Friday, October 22, 2010

Weekly Overseas Health IT Links - 21 October, 2010.

Here are a few I have come across this week.

Note: Each link is followed by a title and a paragraph or two. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.

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http://healthit.hhs.gov/blog/onc/index.php/2010/10/07/the-gift-of-innovation-from-within/

The Gift of Innovation from Within

Thursday, October 7th, 2010 | Posted by: Dr. David Blumenthal | Category: ONC

The health information technology (health IT) sector received an important gift on Sept. 29. In fact, we received two important gifts. Both these gifts came from Kaiser Permanente. And both stemmed from Kaiser’s long-time investment and innovation in health IT adoption and use.

At a ceremony at HHS headquarters last week, Kaiser donated its Convergent Medical Terminology (CMT) for open availability to any HIT developer. The technology enables clinicians to use the terms that are familiar to them in diagnosis and treatment. CMT acts like a simultaneous translator in several directions. For clinicians, it translates clinical language they use to communicate with colleagues into the technical terms that electronic health records (EHRs) use to communicate with other records. For patients, it takes those underlying technical terms and makes them understandable to lay persons. And, it can translate clinicians’ terminology directly into lay language as well. It also facilitates the usability of EHRs and the sharing of health information among clinicians and patients.

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http://www.healthleadersmedia.com/print/MAG-257394/Data-in-the-Clouds

Data in the Clouds

Gienna Shaw, for HealthLeaders Media , October 13, 2010

Web-based data sharing is one solution to the interoperability problem—the challenge of communication between healthcare providers, including physician's offices, hospitals, and specialty practices, which often have different computer and software setups and use a variety of external devices to store and share images. Because everything is online, it's easy to share simple health data such as patient test results and medical history, and it allows patients access to their records, as well. Cloud computing requires no special equipment—just a computer and an Internet connection.

But when it comes to medical imaging, the massive image files shared in picture archiving and communications systems can bog down even moderately speedy Internet connections during peak hours—and accessing large files via a dial-up connection is basically a hopeless prospect.

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http://www.fastcompany.com/1693973/health-20-makes-industry-shift-in-five-years

Health 2.0 Causes Industry Shift in Five Years

BY FC Expert Blogger Francine HardawaySat Oct 9, 2010

This blog is written by a member of our expert blogging community and expresses that expert's views alone.

Since December 2006, when Matthew Holt and Indu Subiya almost single-handedly began the Health 2.0 movement with Matthew's blog and their first conference, the entire world of health care has begun to change. And that's not a simple thing to achieve. Health care is steeped in tradition, regulation, disparate moving parts, and territorial entities (witness the issues involved in health insurance reform). But Matthew and Indu did not shift the system the way President Obama and Congress tried to do, through "push marketing." Rather, they decided to harness the grass roots "pull" brought about by patients and the Web to force movement of the inertial forces.

They took what was already happening--patient empowerment through online communities and early health information sites such as Medscape for physicians and WebMD for patients, and accelerated it by evangelizing patient engagement and empowerment, the prototyping of new technologies, and the shift of responsibility from the doctor to the doctor-patient partnership.

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http://www.govinfosecurity.com/articles.php?art_id=2996

FTC: No Major PHR Breaches So Far

Only Incidents Listed Are Lost or Stolen Credentials

Howard Anderson, Managing Editor, HealthcareInfoSecurity.com

October 11, 2010

In the year since the breach notification rule for personal health records took effect, no major breaches affecting 500 or more individuals have been reported, according to the Federal Trade Commission.

A personal health record is an "electronic record of identifiable health information on an individual that can be drawn from multiple sources and that is managed, shared and controlled by or primarily for the individual," according to the FTC.

Last year, the FTC issued a PHR breach notification rule, as called for under the HITECH Act. Under the rule, which took effect Sept. 24, 2009, major breaches must be reported to the FTC within 10 business days. PHR vendors, and certain companies with which they do business, must report any size breach to the individuals affected within 60 days. But they only have to report the smaller incidents to the FTC annually, 60 days after the start of the calendar year.

Incidents Listed

The FTC has posted a list of 13 incidents affecting 15 individuals in 2009. All were reported by Microsoft Corp., which offers the HealtVault PHR platform. Each case involved lost or stolen credentials, and none of the cases involved is known to have resulted in inappropriate use of patient information, says Cora Han, attorney in the division of privacy and identity protection in the FTC's bureau of consumer protection.

