Long before the eHealth debacle hit Ontario, or the BC health ADM came under police investigation, I was convinced the information technology (IT) industry was milking the electronic health records business, and the taxpayers who are paying for it, for all they can squeeze out and for no good reason. There is nothing about electronic health records, or sharing information securely between doctors, pharmacies and laboratories that is new or difficult. However, if you spend a few million telling uninformed bureaucrats and politicians this is difficult or has never been done before, they will soon come to believe you and offer you hundreds of millions to come up with a solution. This is exactly what the IT industry has done.
Well over a decade ago, I watched a presentation by a Sudbury general practitioner who had developed a comprehensive electronic medical records system to safely gather and store patient information and test results, print prescriptions while cross-checking for potential harmful drug interactions and more. He had done this in his "spare time" while maintaining a busy medical practice. At the time, my colleagues at the Ontario Ministry of Health and Long-term Care were uninterested in such innovation. Senior management was woefully uninformed about technology and our IT department was busy writing software patches for obsolete mainframe computer servers that used reels of tape for storage. This, long after most of the IT world had moved on to more flexible and reliable and less expensive data processing technology. They were, in short, blind to ready-made solutions and, as has been proven, vulnerable to rip-off.
The Globe and Mail reports today on one such solution that still is being shunned by those who stand to make fortunes out of re-inventing the wheel, so to speak.
"Efforts by governments in Ontario and British Columbia to drag their provinces' medical records into the 21st century haven't gone well: Both provinces are embroiled in eHealth scandals that have turned the endeavour into a political poison pill. But the doctors behind two made-in-Canada electronic record systems designed years ago and adopted around the world insist it doesn't have to be this hard."
link: OSCAR shows electronic health system doable - The Globe and Mail
Absolutely, it doesn't have to be this hard. It isn't hard at all.
One of the frequently thrown-up obstacles involves secure networking for moving data between doctors' offices, laboratories, pharmacies and insurers. Admittedly, there is no such thing as an absolutely secure system, but the banking and financial industry has come pretty close. Moreover, the motivation to hack medical files and data transmission is miniscule compared to potential in the financial sector. There is no reason for re-invention except the need and greed to create unnecessary jobs for IT specialists who can bill naive clients exorbitant sums for next to nothing.
The problem is not unique to the health sector. Toronto has spent hundreds of millions demanding manufacturers redesign streetcars on the nonsensical premise that existing street cars that work in cities around the world, under all climate conditions, would never work in Toronto. Similarly, Toronto is insisting that automated transit fare payment systems be re-invented because, apparently, the systems in use in New York and London and Paris and Tokyo and Hong Kong, etc. would never work here. Complete nonsense of course, but there are hundreds of jobs in it for city workers to convince the politicians otherwise. The Toronto Transit Commission has an obsolete and broken communication system which could be replaced in a matter of months with a turn-key solution from any of the triumvirate of wireless phone providers operating in the city, but the transit bosses want to spend years and hundreds of millions designing and installing their own proprietary system on the grounds that a network leased from Bell or Rogers would not be secure. It's like the whereabouts of the Bathhurst street car is a matter of national security. It's not about transit communications. It's about jobs for the IT sector and the hapless managers supervising them.
I have no particular grudge against the IT sector and the people working in the industry deserve to make a living as anyone. However, when the health of the public is at stake, when health care services are delayed because fiscal resources are wasted, it quickly becomes a scandal that taxpayers won't tolerate. Blame shouldn't rest on solely on the naive managers who allow the consultants to convince them the job is vastly more complicated than they imagined and exponentially more expensive. The IT industry should bear an equal share of responsibility for the shameful waste of money that has been the story of Ontario's eHealth initiative. Had the IT sector been responsible and truthful with government, the network could have been in place years ago. It was never complicated. It never needed to be expensive.
