CANADIAN'S AND THE RUSE OF HEALTHCARE 2.0

Healthcare is the world’s most information intensive industry. Every day this industry produces massive volumes of data that, if properly used, can improve clinical practice and outcomes, guide planning and resource allocation, and enhance accountability. Electronic health information is fundamental to better health care. There will be no quantum leap forward in health care quality and efficiency without high quality, user-friendly health information compiled and delivered electronically.

The task of building an information network that patients, providers, managers, and policy-makers can use to improve decision-making at all levels is truly daunting (and the health information “agenda” competes with innumerable other claims on resources.)

That said, Canada’s Healthcare Informatics arena is rapidly changing, primarily due to growing public and private investment in Electronic Health Information Systems (EHIS). At the same time, a recent economic study (November 2009) identifies a serious need for increased labor and skills amongst Canadian Health Information (HI) and Health Information Management (HIM) professionals over the next five years. To compound further, there are fears in both the private and public sector that the successful implementation of EHIS systems is potentially jeopardized due to lack of qualified human resources. Add to this - - issues around Canada Health Infoway Funding, a limited and flawed EHR blueprint, Federal and Provincial politics, lobbying, posturing, competition, and (yes) corruption - - and it’s easy to see how a feast or famine (all or nothing) environment has been established.

From a consumer standpoint in Canada, advancing patient care has also unfortunately been tied directly to those vendors that have the bandwidth to extend a provincial or national solution (even if those platforms are antiquated and in many cases not standardized). This discussion (and subsequent funding) is entirely based on resources, and while absolutely a relevant conversation - - in practice - - has only left Canadian’s with a sub-par platform and an increased tax-burden.

So, while increasing evidence (and PR buzz) attempts to illuminate progress in extending a Canada-wide EHIS - - it’s really only proven to be lip service. As political pressures mount, huge contracts are extended to vendors who are in many cases no more equipped to deliver an integrated EHIS than a local start-up.

The best example one might extend related to the state-of-the-union of Canadian EHIS is from the “Wizard of Oz”.  One might think that it’s only a matter of time before Canadian citizens get wise to the kick-back’s, cost over-run’s, deception, and general systemic corruption in Canadian EHIS. Let’s not even get started on the role of “Consultants” in all of this. The unfortunate challenge is that, unless one is deeply entrenched in this sector for a number of years - - most investigations are only typically scratching the surface.

Neither the Canadian Government nor any of its elected bodies have yet to even get close to the real issues (and savvy multi-national vendors are well aware of this and capitalizing on it.) When Canadians finally pull back the metaphorical ‘curtain’ to see the ‘Wizard’ pulling furiously on ropes and levers - - to attempt to evidence progress - - they’re going to wonder whose hand was on the wheel?  Just take a look at the long, detailed (and growing) list of Federal and Provincial resources (i.e. dollars) allocated to accomplishing specific EHIS tasks that are never completed or even accounted for.

To be continued...

Province of Ontario: Ex-eHealth Chair quits ... again

August 14, 2009 | The STAR | QUEEN'S PARK BUREAU

Hudson's resignation from health ministry comes as PM wades into spending scandal. Premier Dalton McGuinty's go-to man in reducing health-care wait times has left the government – less than two months after being replaced as chairman of the scandal-ridden eHealth Ontario.

Acclaimed neurosurgeon Dr. Alan Hudson last week resigned from his full-time, $292,653-a-year job leading the province's efforts to reduce delays in cancer and cataract surgery, diagnostic imaging, cardiac procedures and hip and knee replacements. Reached on vacation with his family, Hudson said in an interview that he consulted Health Minister David Caplan and others before deciding to step down last Friday after five years in the job.

"Everyone wanted me to stay on, but I am not going to stay on until I die," said the 71-year-old Order of Canada recipient. "It is time for me to do other things – play with my grandchildren, do some travelling."

The news, first reported on thestar.com, came as Prime Minister Stephen Harper yesterday waded into the eHealth spending imbroglio – in which consultants who were paid as much as $3,000 a day raised public ire by expensing tea and Choco Bites cookies – with a caustic rebuke of McGuinty for costly delays in creating electronic health records for Ontarians.

"The federal government had in its budget considerable funds available for the (Canada) Health Infoway, for the expansion and pushing forward of the project to make health records in this country electronic, so I obviously would encourage the provincial government to get on with rectifying the problems in that area."

Senior provincial officials countered that the federal government has not yet given Ontario the cash for electronic health records. Because he was on contract, Hudson will not receive a golden handshake like the $317,000 given to departed eHealth chief executive Sarah Kramer, who finally broke her silence yesterday with an acerbic statement slamming the media and health ministry bureaucrats.

"There's no severance," said Terry Sullivan, chief executive of Cancer Care Ontario, where the wait times offices are headquartered. He noted Hudson was rattled by the eHealth experience, which became a major political headache for McGuinty, prompting him to clamp down on untendered contracts to consultants and the meals and treats they expense to taxpayers.

