Monday, January 14, 2008
Healthcare needs re-engineering
Our family has had a number of interactions with the health care systems in Ontario and Quebec over the past month. The quality of care has generally been great, but if phone companies were run like these hospitals, they would be out of business.
Paper records. New ID cards issued each time you go. Long line-ups at each stage. Wait times to even get scheduled. Digital records that can't be sent electronically because no secure network exists.
I'm not talking about remote areas of the provinces. This is the experience we put up with in major hospitals in Toronto and Montreal.
In some ways, the situation almost reminds me of phone companies, in those days before competition. Except that we had a regulator that made sure that customer service standards were more tolerable.
Talk about an industry that is long overdue for efficiency improvements. What can the telecom industry do to help deliver better health care service at lower cost?
Technorati Tags:
health
Paper records. New ID cards issued each time you go. Long line-ups at each stage. Wait times to even get scheduled. Digital records that can't be sent electronically because no secure network exists.
I'm not talking about remote areas of the provinces. This is the experience we put up with in major hospitals in Toronto and Montreal.
In some ways, the situation almost reminds me of phone companies, in those days before competition. Except that we had a regulator that made sure that customer service standards were more tolerable.
Talk about an industry that is long overdue for efficiency improvements. What can the telecom industry do to help deliver better health care service at lower cost?
Technorati Tags:
health
Posted by Mark Goldberg @ 1/14/2008 08:25:00 AM 
Comments:
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I think you have already provided some insight to this question.
mhgoldberg.com/blog/2007/12/more-than-just-phones.html
For more real examples:
http://business.telus.com/en_CA/BC/sector/Medium_And_Large_Business/Healthcare/bcMlbHealthcare.html
And finally.
https://www.upopolis.com/webconcepteur/web/upopolis/
mhgoldberg.com/blog/2007/12/more-than-just-phones.html
For more real examples:
http://business.telus.com/en_CA/BC/sector/Medium_And_Large_Business/Healthcare/bcMlbHealthcare.html
And finally.
https://www.upopolis.com/webconcepteur/web/upopolis/
Posted by 
: 10:10 AM, January 14, 2008
: 10:10 AM, January 14, 2008 
Canada's lack of IT in healthcare is a national embarrassment and places our health at risk.
As a doctor, I have to put up with lack of communication on a daily basis. My patients get admitted to hospital, have multiple tests and changes to their medications, and I am completely in the dark until 2-3 months later when the hospital summaries arrive (if ever).
Do you know we still have to send in our billings by MODEM?!!?? What other first world country does that?
Patients end up having the same tests done repeatedly due to lack of information availability between doctors, hospitals, labs etc.
It's high time the pointy headed bureaucrats and politicians from the Ministry of Health stopped 'running' our health care 'system' and gave it over to a private company with some technological knowhow!
As a doctor, I have to put up with lack of communication on a daily basis. My patients get admitted to hospital, have multiple tests and changes to their medications, and I am completely in the dark until 2-3 months later when the hospital summaries arrive (if ever).
Do you know we still have to send in our billings by MODEM?!!?? What other first world country does that?
Patients end up having the same tests done repeatedly due to lack of information availability between doctors, hospitals, labs etc.
It's high time the pointy headed bureaucrats and politicians from the Ministry of Health stopped 'running' our health care 'system' and gave it over to a private company with some technological knowhow!
Posted by : 10:48 AM, January 14, 2008
: 10:48 AM, January 14, 2008
Mike Kedar - yes the same driver behind CallNet - has the same opinion that the healthcare infrastructure needs addressing. He's got the quals to do it!
Posted by : 10:53 AM, January 16, 2008
: 10:53 AM, January 16, 2008
Your comments about how the healthcare sector might benefit from efficiencies that the telecom sector might bring about reminded me of David Crane’s column in Sunday’s (January 13th) Toronto Star. In the column Mr. Crane wrote about the World Bank’s recent “Global Economic Prospects” report.
Crane reports that the there were two key messages in the report. The first is that the developing world is moving fast to embrace and utilize new technologies that will allow them to become more competitive and to raise their own living standards. This means Canada and other high-income countries have to continue to be at the frontier of new technologies if they want to retain a competitive edge. The second was that government leadership matters.
In the column he points to the following statement from the World Bank:
"No single blueprint for technological progress exists, but most success stories have involved strong central leadership to ensure a consistent and effective policy framework that supports the development and commercialization of innovations.”
