (PCPs), but that leaves 75% of family doctors and nurse practitioners in the province either unconvinced of their value or too busy to adopt them.“Since the onset of the E2P program in late November 2022, we have been really focused on tool development and getting them integrated with the three most commonly used EMRs in the province—Telus Practice Solutions, Oscar Pro and Accuro QHR,” said Amplify Care’s E2P program manager, Michelle Gloor. “We have seen great uptake in terms of access to the tools, but they should be used more, so we see an opportunity to continue to engage clinicians and promote their use.”Supported by Ontario Health and developed by a consortium of organizations including Amplify Care, the Centre for Effective Practice, and North York General Hospital, the digital tools embed the most up-to-date evidence, quality standards and best practices for patient care, according to Gloor.They assist with screening and diagnosis, provide evidence-based guidance at key decision points, link to external resources, prompt key quality interventions, keep preventative and monitoring activities top of mind and connect patients to self-management supports.Read: NHS ruling ignites global debate: Now will Canada classify AI scribes as medical devices?The Centre for Effective Practice translates Ontario quality standards for each of the conditions into clinical content and has a team of academic detailers that provide one-on-one training with clinicians. Amplify Care, formerly the eHealth Centre if Excellence, develops the tools and provides change management support. The third member of the consortium, North York General Hospital, builds E2P tools for acute care.The most popular E2P tool is for prediabetes and type 2 diabetes —not surprising as there are an estimated 4.4 million Ontarians living with these conditions. Complications including hypoglycemia, long-term microvascular complications affecting the eyes, kidneys and nerves, as well as coronary artery disease, stroke and heart failure can be prevented or delayed through proactive and appropriate screening enabled by the E2P tool. Unfortunately, research on adherence to best practices suggests variability in their use.For example, foot ulcers affect up to 25% of individuals with diabetes, yet only 53% of Canadians with diabetes reported receiving a foot exam by a health professional in the past year.According to Amplify Care, “the E2P diabetes tool supports clinicians in the early identification of patients at risk.” It also assists with “monitoring and assessing glycemic targets, assessing risk factors and complications of diabetes using standardized testing, and providing patient education and resources.”An Amplify Care case study on the anxiety and major depression tool highlights the tool’s use in tracking patient medication history, including dosage adjustments and drug interactions. It also supports “a stepped care approach, a model that ensures patients receive the least intensive, yet effective intervention first, escalating care only when necessary, and minimizing unnecessary psychiatric referrals while ensuring that urgent cases receive immediate, specialized intervention.”The tools are updated from time to time to reflect changes in quality standards and best practices, as well as feedback from clinicians.While there are no immediate plans to increase the number of E2P tools, Gloor cites PCP feedback indicating an interest in additional tools for palliative care, chronic kidney disease and hypertension. Further information about the E2P tools and how to access them can be found here on the Amplify Care website.

Backers behind Evidence2Practice tools wonder why most Ont. FPs aren’t using these EMR tools

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