AMA Dr2Dr and Messaging in AHS Facilities

The Alberta Medical Association (AMA) recently launched a Clinical Secure Messaging (CSM) application, called “dr2dr” for use by Alberta physicians. Clinicians may wonder how this relates to AHS Medical Staff, practitioners, medical residents, and medical students working within AHS facilities or with AHS medical records. At this time, AHS will not be supporting direct connections between dr2dr and any AHS Clinical Information System (CIS, such as eCLINICIAN, Sunrise Clinical Manager, MEDITECH). 

Clinical communications between AHS clinicians, especially when involving identifiable patient information, must use any available AHS-provisioned tools. Default to AHS CIS-based messaging when sender and receiver are users of an AHS CIS. Otherwise, AHS secure email or Netcare messaging should be tried. 

If these resources are unavailable or inappropriate (e.g., sender is does not have access to AHS-provisioned tools), then it may be appropriate to use a non-AHS CSM tool (such as AMA dr2dr) as long as the use complies with AHS policies and procedures cited in the guides. If the non-AHS CSM tool is to be used with an AHS CIS, then an evaluation and OIPC-approved addendum to the CIS privacy impact assessment must be arranged with AHS Privacy prior to implementation.


Clinical Secure Messaging

Instant messaging relates to person-to-person communication tools optimized for short chat-like exchanges. Clinical Secure Messaging (CSM) adds encryption and user-validation protections for secure transmission of clinical information. 

While CSM can be a big help within organizations, perhaps the greatest appeal is for quick, secure, communications between clinicians in different contexts. Growing frustration with facsimile technology increases demand for Internet-based services. However, messaging-type applications are relatively new to medicine and users may not appreciate the harms that could befall patients and practitioners. AHS is working on guides that expose risks and requirements when CSM is used for healthcare (see links).


What's in a name: digital health records?

The acronyms “EHR,” “EMR” and “CIS” are used differently by different vendors, organizations and countries at different times. Canada Health Infoway promotes distinctions that are fairly well adopted in Canada and Alberta. These are adapted to Alberta’s present context:

Electronic Health Record
Longitudinal collection of personal health information supporting multiple health service providers across the continuum of care with appropriate information securely delivered to authorized individuals.
Electronic Medical Record
Record of health services and related information maintained by health care providers in an electronic system for access and use by the providers.
Clinical Information System
Integrated information management platform supporting the collection, access, use and sharing of information supporting the delivery of health services to persons and populations in multiple settings across the continuum of care.