EHR/EMR Use by Hospital Across Canada?

[MedicineLCS]

I was wondering what systems different hospitals across the country use (for future planning) and noticed there was only this old thread: 

As such if anyone knows what systems/paper is used in various systems please add it to the thread! There isn't a open source document anywhere that lists all of them as far as I'm aware. 

I'll start

The Ottawa Hospital including Heart Institute (TOH): EPIC

CHEO: EPIC (different than TOH EPIC) 

SickKids: (EPIC, same version as CHEO apparently)

Rural Ottawa sites: Hawkesbury, Renfrew, St. Francis are implementing EPIC apparently. Pembroke is on paper. 

If you have insight into what is used locally please add it so we have a resource! 

[Hyaline]

Below is from personal experience - take with grain of salt.

In BC: VCH, PHC, and PHSA sites either are, are currently switching over from paper to, or will be using Powerchart/CERNER.

https://cstproject.ca/about-cst/timeline-locations/project-phases

Side note: Even though healthcare in BC Corrections is under PHSA jurisdiction, the EMR used in Corrections for healthcare is different (PAC).

In Ontario:

-CAMH: Powerchart

-Ontario Shores: Meditech Expanse (in joint partnership with Waypoint, and Royal Ottawa Mental Health Centre).

-THP: EPIC

-UHN: EPIC

 

My personal ranking of EMR preferences: EPIC > Meditech Expanse > Powerchart

[shikimate]

I believe Western/LHSC and outlying hospitals around the area are all on power chart now.

having used both powerchart and meditech I have to say meditech is piece of ****, like do we use windows95 anymore?

also still baffles me how 3 different downtown toronto hospitals can have 3 incompatibly different EMRs. Like who's gravy train are they protecting there?

[ameltingbanana]

All of Alberta is in the process of switching to Epic or has switched already. Edmonton and most of Calgary already have. 
 

Hamilton is also now fully on Epic (though 2 different builds between HHSC and St Joes).  
 

edit: I really did not like Powerchart when I worked with it at Western, but anything beats meditech

[Bluberblubo]

To add to the list Scarborough health (3 hospitals) uses epic. Micheal gerron in Toronto, grandriver in Kitchener, and Windsor use powerchart

[Supervenience]

St. Josephs in Toronto uses Sunrise, St. Michaels uses Soarian, NYGH uses Cerner.

[rmorelan]

9 hours ago, Supervenience said:

St. Josephs in Toronto uses Sunrise, St. Michaels uses Soarian, NYGH uses Cerner.

St Michael's is changing soon! Not sure we have announced exactly the new one but it will be a modern EMR system. 

[Edict]

Sunnybrook still uses Sunnycare AFAIK

[Supervenience]

11 hours ago, rmorelan said:

St Michael's is changing soon! Not sure we have announced exactly the new one but it will be a modern EMR system. 

From the rumblings that I have heard, all of the Toronto hospitals will be switching to Epic in the near future.

[ACHQ]

As many have outlined above most places in Ontario are already on or will be on EPIC. (Ottawa, Oshawa/Lakeridge, Scarborough/SHN, Richmond Hill/Vaughan/Mackenzie Health, Toronto/UHN, Mississauga/THP, Hamilton/McMaster Hospitals)

Notable exceptions include: Newmarket/Southlake and Markham Stouffville (I think they are both apart of ?Oak Valley now?) use the newer Meditech, North York General and Toronto East Health Network/Michael Garron and Mount Sinai/Sinai Health System and London Health Sciences use PowerChart/Cerner. St Michael's used Sorian (which was a Cerner system) but it seems like they'll be making a change soon too?

Brampton is still on the *old* meditech system (think dos), however they are in the works of making a change to a new system in the next few years, likely EPIC, but could be Cerner/Powerchart (they haven't officially picked a vendor, but given THP/Mississauga uses EPIC, they will likely go this route).

 

To each their own,  but I'm not a big fan of EPIC (although it can be very powerful/useful), I prefer Powerchart which I found to be effective and efficient and less cumbersome then EPIC (especially with orders and notes).

A lot of this political and not based off physician/user preference. Also I heard Cerner got a bad rap in the U.S. with possible data-breach so that might be the end of their run in the future...

However, I guess this is a step in the right direction to have most hospitals in the same province/area on the same EMR system. Given that we somehow still use fax machines and pagers....

[ellorie]

I actually prefer Cerner but maybe that's because that's what I trained on in medical school and what I used for most of residency (Sinai and CAMH).  My only gripe with it is it doesn't have integrated prescription faxing.

