About a month ago I wrote a blog post about the The Steven Huesing Debates on Digitizing Canada’s Healthcare System. This virtual debate series is intended provide a platform to engage all stakeholders in open, unfettered discussions about the about the major issues impacting eHealth adoption and use, such as:
- Measuring the return on value to the patient
- Improving quality and safety
- Data sharing to respect the privacy rights of patients
- The appropriateness of the current agenda
The debates will be conducted virtually and will include a public commenting period. The first debate took place on 12 April 2011 and the public commenting period is now open. You can find information about the debate series as well as a recording and written synopsis of the first debate here.
I urge readers of this blog to participate in the virtual debate. Please check out the virtual debate website and offer your thoughts and comments. In particular, please offer your thoughts on the topics to be discussed In future debate sessions. The currently identified topics include:
- Patients as co-creators/owners: Should the HIT agenda change to build the infrastructure that ensures personal health information rests with the patient who shares it with others? Do you want patients to genuinely become a co-creators—to share power
- Aligning business models to incent using these systems: What changes in the current approach (business model and incentives) are necessary to speed up adoption and change processes of care to drive out more value?
- The need for e-health policy: The technology roll-out is advancing before we have e-health policies in place. What policies are needed to address challenges or potential barriers?
- Regulation vs. government edict: What would be the best approach to creating a carrot and/or stick regime to speed up adoption by clinicians?
- The right balance between top-down and bottom-up to drive the agenda: Is HIT in Canada emphasizing a more grassroots agenda driven by the patient and providers rather than a top-down approache driven by governments?
- Do we need a higher sense of urgency with the HIT agenda? If the answer is yes, then what do we do to build this into decision making and implementation?
What are your thoughts on these proposed topics? Are there additional topics that should be considered? Please go here to participate. Also, please let people in your own networks know about the debate series and encourage them to participate
I tripped across this blog post today that offers a US perspective on the Canadian health system. I found the summary of HIT in Canada to be particularly interesting:
- “Is in the process of creating EHR for all citizens using a standardized format.”
- “”Physicians can check medication histories and order medications online.”
- “A Chronic Disease Management Infostructure (CDMI) is being created to predict trends and allocate resources more efficiently.”
Hmmmm …. seems that are our PR may be getting ahead of reality I’m pretty sure, for example, that most physicians cannot order medications online save for a few pilot projects.
For anyone following the developments in the US, the evolution of the debate surrounding “meaningful use” has been rather interesting. To receive portions of the ARRA stimulus for buying an EMR, US doctors have to be able to show “meaningful use“. What I find interesting about this process is not in the ultimate minutiae of the definition but in the process and scale.
In the US market to receive funding on a national level (ie selling EMRs to docs in Florida or North Dakota) a vendor must show enough of product functionality to meet meaningful use. I think the national focus is a smart move, especially in combination with the whole process of how meaningful use has been defined. It was not proscriptive at the start of the process, instead it was (and is) defined as time goes on, and input is received from all of the national stakeholders. This avoids state level fragmentation of standards, and gets all the key stakeholders going in roughly the same direction. I think that these two aspects of their program will serve the US well.
How does/did this differ from the process in Canada?
Will this national focus and definition process allow the US to blow by Canada as far as adoption rates for EMRs?
If the US model is “better” what can lessons can be applied in Canada, or is it too late?
I’m starting to feel like the boy who cried Wolf. Unlike the IBM announcement, the SUN board has approved this merger. Oracle is even offering $0.10 more per share than IBM…interesting. Some snippets from the analysts include:
Shannon Cross, Cross Research: “It’s a very interesting acquisition in that it gives Oracle a very strong operating system. It gets hardware, which should be interesting to see since Oracle doesn’t make things. It’s going to give them access to customers who weren’t using the Oracle database.”
Robert Jakobsen, JYSKE “It makes sense also historically, Oracle has been more successful commercializing software than Sun.”
It even appears that even Steve Ballmer from MSFT is “very surprised” according to this article.
I wonder what this is going to do on the eHealth side of things. I think Robert Jakobsen has nailed it. This is not so much about SUN hardware, I seriously doubt Oracle would pay this much money for a declining UNIX server player…although it does get them into hardware. This is about Java and how important this has become to the Oracle stack.
It will be odd, in the Canadian eHealth market, to see Oracle go from pure Infrastructure player to selling Apps and SI services (ie portions of big provincial EHR projects across Canada).
Monday’s grim news about declines in Canada’s Gross Domestic Product (GDP) got me thinking about the possible impact on healthcare spending in general and on healthare IT spending in particular. According to a 13 November 2008 news release from the Canadian Institute for Health Information (CIHI), spending on healthcare was projected to grow to an estimated 10.7% of GDP. The same news release also notes that “this rate has climbed gradually, from 10.0% in 2002, to an estimated 10.6% last year” and that, at 10.7%, it is “the highest rate ever recorded“. Perhaps even more frightening, Glenda Yates, President and CEO of CIHI, is quoted as saying “Health care spending is expected to grow faster than Canada’s economy, outpacing inflation and population growth.”
Most provinces have noted for the past few years that even in a growing economy, year over year increases in healthcare spending were a significant concern and were looking at various ways to curb healthcare spending. Now that the economy is shrinking, how will governments across Canada respond? We have already seen announcements about possible cutbacks in services and even layoffs. Will healthcare IT spending be similarly impacted? Any thoughts?