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http://articles.orlandosentinel.com/2010-10-11/health/os-medical-student-ipod-touch-20101011_1_ipod-touch-ucf-students-medical-schools

UCF gives med students high-tech devices to stay in touch, iPod style

October 11, 2010|By Sarah Lundy, Orlando Sentinel

Second-year medical student Lynn McGrath knows the iPod touch he carries will help him become a better doctor.

If a patient reports certain symptoms, McGrath, 25, can quickly research it on the high-tech device and learn how to treat it in minutes.

"The first year as medical students, it helps us figure out what's going on, but as you become more familiar, it's more of a confirmation," he said.

Starting this semester, the UCF's College of Medicine, which in its second year, is giving every medical student an iPod touch to help in their training.

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http://www.scmagazineus.com/only-40-percent-of-canada-doctors-connected-with-ehr-report/article/180860/

Only 40 percent of Canada doctors connected with EHR, report

James Hale

October 12 2010

Put the patient first.

That's what two of Canada's leading health organizations are saying is the prescription for fixing the country's poor history of introducing electronic health records (EHR). The Health Council of Canada – a nonprofit watchdog agency – released a report that warns that the lack of an integrated EHR is leading family physicians to order unnecessary medications and diagnostic tests. Three days later, the Canadian Medical Association (CMA) – which represents many of the country's doctors – released a health information investment strategy that calls for major investment in primary care technology.

Both reports are a reaction to the fact that fewer than 40 percent of Canada's primary care doctors have access to EHR, compared to 99 percent of physicians in the Netherlands and 96 percent in the United Kingdom.

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KLAS Grades EMR Packages By Specialty

Ambulatory electronic medical record packages used in the 10 most common specialties were evaluated based on client feedback and 25 performance indicators by the research firm.

By Marianne Kolbasuk McGee, InformationWeek

Oct. 14, 2010

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=227701294

When it comes to E-medical record packages and doctor practices, one size doesn’t fit all. Whether an EMR system is right for a particular physician depends on a number of factors, including the number of doctors in the group as well as medical specialty. A new report by research firm KLAS gives grades to EMR packages by specialties.

The new report, which is available free to healthcare providers, covers ambulatory EMR packages used predominately in or sold to 10 of the most common medical specialties, ranging from pediatrics, ear, nose and throat, cardiology, OB-GYN, to multi-specialty.

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http://trailblazersblog.dallasnews.com/archives/2010/10/obamas-health-it-czar-young-pe.html

Obama's health IT czar: young people won't tolerate pen-and-paper medicine

10:45 AM Fri, Oct 15, 2010

Robert T. Garrett/Reporter

The Obama administration's point man on health information technology said today that medical caregivers resist the brave new world of computers at their peril.

"The next generation of patients is not going to be happy with physicians and hospitals and nurses that don't use computers," David Blumenthal , the national coordinator for health IT at the U.S. Department of Health and Human Services , said in Austin. He was in town to speak yesterday at the Texas e-Health Symposium. This morning, he toured a University of Texas learning lab that has produced the nation's first graduates from a stimulus-funded training program designed to crank out medical-sector computer geeks.

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http://www.mobilenewscwp.co.uk/2010/10/healthcare-market-turned-on-to-mobile-reckons-rim/

Healthcare market turned on to mobile, reckons RIM

BlackBerry-maker looks to ingratiate itself more deeply in vertical business markets
UK healthcare bodies are waking up to the efficiency and productivity benefits of mobile applications, according to Research In Motion (RIM) UK healthcare director Daniel Morrison-Gardiner.
Morrison-Gardiner said that, in an economic climate of public spending cuts, healthcare bodies are looking at mobile as a means to reduce operational expenditure.

He said mobile health (mHealth) solutions offer NHS and other healthcare functions an opportunity to reduce the administrative burden on professionals such as midwives, health visitors and community nurses, enabling them to spend more time in the field.

Said Morrison-Gardiner: “We want to allow health professionals to spend more time with patients to deliver a better quality of care and to remove the burden of their everyday activities. What is telling is the number of clinical system providers and other companies approaching RIM over the last 18 months to see how they can leverage our platform to deploy mobile versions of existing solutions.”