[ACHQ]

On 11/30/2022 at 7:18 PM, ellorie said:

I actually prefer Cerner but maybe that's because that's what I trained on in medical school and what I used for most of residency (Sinai and CAMH).  My only gripe with it is it doesn't have integrated prescription faxing.

The Sinai Powerchart/Cerner system is the basic/least featured one. The ones they have at TEGH/Michael Garron and NYGH are much better/robust I believe they have a Rx faxing option.

[ameltingbanana]

On 11/30/2022 at 10:09 AM, ACHQ said:

As many have outlined above most places in Ontario are already on or will be on EPIC. (Ottawa, Oshawa/Lakeridge, Scarborough/SHN, Richmond Hill/Vaughan/Mackenzie Health, Toronto/UHN, Mississauga/THP, Hamilton/McMaster Hospitals)

Notable exceptions include: Newmarket/Southlake and Markham Stouffville (I think they are both apart of ?Oak Valley now?) use the newer Meditech, North York General and Toronto East Health Network/Michael Garron and Mount Sinai/Sinai Health System and London Health Sciences use PowerChart/Cerner. St Michael's used Sorian (which was a Cerner system) but it seems like they'll be making a change soon too?

Brampton is still on the *old* meditech system (think dos), however they are in the works of making a change to a new system in the next few years, likely EPIC, but could be Cerner/Powerchart (they haven't officially picked a vendor, but given THP/Mississauga uses EPIC, they will likely go this route).

 

To each their own,  but I'm not a big fan of EPIC (although it can be very powerful/useful), I prefer Powerchart which I found to be effective and efficient and less cumbersome then EPIC (especially with orders and notes).

A lot of this political and not based off physician/user preference. Also I heard Cerner got a bad rap in the U.S. with possible data-breach so that might be the end of their run in the future...

However, I guess this is a step in the right direction to have most hospitals in the same province/area on the same EMR system. Given that we somehow still use fax machines and pagers....

That's interesting - definitely agree there can be tons of bloat in Epic. It's incredibly functional though (I'm probably a bit biased as I've been using it for > 5 years now in various forms) - you can prescriptions, route notes to family docs/specialists, send referrals, pharmacists/nurses/docs message me on there (saving me pages), there's a phone/tablet app so I can put in orders without needing to boot up my computer.. I found Cerner fast but not terribly functional (though to be fair I really only used it for a a couple months in London and a community rotation in Waterloo). It does seem that Epic is starting to take over

[ACHQ]

17 hours ago, ameltingbanana said:

That's interesting - definitely agree there can be tons of bloat in Epic. It's incredibly functional though (I'm probably a bit biased as I've been using it for > 5 years now in various forms) - you can prescriptions, route notes to family docs/specialists, send referrals, pharmacists/nurses/docs message me on there (saving me pages), there's a phone/tablet app so I can put in orders without needing to boot up my computer.. I found Cerner fast but not terribly functional (though to be fair I really only used it for a a couple months in London and a community rotation in Waterloo). It does seem that Epic is starting to take over

Yes a lot of functionality to it which is why most people prefer it as their EMR of choice.

but what my colleagues and I have noticed (and this may not be limited to just EPIC), but with one of the nearby hospitals switching to EPIC, we have noticed that patients consultation/progress notes, discharge summaries etc... have been unbelievably long and cumbersome/pain to read. It is clear that these notes have become (as you so nicely put it) full of bloat, and its clear that clinicians have taken advantage of the functionality of EPIC by having it pull various results, PMHx, MEDS etc... into their notes, however it has done so in the worst possible way. Much of the onus is on the physician to look over the notes and try to trim it down to a readable format, but in there defence we are all busy and can't spend the time to do so (and doing so would take away all that time that was "saved" from EPIC's functionality).

I may be old school, but dictated notes from clinicians are so much easier to read as the clinician often time synthesizes what would be 10-12 pages on EPIC into 2-3 pages. Again to each their own...

[MD_PharmD01]

thanks

[zxcccxz]

.

[zxcccxz]

41 minutes ago, MD_PharmD01 said:

Hello everyone!
I hope all is well. 
Could someone share with me the instructional guide to learn how to use EPIC please ?

I will be doing an elective in 3 months and wants to get familiar with the system!

Thank you so much for your kind help!!

I would recommend waiting until right before your rotation to do the training as you’ll likely forget everything you learned if you do it too early without actually using it clinically. 

Not sure where exactly your elective will be - I know there is some differences in the software depending on geography despite it all being on the EPIC platform. All of Alberta is on EPIC now and there is an online manual for how to use it here: https://manual.connect-care.ca/tools/Patient-Portal

Hopefully that’s helpful.