eHealth Ontario – On the Right Track?

“There is no such thing as bad publicity except your own obituary. “
Brendan Behan (Irish author & dramatist; 1923 – 1964)

The folks at eHealth Ontario probably don’t agree with Mr. Behan this morning.  For nearly two weeks eHealth Ontario has the subject of intense media and political scrutiny, culiminating yesterday with the departure of President and CEO, Sarah Kramer.   With media attention focused on eHealth Ontario’s spending practices, I’d like to take a step back and discuss eHealth Ontario’s mandate and strategic plan.

Management and spending practices aside, do you think that eHealth Ontario is good idea?  Do we need to spend money on eHealth?  If so, is an agency such as eHealth Ontario needed to advance an eHealth agenda for Ontario? 

Mike

3 responses to “eHealth Ontario – On the Right Track?

  1. Interesting questions Mike.

    I think it is necessary to have some kind of centralized agency/group that directs the overall Ontario eHealth investment strategy. If you go back in time to the 1990s we see what happens when we leave eHealth investing up to the individuals silos (acute, primary etc). Fragmentation and a significant difference in automation as you move between entities. If we leave it up to the hospitals and others we will have those with more relative means (GTA hospitals/groups) delivering more cost effective services, while those without going back to manual processes. Although most care is local, just imagine the effect on a patient who has to cross these differing entities. Not very health/cost effective.

    I have recently heard some argument that we should just let Canada Health Infoway do the investing on behalf of provinces. Not sure how I begin to respond to that, other than to call it a red herring argument. CHI is a national organization that acts as a strategic investor. Whether you agree with their strategy or not, they simply are not given the funds to deliver all this is required. They need local/provincial partners that have access to separate pots of funding to get this whole EHR thing done.

    I guess the alternative to investing in eHealth is to stop investing. What do we do (in 10-20 years) when an inefficient healthcare system is consuming 110% of the provincial healthcare budget. Don’t believe me, just look at what others are projecting on this matter. I have always felt that IT is not a silver bullet, but its an important part of getting spending under control.

    In closing, whether I agree with the firing of top management at eHealth Ontario is largely irrelevant. What is more important is what effect is this going to have on the politicians who are deciding whether to invest in eHealth or not? Its hard not to see a freeze on parts of the strategy for at least a year. Can we afford to do this?

    Mark

    Mark

  2. An editorial in today’s Ottawa Citizen (http://www.ottawacitizen.com/Health/real+scandal/1676278/story.html) nicely sums up my views. In particular, the editorial concludes that:

    “The latest disruption to eHealth Ontario could delay this important work further. In the long run, that could cause more damage and cost more money than any consultant’s muffin habit.”

    As I have stated before, I am not going to comment on eHealth’s contracting practices nor on the behaviour of individual consultants. Third-party and Ontario Auditor reviews will have access to more information that I do to make a determination of any improper practices or conflicts of interest. My concern is that we need to get on with moving the eHealth agenda ahead in Ontario and we risk throwing out the baby with the bathwater as we, quite rightly, review eHealth Ontario spending practices.

    Mike

  3. Two addition reader contributions to the Ottawa citizen today point to the need to move beyond the spending scandal and to start discussing eHealth’s mandate and the need for electronic health records. In one case, a letter to the editor points out how Sarah Kramer’s severance package might be otherwise spent:

    http://www.ottawacitizen.com/opinion/Squandered+eHealth+money+could+help+desperate+parents/1687487/story.html

    The letter’s author characterizes the current situation at eHealth Ontario as “gross mismanagement of my health-care dollars”.

    The second reader contribution is a short essay entitled “Give the people control of online health records” (no link is available for this article). This article explores Ontario’s eHealth strategy and proposes an alternate approach based on individual electronic health records. Under the proposed scheme, “the patient or ambulance attendant swipes a health card to give temporary access of records”.

    If we don’t start talking about the province’s eHealth strategy and how electronic health records will contribute to a more effective and efficient healthcare system then we may lose a great opportunity to shape the very future of our healthcare system.

    I am not suggesting that a review of eHealth Ontario spending (and perhaps that of other Crown agencies) isn’t needed. Rather, I am suggesting that we add other dimensions to this debate that explore how the money allocated for eHealth will be spent and why it is critically important that we make these investments. As I have said many times before, let’s not “throw the baby out with the bath water” as we try to get to the bottom of the current spending “scandal”.

    Mike

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