Morrison-Gardiner said BlackBerry-maker RIM is in discussion with a number of providers to the healthcare market about deploying its mobile systems.

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http://www.fierceemr.com/story/data-exchange-must-become-seamless-and-invisible/2010-10-14

PHR data exchange must become 'seamless and invisible'

October 14, 2010 — 12:24pm ET | By Neil Versel

While vendor after vendor and publicist after publicist keep contacting a certain FierceEMR editor about how their personal health records are going to revolutionize healthcare by empowering consumers, some people still keep their heads out of the clouds and somewhere close to reality. To the exclusive latter group we can add David Ellis, corporate director of planning and future studies at the Detroit Medical Center and publisher of Health Futures Digest, and Stephen J. Cavanagh, associate dean of the Wayne State University College of Nursing in Detroit.

"PHRs require considerable attention from the patient, do not talk to one another and are built on a shaky centralized foundation. To reach their true potential, PHRs must become largely invisible, communicate with each other, and remain a network of information stored in various locations," Ellis and Cavanagh write in the October issue of Hospitals & Health Networks.

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http://www.fierceemr.com/story/next-generation-emrs-may-include-personal-genomics/2010-10-14

Next generation of EMRs may include personal genomics

October 14, 2010 — 2:37pm ET | By Neil Versel

As if putting medication histories and care plans into EMRs weren't causing enough consternation for doctors and nurses nationwide, wait until you hear what's coming down the pike.

"The vision, as we see it, is that the genome is really a component of the patient's electronic medical record," Richard Resnick, acting CEO of personal genomics firm GenomeQuest said Wednesday, MassDevice reports. Extra work, perhaps, but it's for the betterment of patient care, according to Resnick and other speakers at Harvard Medical School's World Health Forum in Boston.

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Small Medical Practices Don't Find EHR Adoption Meaningful

Federal incentive payments aren't enough to overcome problems, like increased costs and disruption to workflow, doctor offices perceive with electronic health records.

By Nicole Lewis, InformationWeek

Oct. 12, 2010

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=227701184

Even as the federal government continues to push the adoption of electronic health records (EHRs) by injecting billions of dollars into programs that encourage healthcare delivery organizations to implement the technology, these efforts may not be enough to lure many physicians at small practices to purchase an EHR, Richard Gibson, president of Oregon Health Network in Portland, Ore., told members of Congress

In testimony before the subcommittee on technology and innovation on September 30th, Gibson said that while the majority of 400,000 eligible professionals still need to acquire an EHR, adoption will be toughest in small physician offices that don't have the resources to acquire an EHR or the time and staff to install the technology.

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http://govhealthit.com/newsitem.aspx?nid=74826

Veterans’ CIO pledges no more major IT failures

By Kathryn Foxhall
Friday, October 08, 2010

The Veterans Affairs Department will have no more “hundred million dollar” IT project failures, VA’s chief information officer told senators who oversee the VA.

At a hearing this week, members of the Senate Veterans Affairs Committee made it clear that they want to keep a spotlight on VA’s IT management practices in view of the agency’s mixed record meeting production and efficiency targets. Roger Baker, VA’s chief information officer, who’s been on the job for 16 months, said the agency is not where it should be. He described efforts at VA to instill better project management procedure.

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http://www.ehealtheurope.net/comment_and_analysis/644/expert_view:_martin_ellis

Expert view: Martin Ellis

13 Oct 2010

The chair of the Intellect Clinical Safety Committee discusses recent changes to European regulations that are likely to affect healthcare IT providers. He also outlines the work that Intellect will be doing to develop documentation and guidance for e-health manufacturers.

It is an unfortunate fact of life, but on rare occasions the very health services that you rely on to make you better can end up causing you harm.

For example, errors in medication management, incorrect surgery and hospital acquired infection all contribute to patient mortality and morbidity. Fortunately, patient safety management is now a high priority for trust boards.

Similarly, while information technology is a powerful component of a healthcare provider’s strategy to help reduce clinical risks, it also has the potential to introduce new hazards for patients.

These include, for example, organisation-wide unavailability of electronic drug charts or the failure to correctly display critical clinical information.

This has sparked urgent debate in the international health informatics community about the risks of harm associated with introducing this new technology.

