Canada Health Infoway vendor meeting

I had the opportunity to go to the first CHI vendor meeting (held yesterday in Victoria)  since the $500M budget announcement.  It was an interesting dynamic. The room was full of mainly acute care vendors like Oracle, Siemens, etc looking to find out how CHI was going to be spending the $500M over the next two years. I’m not sure they got the answer they were looking for.

At this point exact spend info was not forthcoming for a variety of valid political reasons, but what was interesting was a number of key messages from CHI:

1) This is not specifically about healthcare IT funding, it is about creating jobs.

2) This is going to roll out very quickly (likely to see at least two net new spending programs in the next 3-6 months) compared to past CHI efforts.

3) CHI is facing political pressure from their masters to connect as many long ignored silos outside of acute care, to existing CHI systems. The bulk of the money is going to be spent outside of the provincial IT systems, with some for acute and community but the big winner are EMR systems.

4) CHI will for the first time consider directly investing with vendors, specifically EMR vendors to ensure their product roadmaps will allow for integration with CHI supported systems.

5) My guess is that the existing and planned certification bodies (ie PITO, OntarioMD, etc) have just won the lottery. It would not suprise me to see several hundred million earmarked for them. What will be intersting is how this money is allocated. Given CHIs interest in maintaining control I would think they would co-invest with the bodies to suppliment the existing 70% discount. It is unlikely that they will simply hand the money over and let the certification programs take all the glory.

I can think of about 15 other things that were of interest, but these struck me as top of mind. What does everyone else think?

5 responses to “Canada Health Infoway vendor meeting

  1. I have heard that the most recent infusion of cash into Canada Health Infoway is essentially infrastructure dollars and therefore must be spent over the next two years. This information seems to be supported by Infoway’s plans to aggressively roll out new spending programs and the comment that the funding in intended to create jobs.

    What will be interesting to watch is the impact that accelerated spending on EMRs will have on the vendor landscape. This market is characterized by a large number of vendors, most of whom are relatively small (less than $10M in revenue). Many of these vendors will be challenged to meet what could potentially be a significant spend in a relatively short period of time. Further, this market is overdue for consolidation and Infoway’s investments may be the catalyst to percipiate this consolidation.

  2. Maybe this infusion of funds should be used to create an EMR/EHR standards body from which $$$ would flow to vendors participating in making their systems compatible within a certain time frame.
    To me, certification should not only apply to functionality, but also to interoperability.

    Perhaps this mandated time frame would force vendors to amalgamate resources, which could be a good thing for the industry as a whole.

    • I have argued in the past that government’s role should be to set standards not select vendors. Instead of trying to figure who is the “best vendor”, government (and gov’t funded agencies like Canada Health Infoway or the newly created Ontario eHealth agency) should develop standards (interface and minimum functionality) to which vendors must conform and then let the private sector invest in development solutions. As a totally facetious example, if a vendor determines that there is a market for providing an EMR solution to left-handed doctors they should be able to invest in devleoping such a solution. As long as it conforms to published standards, why should the government care if there is another player in the market?

      • Mike,

        You have hit on another of my pet peeves. Why do those in government want to pick the winners and losers in healthcare IT? It seems very wrong to me. Let the market sort it out. I wonder how much of the “let’s protect the docs/hospitals/etc from the bad vendors” derives from the political nature of Canadian healthcare delivery and how much is cost.

        If I am a CIO (on the government side of things) my first temptation is to limit my support and interface costs. This is much easier if I limit the number of companies I deal with via RFP. Not sure that I support this thinking, but I can to a limited sense understand the economic argument.

        What drives me around the bend is when this thinking comes across as paternalistic. Doctors are not employees of the RHAs or province, they to a large extent like 65K private contractors. This to a large degree is why many in the acute world have their projects fail when doctors are involved. You cannot dictate to them like they are employees, they will ignore you.


  3. Further to my last comment, while I might like to see more of a free market approach to EMRs in Canada, Mark and I created this blog to coment on what is happening in the market and reflect on the implications of decisions that are being made. With this framework in mind, it is clear that the provincial funding programs will remain in play and, given the Infoway’s need to accelerate program spending, will likely play a key role in distributing funds for EMR implementations. This reality will have, we believe, a profound impact on the vendor landscape and is one that vendors and investors should pay attention to.

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