"He was distressed and troubled by the whole experience. ... I assume that was part of his calculus," Sullivan said of Hudson, crediting him for the innovative wait-times system that began tracking treatment times with an eye to improving them. A replacement for Hudson on the wait-times file has not been determined, but Sullivan urged the government to do so, noting that general surgeries will eventually be added to the list.

Hudson's departure is a further blow to McGuinty's Liberals in the wake of the eHealth debacle, in which revelations of spending abuses have continued to emerge – including an estimated $25,000 spent on writing and tweaking a speech for Kramer. She left the agency in June amid furor over executive perks, big bonuses and untendered contracts that total at least $16 million of taxpayers money. Kramer's 448-word statement issued yesterday appears to have been triggered by McGuinty's declaration Wednesday that it was a "mistake" to put her in the job.

She defended eHealth's hiring of (overtly) highly paid consultants, saying she had to take over a "moribund and deeply troubled and dysfunctional organization." While she acknowledged the expense was "not negligible," she deemed it an "essential investment" in speeding progress to creating electronic health records.

"As with any major change, our efforts were met with strong, intractable resistance and outright hostility in some quarters, including within the Ministry of Health and a few other vested interests in the health care sector," Kramer wrote, also blaming "sensationalized media coverage." She did not respond to requests for an interview.

Hudson defended Kramer's performance, saying she did the best she could to bring electronic health records to the masses. "She is not a dreadful person," he told the Star.
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HAMILTON HEALTH SCIENCES (HHS) WINS MEDSEEK’s 2009 eHEALTH EXCELLENCE AWARD

MEDSEEK recognizes HHS for its outstanding web portal vision, innovation, performance and achievement.

BIRMINGHAM, Ala.--(BUSINESS WIRE)--MEDSEEK, the leading provider of enterprise portal connectivity solutions, announced today that Hamilton Health Sciences (HHS) won MEDSEEK’s 2009 eHealth Excellence Award for outstanding vision, innovation and performance in using web portal technology to enhance care delivery, information access and service. The award was presented to Dale Anderson, HHS’ manager of projects and eHealth solutions, at MEDSEEK’s 9th Annual eHealth Client Congress in Tampa, Fla., on Feb. 25, 2009.

Hamilton Health Sciences is one of the most comprehensive health care systems in Canada. Its six hospitals and cancer facility are licensed for more than 900 beds and serve more than 2.3 million residents of Hamilton and central south and central west Ontario. Through its affiliation with McMaster University's Faculty of Health Sciences, HHS offers some of the most innovative treatments and talented medical professionals in Canada.

“MEDSEEK is pleased to recognize HHS for the exceptional efforts it has made to provide safe, high quality care as well provide a total user experience throughout the entire healthcare system,“ said Peter Kuhn, MEDSEEK’s CEO. “We are excited to acknowledge the impact our portal solutions have had across HHS’ enterprise and among its physicians, patients and employee constituencies.”

Over the past 4 years, more than 2,700 HHS clinicians have registered to access its patients’ electronic medical records in real time via a portal called ClinicalConnect. Through this portal, clinicians have access to a unified, single view of a patient’s clinical reports, laboratory results, medication lists, images and other data stored in disparate clinical systems. These systems include a hospital information solution from MEDITECH, picture archiving and communication system from GE Healthcare as well as a health information management application from Sovera Document Imaging.

In 2007, HHS redesigned its consumer portal to make it easier and more convenient for patients and visitors to access health information and interact with the organization. The consumer portal provides greater emphasis on patient education and included an upgrade of the existing infrastructure to make the site more stable and reliable for end users.

HHS, which is the largest employer in Hamilton, has also implemented an employee portal to disseminate and streamline communication with its more than 10,000 employees, improving efficiency, productivity, job satisfaction and staff retention. Employees are using the portal to access staff directory, schedules, internal job postings, training and more, helping HHS’ human resources department operate more efficiently.

“We are honored to be recognized by MEDSEEK for excellence in the use of eHealth to improve patient care, safety and operational efficiencies,” said HHS’ Anderson. “We chose to partner with MEDSEEK for its unparalleled insight into healthcare technology innovations and best practices, and its focus on the user experience which has truly transformed and streamlined our ability to provide quality patient care.” Although ClinicalConnect began at Hamilton Health Sciences, it is now being extended and adopted by the Local Health Integration Network or region to interconnect other hospitals, community healthcare agencies and healthcare providers.

About Hamilton Health Sciences
Hamilton Health Sciences is a family of six unique hospitals and a cancer centre, serving more than 2.3 million residents of Hamilton and central west Ontario. Hamilton Health Sciences is the second largest hospital group in Ontario and serves as a regional referral centre for burns, trauma, cardiac, stroke, neurosurgery, pediatrics, digestive diseases, high-risk obstetrics, cancer, orthopedics and rehabilitation services. With a staff of approximately 10,000, the hospital is the largest employer in Hamilton, Ontario. As an academic teaching hospital with more than 900 beds and an affiliation with McMaster University and Mohawk College, Hamilton Health Sciences is committed to providing exemplary health care for the people and communities we serve and advancing excellence in education and health research.

About MEDSEEK
For more information, visit www.medseek.com or call 888-MEDSEEK.