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http://www.healthleadersmedia.com/content/TEC-257573/Predictive-Modeling-May-Reduce-Hospitalizations

Predictive Modeling May Reduce Hospitalizations

HealthLeaders Media Staff , October 12, 2010

The Visiting Nurse Service of New York has adopted advanced information technology designed to improve patient care. The effort appears to be effective in reducing hospitalizations and re-hospitalizations, according to a paper published in the Journal for Healthcare Quality.

The VNSNY Center for Home Care Policy & Research launched the Outcomes Initiative to support research, evaluation, and informatics services. The system identifies patients at risk for hospitalization, identifies patients eligible for and in need of physical therapy, and assesses the performance of clinical staff and programs.

Together, these and other HIT initiatives have been instrumental in helping VNSNY achieve a 12% decrease in the overall patient rehospitalization rate between 2001 and 2009, according to the authors. They also report a reduction in patient episodes ending in hospitalization, from 37% to 27%, during that period.

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http://www.healthdatamanagement.com/issues/18_10/health-care-technology-news-connecting-the-dots-41054-1.html?zkPrintable=true

Connecting the Dots

Health Data Management Magazine, 10/01/2010

When it comes to business intelligence, the University of Pittsburgh Medical Center offers an object lesson in a major industry challenge. The integrated delivery network-which spans 20 hospitals and a health plan-runs some 200 different information systems, of which 100 publish to a data warehouse. Depending on the need, UPMC administrators can turn to several sources for BI metrics, says Lisa Khorey, director of interoperability. These include UPMC's inpatient EHR system, from Cerner; its ambulatory record system, from Epic; and the data warehouse, a store house whose supporting vendors include Cognos and DBMotion. "You ask different questions, you need different views into the data," says Khorey, who oversees the warehouse.

For many provider organizations, creating such a diversely-sourced data warehouse is the first step toward creating the kind of data analytics tool they will need as the industry is reshaped by payer requirements and patient expectations.

"The industry's biggest need is a reporting overlay over multiple vendors in disparate systems to drive actionable results," says Matt Seefeld, CEO of Interpoint Partners, an Atlanta-based BI software and consulting firm. "There is too much data flowing through health care. If you're going from system to system hoping to get the big picture, you will need a BI medium to create a layer to look across the organization."

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http://www.healthdatamanagement.com/issues/18_10/health-care-technology-news-a-little-faith-goes-a-long-way-41056-1.html

A Little Faith Goes a Long Way

By Greg Gillespie

Health Data Management Magazine, 10/01/2010

Spring and summer were filled with restless nights for Jim Sinek. The president and CEO at Faith Regional Health Services was losing a lot of sleep over the huge gamble the 166-bed community hospital was taking: implementing an electronic health record in less than six months, though it had little experience with enterprisewide I.T. implementations. And, unlike many decisions, this decision couldn't be undone or slowed down.

Sinek and his management team already had drunk the Kool-Aid by having Faith Regional's new bed tower designed in a way that made it hostile to paper charts by decentralizing nursing units and limiting printing capabilities. When the lights went on in that tower, the EHR simply had to be in place at the Norfolk, Neb.-based provider, which sits in a largely rural region in the Northeast corner of the state.

But Sinek had faith, pun intended, in both the project leaders and the management structure devised to execute the implementation and the subsequent changes in workflow and care processes.

The community hospital took calculated risks at every step of the project: implementing a complex EHR-Soarian Clinicals, from Siemens Healthcare, Malvern, Pa.-developed for large hospitals; focusing first on computerized physician order entry, politically and technologically the most fearsome of technologies; taking a multi-year implementation timeline and trimming it down to less than six months; and simultaneously doing a staff reorganization that initially spread fear through the nursing staff.

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http://www.healthdatamanagement.com/news/health-care-technology-news-privacy-federal-claims-database-41149-1.html

Privacy Pros to Feds: Not So Fast on Database

HDM Breaking News, October 8, 2010

The federal government's plan to create a national database of health care claims data is raising red flags for privacy advocates. The proposal, they argue, gives lip service to ensuring the privacy and security of the data and needs considerable additional details.

In a notice published Oct. 5, the U.S. Office of Personnel Management briefly outlined the Health Claims Data Warehouse that will contain a range of protected health information culled from claims handled by three federal insurance programs (see story). They are the existing Federal Employee Health Benefit program and two benefit programs created under the health reform law: The National Pre-Existing Condition Insurance Program and the Multi-State Option Plan.

