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eHealth check up

In technology and medicine, the saying is that you should never be the first to try something new, but you should also never be the last.[rssbreak]

That’s a great rule of thumb on electronic book readers and new allergy medications, and doubly so when it comes to modernizing the public health system.

On that front, Ontario is looking more and more like it will be among the last to switch from paper files to electronic records.

The eHealth spending scandal is maddening for many reasons, least of all because money was misspent. Converting to EHRs was already urgent, but Ontario’s progress, slow as it was, has now stalled. The loss of virtually everyone at the top of the organization means eHealth’s 2015 deadline is quite likely blown.

Secondly, there’s little chance that any government – especially the Liberals, under whose watch this scandal unfolded – will continue to throw the necessary money at the project.

But in order to determine the project’s completion date or budget, it’s necessary to know exactly where eHealth is in the scheme of EHRs. This is beyond necessary from a technological standpoint, and I can only assume from a political, managerial and virtually any other point of view as well.

So, to begin to arrive at a solution, eHealth needs to open up. Without giving away anything in terms of patient confidentiality (obviously), why not show some transparency and release information about what progress the government has made?

The auditor general claims there is little to show in terms of work completed, but offers only receipts for cookies and tea as evidence. What the AG didn’t mention was that although billing rules were broken, egregiously, eHealth was on the right track.

It was looking in-depth at Alberta’s Netcare, Canada’s most successful and advanced computerized health records system. The grave error was hiring Albertan consultants who charged to watch television shows.

Granted, Netcare is far from perfect (it suffered a damaging Trojan horse virus earlier this year) and serves a population that barely matches the GTA’s, but the fundamentals are there. (Netcare, just to put eHealth’s $1 billion budget in perspective, had a base cost of $615 million.)

At the risk of oversimplification, all eHealth needs to do is make a carbon copy of our western cousin and implement it here. Build secure databases – using international standards (XML and HL7, as used by Netcare) – showing demographic and pharmaceutical data, allergies, immunizations and tests, as well as various registries, reports and doctor visits. Then enter the data.

Doesn’t sound that difficult. But then, the only people who know for sure aren’t saying.

joshuae@nowtoronto.com

For more ways to bring Ontario up-to-speed on electronic health records, see here.

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