This past weekend there was a spate of tweets, most of them retweets, related to a “new” auditor general’s report. As reported in an earlier blog post, this audit report was released Nov 3/2009. Digging beyond the highlights reported in the mainstream press, the AG’s report concluded:
- “Canada Health Infoway is exercising due regard in managing funds from the federal government to achieve its goal related to the implementation of electronic health records (EHRs) across Canada.”
- “Infoway has set a good foundation for the work it is doing by applying appropriate governance mechanisms to carry out its mandate and objectives.”
- “It has also implemented appropriate management controls for operational spending, although controls for contracting for goods and services need to be strengthened.”
- “Infoway is exercising due regard in approving, monitoring, and making best use of its funds for EHR projects. However, Infoway ought to better document its analyses of project deliverables before releasing payments.”
- “Infoway approves projects that are designed to align with the Blueprint and comply with standards. However, it does not have sufficient assurance that, once implemented, projects will comply with these requirements.”
- “…the Corporation does not annually report progress achieved against expected progress and it does not report on its performance targets that are related to the use of EHR systems. Also, it does not report on project adoption and project compliance with requirements for national compatibility. This information is important to providing a complete picture of progress achieved.”
- “Health Canada ensures that Infoway complies with the funding agreements. However, at the time of the audit, the Department had not yet fully developed an approach to its ongoing monitoring activities to detect early warning of potential non-compliance.”
- “Infoway has accomplished much in the eight years since its creation. Progress achieved thus far required the collaboration of Infoway, all provinces and territories, and other stakeholders. Significant challenges remain to ensuring that tangible benefits of EHRs are realized across the country.”
These conclusions hardly seem to point to widespread problems or misspending of public funds.
I have stated in past blog posts that I support the concept of a national eHealth agency and that, in general, I support Canada Health Infoway That said, there is clearly some public dissatisfaction with Infoway and its operations. I encourage continued debate regarding further Infoway funding and offer this blog as a vehicle for such discussions. I am more interested in an open and vigorous debate than I am defending Infoway.