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‘At my breaking point’: Halifax doctor pulls out of online health care tool

WATCH ABOVE: A Halifax doctor says the online portal that was designed to help improve patient care almost cost her livelihood. Jennifer Grudic has the story of what’s gone wrong with the innovative approach to health care.

A Halifax doctor says she can no longer sustain using the MyHealthNS online portal due to a lack of government supports.

Dr. Ajantha Jayabarathan said she reached her breaking point this week when she sent her patients an email announcing she would be “unplugging” from the service as of July 31.

“As patients in the practice age and develop more complex medical conditions, it takes longer visits to manage their care. Government has not made any inroads, to help a doctor such as myself to provide this essential service,” said Jayabarathan in the email.

READ MORE: Physician shortages topic of debate at Nova Scotia Health Authority annual meeting

Jayabarathan was one of the first doctors in the province to begin using MyHealthNS. She said she had faith the rules surrounding compensation would change once it was proven successful.

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“The way the rules are set up, a doctor only gets paid when they see a patient face to face. So by using any kind of telephone or email or a PHR (Personal Health Report), you don’t get paid,” said Jayabarathan.

“I really believed that some of us had to sacrifice something in order to prove that this actually worked.”

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The online tool officially launched last summer and allows patients to access medical records, test results, and communicate with their doctors online.

Jayabarathan said while she’s seen tremendous improvements in her ability to care for patients as a result of using the tool, it’s also meant an 18 per cent blow to her income and hours of unpaid work.

“I thought, surely, the people who run the pilot, the federal government, the provincial government, would recognize this has value because we’ve proven it and maybe support it by funding us differently or providing compensation when we don’t see a patient face to face,” Jayabarathan said.

READ MORE: Nova Scotia ERs closed again due to doctor shortage

On Thursday, Nova Scotia’s Health Minister Randy Delorey said through a three-year pilot project, the online personal health reports were identified as the most valuable feature in the first phase of this new system roll out.

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“There’s a clinical advisory group that participated and makes recommendations on how to use the system, particularly around the release of those records to patients,” he said.

“There’s an option in the system, and the recommendation from this group is to use the option that would automatically ensure that those records are made available to patients.”

He said this feature limits the amount of time doctors are spending to make this information available, while acknowledging other features such as e-messaging are more likely increase their workload.

“I think those would be the areas that you would expect to see more discussions around compensation,” Delorey said.

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“Payment negotiations with doctors takes place through the Doctors Nova Scotia organisation. That agreement was just brought in place, I believe signed in September of [2016], so there are a lot of processes that take place when you get into negotiations.”

READ MORE: Nova Scotia doctors vote in favour of new contracts with province

Doctors Nova Scotia said while they fully back the MyHealthNS tool, they say changes to the funding model are necessary to make it successful.

“We have been pursuing that for well over two years at this stage without success through negotiations,” said Alana Patterson, director of negotiations and practice support.

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She said that while she believes government would be supportive of such a change, she hasn’t detected any sense of urgency.

“I think it is as simple as if the government and we were to sit at a table and start to talk about the funding model as we had been asking, we think that this can be easily, reasonably resolved and this great and innovative tool can be made available as it should be,” said Patterson.

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The MyHealthNS tool is currently available to doctors across the province, however, there are currently just over 200 using it.