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CALL FOR SUBMISSIONS

ACUMEME is seeking articles, commentary and ideas on the state of electronic health records (EHR) and e-Health 2.0 in Canada. Have something to say? Here’s your sounding board. Anonymity assured. E-mail us at acumeme@yahoo.com.

Government of Canada Supports Electronic Health Record System that Will Save Time and Lives

Wed., Feb. 11, 2009 | OTTAWA, ONTARIO
The Honorable Leona Aglukkaq, Minister of Health, today announced that the Government of Canada, through its Economic Action Plan, is continuing to support the creation of health information systems designed to benefit Canadians by saving time and lives, while also creating economic stimulus.

Support from Budget 2009 will assist Canada Health Infoway in implementing electronic health records. It will also speed up the implementation of electronic medical record systems for physicians, as well as connect hospitals, pharmacies and community care facilities.

"An electronic health record system will improve the safety and accountability of the overall health-care system," said Minister Aglukkaq. "It will save time and lives by reducing duplication, improving the management of chronic disease, improving access to care and boosting productivity. This will result in a positive contribution to Canada's economy, including the creation of thousands of sustainable, knowledge-based jobs throughout Canada."

Many other countries are following Canada's adoption of electronic health records, which give health-care providers a complete picture of their patients' health history and help them to provide better care. Electronic health records will also help to reduce wait times by speeding the flow of information through the system, eliminating duplicate or unnecessary tests, and reducing hospital stays due to adverse drug events. Automated alerts and reminders will help to reduce medication errors and remind health-care providers of necessary tests or vaccinations.

Funding of $500 million announced today is in addition to $400 million in support provided to Canada Health Infoway in Budget 2007. This brings the Government of Canada's total commitment to this initiative to $2.1 billion. Since its inception, Infoway and its provincial and territorial partners have made good progress in making electronic health records a reality in Canada. Across the country, increasing numbers of Canadians and health-care providers are gaining access to health information through secure electronic systems.

"The Government of Canada's continued investment in the development of electronic health record systems across Canada will result in continued modernization of the health-care system, with tangible results for Canadians in every corner of the country," said Richard Alvarez, President and CEO, Canada Health Infoway. "In addition to benefiting the health system, electronic health records are also reducing operating costs and stimulating the economy by creating thousands of jobs."

Canada Health Infoway is an independent, not-for-profit corporation established in 2001 to accelerate the development of health information and communication technologies such as electronic health records (EHR's), telehealth, and public health surveillance systems on a pan-Canadian basis. Its members are the 14 federal, provincial and territorial Deputy Ministers of Health.

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Canada Health Infoway Launches new Canadian e-Health Certification

The government-funded organization works to accelerate the adoption of electronic health records in Canada. Its new e-health certification aims to make consumer health vendors bake more security, privacy and interoperability features into their applications.

Canada Health Infoway is launching a new certification service for vendors who create consumer e-health applications. The non-profit organization hopes its new e-Health Certification Service will encourage health IT vendors to take advantage of the considerable progress Canada has made in setting standards and deploying interoperable electronic health records. With interest in consumer health products continuing to grow, ensuring these solutions work well with technologies used to store Canadian health data is essential.

These products can help individuals organize their health information and gather medical records from doctors, hospitals and pharmacies. It can also help doctors keep up-to-date on changes to your digital health records.

“The key word is interoperability and this should be the driving force for technology solutions in all sectors,” John Reid, president and CEO of the Canadian Advanced Technology Alliance (CATA Alliance), said. “In the health care sector, you want solutions and information to be portable from one geography to the other and that’s the whole idea behind these standards.”

Bernard Courtois, president and CEO of the Information Technology Association of Canada (ITAC), also applauded the national standard and said it could boost the confidence of the market considerably.

“It’s a sign that electronic health is making progress and reaching the consumer world, not just the health care system world,” he said. “Canadians will realize that e-health is something they can’t do without in a modern health care system.”

In addition to better interoperability, organizations investing in certified e-health solutions can also expect a high degree of confidence that the products they buy meet stringent security standards. When applying for certification, a vendor will need to fill out a self-assessment form on how well their product meets Infoway’s standards. After passing this stage, vendors will have to “provide an overview of their privacy policy” and “demonstrate very specific test scripts through their applications,” according to Shelagh Maloney, Infoway’s executive director of external liaison.

“Our ultimate goal is that buyers of these systems, especially the health organizations, will make it a mandatory requirement in their buying process to purchase consumer health platforms certified by Infoway,” she said.

Maloney, however, did not want to comment on the specific costs vendors can expect to pay for going through the certification process. Courtois said that whatever the costs might be, they need to be affordable in order to allow smaller companies a chance at becoming certified.

Traditionally, the problem with certifications is that there’s just too many of them, he added, “if you have to obtain multiple health certifications, it can waste lots of time and money, and really doesn’t provide much help for the buyers,” Courtois said. “This makes things tougher for smaller companies, but it’s also an expense for larger companies and it would be naïve to think that the cost doesn’t get factored back into when they sell the application.”

Reid added that by creating cost-effective – but also well-respected – national standard, vendors can truly differentiate themselves and improve the e-health application market.

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