Given your recent experiences, it shouldn’t surprise you that even Ontario’s Ministry of Health admits that it is “significantly behind in reaping the benefits of information technology” and slow to introduce the innovations that have take place. The Ministry admits (http://www.health.gov.on.ca/ehealth/ ) that “To improve efficiency and system integration that will deliver care that meet patient's health care needs, the health care system must leave the paper-based model behind, and leverage the advances in information technology”.
The Ministry goes on to say “The Ontario Government recognizes the benefits of information technology and has a comprehensive e-Health strategic approach to bring about the necessary changes in our health care system”. That strategy is comprised of a series of projects that represent the building blocks for a secure electronic health care system in Ontario. The Ministry claims that while “The journey toward an integrated e-Health system in Ontario still has significant milestones ahead….a number of major advancements have been reached”.
The Deputy Minister of the Ministry of Health and Long Term Care defines e-health as “the electronic collection and secure sharing of health information so that clinicians can provide the best care, and people can take better care of themselves and their families." The vision for Ontario's health care system is to ensure the delivery of the right information about the right individual to the right person at the right place at the right time, to improve the care and health outcome of each patient.
In 2002, the Ontario government formalized its commitment to e-health with the creation of The Smart Systems for Health Agency (http://www.ssha.on.ca ). The Agency, which is supposed to be “the enabling force behind a province-wide information technology infrastructure delivering world-leading e-Health solutions”, began operations in April 2003. The Agency claims it is “helping improve health care delivery by securely and reliably providing systems and solutions that connect doctors, nurses, hospitals, pharmacies and laboratories to each other and to patient information”. The Ontario Network for e-Health (ONE) is the suite of products and services the Agency has and is putting together that health care providers (supposedly) use to reliably and securely share patient information.
I’ve used the words “supposed” and “supposedly” above because there have been problems with respect to the Agency. These are all covered in an operational review Deloitte Consulting carried out recently. The report, published on November 6, 2006, assessed SSHA’s progress against its mandate and against six areas of analysis: strategy; governance, accountability and controllership; products, services and operational processes; operational cost and funding; stakeholder perspectives; and jurisdictional comparisons. The complete report can be found at http://www.health.gov.on.ca/english/public/pub/ministry_reports/ssha_06/ssha_rep_01_20061114.pdf .
One key finding that relates to the telecom sector was that “The Agency has made significant progress in addressing its founding mandate and business purpose, namely the introduction of secure networks and data centres. However, there is a considerable way to go before value will be realized from the enabling infrastructure”.
With respect to this finding the report indicates that the “SSHA has installed over 1,700 circuits to connect public hospitals, CCACs, public health units, physicians, and other provincial healthcare providers. The Agency has provisioned two data centre facilities. The result is an ability to host its current 19 applications in a highly available environment. However, significant questions exist relating to the effectiveness of certain decisions and the value obtained from significant investments”.
The report notes “the Agency has faced substantial challenges with respect to the rate of user adoption as well as security architecture methods and expectations. Adoption of secure email as a means of transmitting electronic health information has not met Ministry and SSHA expectations…..Similarly, there are issues to overcome with respect to access to a secure eHealth environment. The initial vision of PKI certification of end users has proven to be problematic. In order for the province to leverage value from its investment in a secure eHealth environment, issues regarding user adoption and security will need to be addressed. There is a need to incorporate the lessons learned from previous investment decisions into future plans”.
Deloitte also noted that “it (was) not possible to assess the cost/benefit of past investments (and that it) may also be too early to assess the value of these investments as the healthcare sector has been slower to adopt electronic information management than other sectors……The Agency has also identified the need for substantial performance improvement in its core business of network and data centre operations. However, progress in these areas has been too slow”.
And that’s why you experienced the frustrations you did. The key question now is to see how the government proceeds to give Ontarians a modern, efficient, effective and secure e-health system.
Crane reports that the there were two key messages in the report. The first is that the developing world is moving fast to embrace and utilize new technologies that will allow them to become more competitive and to raise their own living standards. This means Canada and other high-income countries have to continue to be at the frontier of new technologies if they want to retain a competitive edge. The second was that government leadership matters.
In the column he points to the following statement from the World Bank:
"No single blueprint for technological progress exists, but most success stories have involved strong central leadership to ensure a consistent and effective policy framework that supports the development and commercialization of innovations.”
Given your recent experiences, it shouldn’t surprise you that even Ontario’s Ministry of Health admits that it is “significantly behind in reaping the benefits of information technology” and slow to introduce the innovations that have take place. The Ministry admits (http://www.health.gov.on.ca/ehealth/ ) that “To improve efficiency and system integration that will deliver care that meet patient's health care needs, the health care system must leave the paper-based model behind, and leverage the advances in information technology”.
