Chelsea Gould waited a year to get an MRI of her injured back, but getting into the Caleo Clinic took only a few weeks.

"I filled out the application online and then got a call about an appointment," says the 31-year-old former triathlete in the clinic's northwest Calgary waiting room.

Chelsea Gould

Chelsea Gould says that it took only a few weeks for her to get an initial appointment at Caleo Health after waiting a year for an MRI of her injured back. (Judy Aldous/CBC)

It wasn't always that simple. Caleo, which is the only public, integrated spine clinic of its type in southern Alberta, used to suffer under staggering wait times.

The clinic decided to invest in a simple solution that has nothing to do with hiring more doctors or introducing some new experimental treatment.

The answer is much more mundane than that: secure online messaging.

The results are remarkable:​

  • Time to make first contact with referred patient has dropped up to 90 per cent from six to 12 weeks to just five days.
  • Time to see spine assessment team dropped by 60 per cent, or from six to eight months down to two to three months.

Secure mail, however, cannot speed up the time it takes to have surgery; the wait time for that remains at 18 to 24 months.

Axe the fax

It's hard to fathom that just using better technology can reduce wait times that dramatically, but then consider the process behind every referral.

Caleo receives upwards of 5,000 referrals a year — all of them sent by fax.

"In the past, we had 'file rooms' full of documents so if a patient called to see if we'd received their referral, we'd have to go into that room and search through hundreds, sometimes thousands of pieces of paper," said clinic director Dr. Mark Lewis.

Dr. Mark Lewis

Dr. Mark Lewis, clinic director at Caleo Health, stands near a fax machine that he wants to render obsolete through the use of secure-mail communication. (Judy Aldous/CBC)

Clerical staff would have to enter referral information into the computer, then contact the patient by phone — which might require a few phone calls.

Once an appointment is made, then intake information would be filled out in paper. Now, all of that is done virtually through the a secure online portal.

"We hope that by 2017 we can get rid of all our fax machines," Dr Lewis laughed.

Carrot and stick

There is mounting pressure and incentive for physicians to make the leap to secure messaging.

First the carrot. 

As of April of this year, doctors can now bill the province for the messages they send — work they would have had to do on their own dime previously.

The stick? 

Dr. Brendan Bunting, with the Alberta Medical Association, says that is coming from the authorities that oversee doctors — including the lawyers.

The way doctors communicate right now is not secure.

If you went to any hospital, Dr. Bunting says you would see "many of the doctors are busy texting each other about patients they see on the wards."

"And they're taking photographs of x-rays and they're sending to their boss and asking them what to do and there's a lot of two-way communication just using iPhones and Blackberries, and all of this is not secure."

Secure messaging race is on

The push to get doctors using secure mail is happening and software companies are rushing to meet the demand.

The secure mail system Caleo uses was created by a Calgary-based company called Brightsquid. It offers messaging, but also online patient registration.

Caleo also offers an e-consult service through the Brightsquid portal.

Now the Alberta Medical Association is set to launch a similar program on July 4 called dr2dr.

At a cost of about $35 a month, physicians would be able to securely message each other. Dr. Bunting hopes physicians will choose this software over others.

"The problem with all these competitors is that they're not all compatible with everyone else. In fact they're incompatible with each other. So that's a bit of a problem. AMA hopes to provide a system that everyone wants to use."

Better for the patient

The next step, according to Dr. Norm Yee, is to loop in the patient to this secure system of communicating.

A family doctor, Yee pays a monthly subscription for secure messaging and uses it to communicate with his patients.

Dr. Norm Yee

Dr. Norm Yee says he emails with his patients using a secure mail system. "I'm in the service industry and this information is important to my patients." (Judy Aldous/CBC)

He will even forward test results, something most physicians are loath to do.

"Not everyone believes that everyone should have access to their own test results, as if we are the paternalistic gate keepers of 'doctor knows best.' The information is theirs."

Yee says doctors are wary of increasing their workload though he insists it has not made him "slave to his computer."

In the end, Yee says patients are starting to demand better and more communication with their doctors and he wants to provide it.

"I'm in the service industry."

Corrections

  • An earlier version of this story said the time to see a spine assessment team dropped to two to three days instead of months.
    Jun 15, 2016 2:04 PM MT