According the Times of London (http://business.timesonline.co.uk/tol/business/economics/pbr/article6946336.ece), parts of the ambitious National Programme for IT may be scrapped. According to the article, Alistair Darling, Chancellor of the Exchequer, is quoted as sayiing that the UK National Health Service (NHS) “has quite an expensive IT system that, frankly, is not essential for the front line. That’s something we do not need to go ahead with just now.”
Equally damning are comments from the opposition. Norman Lamb, the Liberal Democrats’ health spokesman, is quoted in the article “This whole programme has been disastrously flawed from the start. It has held back the development of IT at a local level, cost billions and is running years behind schedule. Labour has been in denial for years and this is a belated and partial recognition of the scale of their failure. The truth is that the national programme should be abandoned in its entirety, subject to existing contractual obligations, and instead we should start building from the bottom.”
What lessons can Canada learn from the UK experience? Australia, for example, is considering a major changes in their eHealth strategy that would see a shift away from a centralized EHR to extensive use of personal health records to store longitudinal health information. As I argued in a recent Health Information Management & Communications Canada article, the Canadian health sector is an ecosystem, in which multiple healthcare delivery organizations and individuals operate, each with their own mandate and agenda. While there is clearly a need for these organizations and individuals to interact and exchange information, they do so as distinct entities driven by their own needs and agendas and not as members of the same corporate entity. Canadian eHealth strategy needs to reflect this reality.
eHealth Ontario, the much maligned agency responsible for development and delivery of electronic health records in Ontario, seems to grasp the ecosystem concept. At a recent eHealth Ontario briefing session, acting Senior Vice President (A) Strategy / Development / Delivery used the word “ecosystem” several times and explained that the organization intends to pursue a “bottom up, top down” approach to rolling out a Health Information Access Layer (HIAL) strategy to more effectively deal with the ecosystem reality .
What are your thoughts on Canada’s eHealth strategy? Are changes needs? If so, what elements of the current strategy should we retain and what needs to be revisited?