In many blog posts over the past few months I have implored Canada Health Infoway to open a public debate on the Canadian eHealth strategy. Most recently I made this plea in a blog post regarding significant changes that have been proposed for the Australian eHealth strategy. Some reasons for considering a different approach to sharing patient health information are contained in a recent article on the Australian eHealth strategy. In this article, John Backhouse, Information Builders’ regional programme director for health care, asks some questions that we should, I believe, be asking in Canada: “What is it the government wants to achieve with the e-health record? Are we trying to get an entire health record for the patient or are we creating a care summary record? Which one we are trying to achieve, and what is the usefulness of what it will enable the clinicians to do?”
Booz & Co principal, Klaus Boehncke, co-author of a report on the Australian eHealth system, and Mr. Backhouse both warn that a “top down” Government imposed information system for health authorities, patients and practitioners will not work. Instead, Mr. Backhouse recommends that “You need to take it bottom up, then aggregate the data to provide to executives in the health areas.” Mr. Barkhouse goes on to explains that:
“Clinicians treat as they find, and use diagnosis tools as methods to get to the root cause of the problem, so an e-health record will not have any impact on this clinical process. However an e-health record, if used as a summary record, is a powerful tool for managing community care, aged care and end of life care. This will enable continuity of care between multiple health care professionals. If this is done from a bottom up approach – local organisation to local authorities to regional areas – this will be a successful project.”
I think that a “bottom up” approach should be considered in Canada. More importantly, I believe that we need an open and transparent debate on Canada’s eHealth agenda. Anyone else feel the same way?