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Imagine finding out about your cancer diagnosis on a Saturday night – without a trusted oncologist to review your records.

The real-time functionality of Hamilton Health Science’s (HHS) new patient records system, MyChart by Epic, has made patients the bearers of “bad news” instead of doctors.

“I’ve had patients telling me the bad news rather than me telling them (the news),” said Dr. Richard Tozer, chief of medical oncology at Hamilton Health Sciences.

While some patients do well, others “get really, really upset” – finding themselves, for example, emailing Tozer at 8:30 p.m. on a Saturday night, he said.

“The problem is that MyChart (has) no filters,” Tozer said.

The change in how records are disclosed to patients began with the launch of Epic in June this year, replacing the hospital’s existing system, Meditech. Epic’s program is a standardized $175 million patient portal designed to simplify patient access to medical reports, appointments, and prescriptions, all in one place.

Tozer said the problem he had with the system was raised with the administration, but “there is no easy solution.”

While finding sensitive information without notice could be confusing for many patients — or could give them severe anxiety — Tozer said, “The results belong to the patient. They have all the rights.

Tozer gives his patients a warning, much like a disclaimer from Netflix before a TV show begins, he said. “But again, it’s within the patient’s rights.”

This means patients can decide if they want to access the results on their own or wait for the doctor to review the records with them.

Doctors “have medical training” and they “know how to interpret these things. And expecting patients to be able to interpret these things…the way we do it is unrealistic.

HHS spokeswoman Wendy Stewart told The Spectator that the decision to make test results available in real time was based on best practices, as well as input from HHS physicians and patient advisors and health professionals. other healthcare organizations that have implemented Epic.

But, she said, real-time access to test results may not be suitable for all patients.

For those who don’t want to see their test results, a notification can be turned off in MyChart, Stewart said.

Tozer knew for a decade that this day would come — along with the need for technological advancements in the healthcare system. In his opinion, it’s not that bad and it depends on how the patients would decide to take the news.

At HHS, there are more than 26,000 patient-created MyChart accounts, and in some cases, they are assigned a proxy to help them navigate the app.

Stewart said the app is optional for HHS patients and signing up for the app does not influence scheduled services, including printouts of visit information, medication instructions, instructions procedures or surgery and phone calls to book and confirm appointments.

Still, the app can be tricky to navigate for many users, young and old.

The new patient portal was particularly difficult to use for Roy Miller, a 76-year-old Hamilton man who has spent much of his life working in technology.

When Miller turned 75, his doctor suggested it would be a good time for an MRI.

The average wait time for lower priority patients could range from 74 days to 253 days at Hamilton facilities – Hamilton General Hospital, Juravinski Hospital and West 5th Campus of St. Joseph’s Health Care System.

Miller agreed and signed up for the date.

On the scheduled day, Miller said, West 5th staff made a mistake and he was given the choice of waiting another six months for the next appointment or spending the night in the hospital and getting a medical treatment right away. opening for his MRI.

“It seemed like a good idea, but in retrospect it wasn’t a good idea because once I was there,” the hospital suggested further testing – part of the regular checkup to detect the impacts of aging on his body.

After the tests were done at the hospital, Miller was prompted to sign up for MyChart to easily access his reports, but he ran into issues using the app. MyChart requires patients to register via an email address with which they receive regular communications.

Patients’ familiarity with navigating and accessing web pages helps them better use the application. “Even with this ability and my years of online experience, I was very annoyed with the system,” Miller said.

In a letter to the editor published Aug. 30, Miller said he spent “many hours updating and correcting (his) health record.”

“If Americans can put a man on the moon, why can’t Hamiltonians have a medical system they can easily access and use with or without a computer?”

Dr. Pamela Baxter, professor of nursing at McMaster University, said that when it comes to the use of technology in older adults, the principles of equity and inclusivity “seem to be lost”.

“It comes down to software developers, who need to recognize that they are responsible for ensuring fairness when developing the technology,” she said.

Baxter emphasized the need for advanced technology education, not only for patients but also for their families and caregivers, to help patients navigate confusing waters.

She suggested a good start would be to bring the issue back to the aging population – “not isolating them from technological advancements” – and learning how to improve accessibility for them.

But Tozer doesn’t think usability “has to do with age.” Cautioning against ageism, he said MyChart’s user-friendliness depends “on how comfortable individuals are…also prevalent among young people as well”.

Quoting his 90-year-old father who “chooses MyChart regularly,” Tozer said the app could be “very useful.”

Stewart said that of the 155 million unique MyChart patients worldwide, 25% of them are over the age of 61.

For Tozer, who works closely with patients at HHS, the benefits of the improved health records system “outweigh the risks,” saving emergency physicians from making “some bad decisions” in the absence of “the trajectory.” (of the patient) of the disease”. ”