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http://www.healthleadersmedia.com/content/TEC-257634/Costly-eICUs-Get-Results.html

Costly eICUs Get Results

Gienna Shaw, for HealthLeaders Media , October 12, 2010

Virtual ICUs got a bad rap: That's what early adopters of remote intensive care unit monitoring systems said in response to a study published last year in the Journal of the American Medical Association. The authors of the JAMA study said they found "no association between implementation of telemedicine technology and adjusted hospital or ICU mortality, [length of stay], or complications." And, the authors noted, the systems are expensive, easily running to seven figures a year for software, hardware, two-way video and audio equipment, clinical salaries, and licensing fees.

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http://www.ehiprimarycare.com/news/6306/english_nhs_urged_to_adopt_welsh_eps

English NHS urged to adopt Welsh EPS

11 Oct 2010

A pharmacy body is calling for NHS Connecting for Health to adopt the Welsh model for electronic transfer of prescriptions, in place of Release 2 of the Electronic Prescription Service.

Numark, a support organisation representing 2,500 community pharmacies, said the experience of its members has shown that the Welsh 2DRx project was working much more effectively than EPS R2.

Numark’s IT steering committee said it was impressed with the ease with which Wales was coping with 2D electronic prescriptions.

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http://www.govhealthit.com/newsitem.aspx?nid=74844

Dash it all

By John Moore

Monday, October 11, 2010

When the Michigan Health Information Authority (MiHIA) sought a way to boost the visibility of population health quality among its constituents, the group took its cue from the business world: it decided to build a performance measurement dashboard.

A dashboard takes in performance information of various kinds and presents the underlying trends in graphical format. Users can scan charts and diagrams depicting key performance indicators in much the same way a driver views a car’s instrumentation. The technology has typically been the province of corporate executives who need a quick, at-a-glance overview of sales, ongoing projects and other activities.

In MiHIA's case the objective is to get local government leaders, providers and the public to rally around community health improvements. Traditionally, public health officials were the individuals most concerned with community health data. But MiHIA seeks an expanded audience.

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http://www.modernhealthcare.com/blogs/it-everything/20101011/310119999

Predicting your future

Pharmacy benefits manager Express Scripts says it can predict the future.

It may not have a crystal ball tuned in for lottery numbers, but when it comes to drug compliance, the St. Louis-based pharmacy benefits manager says its computers can "accurately predict up to a year in advance which patients are most at risk of falling off their physician-prescribed drug therapy" and then "intervene in customized ways to improve those patients' adherence."

How?

Both Express Scripts in its news release and company spokesman David Whitrap are a bit sketchy on the details.

Whitrap, senior manager of public affairs, said the technology is proprietary, so, "there is a limit to how much we can talk about all of the factors that go into the mix."

In the news release, though, Express Scripts raised the lid on its black box for just a peek. According to the release, the company's computer models, developed over the past year by Express Scripts researchers and predictive modelers, "incorporate past patient behavior and demographics, characteristics of the particular medical condition and prescription drug and a number of other factors that Express Scripts has identified as relevant."

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http://www.kjonline.com/news/health-care-workers-get-computer-skills-training_2010-10-09.html

October 10

Health-care workers get computer skills training

By Leslie Bridgers

Staff writer

FAIRFIELD — Before Jeri Gilbert started an online course in electronic health records last week, she didn’t know what a Web browser was.

Many of the students who signed up for the Kennebec Valley Community College course are a lot like Gilbert — nurses, not computer people.

Their workplaces, however, now need people with expertise in information technology as they move toward computerizing all their health records — a change President Barack Obama charged all hospitals and health care providers to make by 2015.

The purpose of electronic health records is to make patients’ complete medical histories readily available to any health-care provider, in order to avoid repetition of tests and medical errors. Concerns have been raised about ensuring that the records are kept private.

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http://www.jsonline.com/business/104617969.html

Epic Systems rides wave of records upgrades

Verona company profits as hospitals make move to digital

Oct. 9, 2010

Aurora Health Care has spent more than $150 million to move to electronic health records since it began the arduous task 15 years ago.

The foundation for its system, spanning its hospitals throughout eastern Wisconsin, has been software from Cerner Corp. Aurora was one of the company's first large customers.