The Ministry goes on to say “The Ontario Government recognizes the benefits of information technology and has a comprehensive e-Health strategic approach to bring about the necessary changes in our health care system”. That strategy is comprised of a series of projects that represent the building blocks for a secure electronic health care system in Ontario. The Ministry claims that while “The journey toward an integrated e-Health system in Ontario still has significant milestones ahead….a number of major advancements have been reached”.
The Deputy Minister of the Ministry of Health and Long Term Care defines e-health as “the electronic collection and secure sharing of health information so that clinicians can provide the best care, and people can take better care of themselves and their families." The vision for Ontario's health care system is to ensure the delivery of the right information about the right individual to the right person at the right place at the right time, to improve the care and health outcome of each patient.
In 2002, the Ontario government formalized its commitment to e-health with the creation of The Smart Systems for Health Agency (http://www.ssha.on.ca ). The Agency, which is supposed to be “the enabling force behind a province-wide information technology infrastructure delivering world-leading e-Health solutions”, began operations in April 2003. The Agency claims it is “helping improve health care delivery by securely and reliably providing systems and solutions that connect doctors, nurses, hospitals, pharmacies and laboratories to each other and to patient information”. The Ontario Network for e-Health (ONE) is the suite of products and services the Agency has and is putting together that health care providers (supposedly) use to reliably and securely share patient information.
I’ve used the words “supposed” and “supposedly” above because there have been problems with respect to the Agency. These are all covered in an operational review Deloitte Consulting carried out recently. The report, published on November 6, 2006, assessed SSHA’s progress against its mandate and against six areas of analysis: strategy; governance, accountability and controllership; products, services and operational processes; operational cost and funding; stakeholder perspectives; and jurisdictional comparisons. The complete report can be found at http://www.health.gov.on.ca/english/public/pub/ministry_reports/ssha_06/ssha_rep_01_20061114.pdf .
One key finding that relates to the telecom sector was that “The Agency has made significant progress in addressing its founding mandate and business purpose, namely the introduction of secure networks and data centres. However, there is a considerable way to go before value will be realized from the enabling infrastructure”.
With respect to this finding the report indicates that the “SSHA has installed over 1,700 circuits to connect public hospitals, CCACs, public health units, physicians, and other provincial healthcare providers. The Agency has provisioned two data centre facilities. The result is an ability to host its current 19 applications in a highly available environment. However, significant questions exist relating to the effectiveness of certain decisions and the value obtained from significant investments”.
The report notes “the Agency has faced substantial challenges with respect to the rate of user adoption as well as security architecture methods and expectations. Adoption of secure email as a means of transmitting electronic health information has not met Ministry and SSHA expectations…..Similarly, there are issues to overcome with respect to access to a secure eHealth environment. The initial vision of PKI certification of end users has proven to be problematic. In order for the province to leverage value from its investment in a secure eHealth environment, issues regarding user adoption and security will need to be addressed. There is a need to incorporate the lessons learned from previous investment decisions into future plans”.
Deloitte also noted that “it (was) not possible to assess the cost/benefit of past investments (and that it) may also be too early to assess the value of these investments as the healthcare sector has been slower to adopt electronic information management than other sectors……The Agency has also identified the need for substantial performance improvement in its core business of network and data centre operations. However, progress in these areas has been too slow”.
And that’s why you experienced the frustrations you did. The key question now is to see how the government proceeds to give Ontarians a modern, efficient, effective and secure e-health system.
Posted by : 2:28 PM, January 16, 2008
: 2:28 PM, January 16, 2008
There's a story in the 'Legal Post' Section of today's Financial Post about the difficulties in securing and protecting data in the health-care sector. According to the Chief Privacy Officer at Ontario's Smart Systems for Health Agency, Michael Power, security controls in that sector are more complex than they are in the retail sector where we've seen some interesting flaws over the years (Winners/Home Sense, for example).
Mr. Power is responsible for operationalizing privacy in Ontario's e-health system. He claims there's a lot of ground to be covered before official electronic health records see the light of day. So, I guess it will be a while yet Mark before your nirvana is in sight. Be patient - it is a virtue.
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Mr. Power is responsible for operationalizing privacy in Ontario's e-health system. He claims there's a lot of ground to be covered before official electronic health records see the light of day. So, I guess it will be a while yet Mark before your nirvana is in sight. Be patient - it is a virtue.
Posted by : 4:29 PM, January 23, 2008
: 4:29 PM, January 23, 2008 << Home
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