Despite a multimillion-dollar contracts scandal tagged to her name, Sarah Kramer, erstwhile president and CEO of eHealth Ontario is reportedly getting a top-dollar separation package following her departure from the not-for-profit agency.
Ontario Health Minister David Caplan, on Sunday, said that he was revoking Kramer's appointment upon the request of eHealth Ontario's board of directors. Caplan placed Ron Sapsford, deputy Minister of Health and Long-Term Care as acting eHealth Ontario president and CEO until an interim eHealth chief is found. He said the Kramer's departure was "an important step to restore public confidence in the agency and its mandate of modernizing our health care system."
Ontario's electronic health records program has been lagging behind those of other Canadian provinces. Canada Health Infoway reports that by the end of 2010, Prince Edward Island, Alberta, the Northwest Territories, Quebec and British Columbia will have the basic infrastructure for delivering e-health records.
Kramer, who was previously vice-president of Cancer Care Ontario, attracted media attention a few months into her job when she received a $114,000 bonus in March after sending a memo to staff that they will be receiving reduced bonuses for the year.
Last month the CBC News also reported that the health agency doled out more than $4.8 million in contracts within the first four months of its creation in September 2008 without a public bidding process.
Consultants reportedly received millions of dollars in compensation for, among other things, watching a TV program about electronic health records, reading the New York Times, sending out e-mail messages, making cell phone calls and conversations on the subway.
Kramer will be receiving 10 month's salary or nearly $317,000 in compensation under an agreement reached with eHealth board, according to the Canadian Press.
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The eHealth scandal underscores the growing need for government agencies to top up its in-house resources of IT talent, according to one technology analyst.
"It's really unfortunate, but the amount that eHealth Ontario spends on consultants is pretty standard among government agencies," said Carmi Levy a London, Ont.-based independent technology industry analyst.
The problem is most agencies do not have their IT specialists among their staff and are dependent on outside consultants that charge a hefty fee for their services, Levy said. "When you have government agencies exploring new territories and they also need to deliver results within a short time frame, this sort of thing is bound to happen."
"Clearly, the more government projects become tech-driven, it becomes imperative for government agencies to evolve and develop technology expertise from within," Levy said.
In a letter to Caplan, the board of directors of eHealth Ontario wrote: "Both the Board and Ms. Kramer feel that a change in leadership is required to restore public confidence in the organization's ability to our important mandate forward. Therefore, Ms. Kramer has decided to leave the organization."
"The Board thanks her for her service and dedication to ehealth in Ontario. We hereby request that you recommend to the Lieutenant Governor in Council, the revocation of the Order in Council appointing Ms. Kramer as CEO of the Corporation," the directors said.
eHealth Ontario declined to provide a statement today, but last week Kramer spoke to ITWorldCanada and defended her decision to enlist consultants without a public tender.
"There might be some public perception that we are not being responsible with the taxpayers' money. But eHealth Ontario is results-oriented. Every dollar is being spent towards patient safety and quality of service," she said.
Kramer said she was under pressure to deliver the goods within a short period and make up for shortcomings of the previous e-health initiatives.
"We were created to fix a lagging program. We are working on a tight deadline and so we had to leapfrog (some processes)," she said.
eHealth was established by the Liberal government some eight months ago to merge the e-health programs of the Ministry of Health and Long-term Care and the Smart Systems for Heath Agency (SSHA). eHealth's mandate was to develop a digital record system for the province by 2015 to enable health-care providers to electronically share patient information. The program is supposed to prevent medical errors and reduce costs.
The Canada Health Infoway reports that without a comprehensive e-health record system, for every 1,000 patients in the country, the following will likely happen:
• 75 individuals admitted into hospitals will suffer an adverse drug event
• 150 lab tests performed will be unecessary
• 320 emergency room patients will have an information gap, resulting in an average increased stay of 1.2 hours
Kramer said her decision to hire consultants without a public tender was necessary because of her agency's lack of expertise in technology and the tight deadlines eHealth was working on. "We are not a tech company or an organization that is about buying computers. That is why we have to look outside of the agency," she said.
"It was within the law and I have the mandate to hire consultants without public bidding if the situation requires it," she added.
Kramer said, the consultants she hired had worked with the government's e-health initiative before and had gone through previous scrutiny.
Examples of the lucrative contracts signed out by eHealth were $915,160 to health-care consulting firm Courtyard Group and two contracts worth $1 million to Accenture Inc., the CBC reported.
Michael Guerriere, a managing partner of Courtyard Group, was also named as eHealth's interim senior vice-president of strategy and billed more than $3,000 a day as consultant, the report said. Guerrierre's wife, Miyo Yamashita, who heads Anzen Consulting of Toronto, received more than $300,000 in eHealth contracts.
The CBC reported that she charged $300 an hour for communications advice and services such as reviewing Kramer's holiday voice-mail greetings and confirming details for a seasonal party, reading New York Times articles on diabetes and electronic health records and a "debriefing" chat on the subway. ITWorldCanada sought interviews with Accenture, Guerriere and Yamashita, but got no response.
eHealth also paid two consultants who are based in Alberta. Documents show Allaudin Merali and Donna Stratling charged $2,700 a day for their services and billed the agency for their flights and accommodation in Toronto. The total cost runs to about $1.5 million.
Asked to justify the high-priced e-mail and travel receipts her consultants racked up, Kramer said: "Communication is vital in this work. And traveling is needed because you can't do this type of thing sitting around in boardrooms."
Kramer said that during her tenure she managed to iron out the issues over the consolidation of the province's previously separate