Yet this year, Aurora decided to replace its system with one designed by Cerner's biggest competitor, Epic Systems Corp. in Verona.

The move will cost Aurora more than $100 million and take at least three years.

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http://www.fiercehealthit.com/story/markle-survey-shows-strong-consumer-physician-support-blue-button-downloads/2010-10-11

Markle survey shows strong consumer, physician support for 'blue button' downloads

October 11, 2010 — 12:13pm ET | By Neil Versel

Remember the idea of adding a "blue button" to EMR screens to make it easy to output personal health data? The Markle Foundation, which has been leading the campaign, has released a study showing that two-thirds of physicians and consumers alike "agreed with the concept of a blue button that you can click to download your own health information," according to a press release.

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http://www.fiercehealthit.com/story/population-health-management-improves-prevention-outcomes/2010-10-11

Population health management improves prevention, outcomes

October 11, 2010 — 1:34pm ET | By Neil Versel

Two new studies suggest that a Kaiser Permanente population health management application can help physicians provide better care for a large, diverse panel of patients with diabetes and heart disease. (We're bracing ourselves for a certain anonymous commenter to rant again about how we must be on the Kaiser payroll or something for highlighting this news.)

The app, called the Panel Support Tool, is a web-based tool for primary-care physicians to manage care for individual patients, small groups or entire panels by comparing the care they deliver to nationally recommended best practices. It is integrated with KP HealthConnect, the organization's name for its Epic Systems EMR.

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http://www.fiercehealthit.com/story/onc-contract-could-lead-another-seminal-iom-report/2010-10-04

ONC contract could lead to another seminal IOM report

October 4, 2010 — 5:52pm ET | By Neil Versel

I've lost count as to the number of contracts the Office of the National Coordinator for Health Information Technology has handed out in its efforts to promote and advance the field of health IT, but a new one deserves more attention than most. That's because the recipient is the Institute of Medicine and the purpose is to help assure that the nation's massive investment in IT will pay off in terms of patient safety.

For all the nasty politicking that's gone on over health IT and other aspects of healthcare policy, the IOM remains perhaps the nation's most unassailable authority on patient safety and healthcare quality--something ONC mostly acknowledged in awarding the one-year, $989,000 contract.

"Since 1999, when the IOM published its ground-breaking study To Err Is Human, the Institute has been a leader in the movement to improve patient safety," national health IT coordinator Dr. David Blumenthal said in an HHS press release. "This study will draw on IOM's depth of knowledge in this area to help all of us ensure that HIT reaches the goals we are seeking for patient safety improvement."

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http://www.zawya.com/Story.cfm/sidZAWYA20101011050112/Jordan%20Health%20Initiative%20launched

Jordan Health Initiative launched

11 October 2010

AMMAN - The government on Sunday announced the launch of the Jordan Health Initiative (JHI), which seeks to improve medical services and healthcare offered to citizens through the integration of technology.

Underlining the importance of the initiative, prepared in collaboration with Cisco, Minister of Health Nayef Fayez said it will be implemented in the country's 32 public hospitals, noting that the national e-health programme launched early 2009 is an integral part of the initiative.

The JHI is a national public-private partnership, which aims to transform the delivery of healthcare in Jordan into a world-class regional best practice focused on providing high quality medical services through the utilisation of state-of-the-art technologies designed to provide citizens with the best affordable service and thereby achieving economic growth, according to the health ministry.

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Enjoy!

David.

1 comment:

John G. Abbott, CEO, Health Council of Canada said...

October 22, 2010

Electronic medical and health records can improve the delivery of appropriate care, enhance the management of chronic disease and improve patient safety, and yet their use is low among Canada’s family physicians.

Last week, the federal government announced $11.7 million in funding over five years for a new national network called the Canadian Primary Care Sentinel Surveillance Network that will collect electronic medical records and store information about chronic diseases specifically. The goal is to attract 1,000 family doctors to the program by 2015 to gain greater understanding of chronic diseases in Canada. The project, run by the College of Family Physicians of Canada in collaboration with the Canadian Institute for Health Information, has the potential to help researchers and policy makers understand trends in chronic diseases, and subsequently to help doctors better treat their patients. While Canada continues to lag behind several countries, this is a clear step in the right direction.