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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