Canadians’ access to health care when they need it – with shorter wait times – is a problem best solved by information technology because it is beyond most bureaucrats’ bailiwick, according to one private sector prognosticator.
In recent years, most governments have been pointing to a promised land of efficient, effective health care with minimal wait times. But, says Michael Green, “most people want to get access (to health care) immediately.”
“I think the government strategy is to have wait time targets,” said Green, vice-president for health care at Toronto-based Agfa Inc. “There are other issues like public safety, but I don’t think those are at the top of the public mind.”
Green said many in his shoes believe technology that can provide long-term solutions and guarantee an improvement to the health care system is a better investment.
In the 2004 10-Year Plan to Strengthen Health Care, the federal and provincial governments agreed to develop benchmarks for wait times in five priority areas by the end of 2005 and to achieve significant reductions in wait times by March 31, 2007.
“Implementing technology and resources that are currently lacking, such as MRI machines and Picture Archive and Communications Systems (PACS), can actually reduce wait times,” said Green. “It will also remove the need for patients to travel in order to receive care.”
Green said that as a clinical biochemist he is acutely aware of both the patient care benefits and importance of health care diagnostics. He is working to meet the challenges and new opportunities presented by the government’s initiative to introduce electronic health records (EHRs) across the country.
“I know from my experience working with the National Health in the U.K., that if you target wait times they will work on those targets, but other targets may suffer,” Green said. “Cosmetically there may be an improvement in the health system, but underneath it there may be some services that get worse.”
An additional $3 billion over five years is needed from the federal and provincial governments to reduce wait times for key health care procedures in Canada, according to the Wait Time Alliance for Timely Access to Health care, a group of Canadian medical organizations.
In the end it comes down to available resources, according to Green.
“I don’t believe you can just throw more money at the problem,” Green said. “There are a lot of efficiencies and economies that can be gained in the current system. Using information technology is one of them.”
Hospitals have to examine their current processes for information management – such as patient appointment scheduling – and make those more efficient, he said.
“Most hospitals probably do not have the most efficient systems in place,” Green said. “And there is also the critical issue of physician shortage.”
Because there is a shortage of radiologists, for example, there is a shortage of diagnostic imaging capabilities, he said. That was a result of lack of government investment in medical schools 10 or more years ago.
“It takes 10 or 12 years to train a radiologist from graduation, so it is not a problem you can fix overnight,” Green said. “There are more and more diagnostic studies done all the time, so the workload is increasing as the population of radiologists is decreasing.”
PACS technology is one area Green cites that can increase the efficiency of a radiologist.
“If you eliminate film from a hospital you create an electronic image that is available to anyone, at any time, and at any number of locations.” Green said. "You can do distance consulting and all sorts of other things that increase the efficiency of the process.”
An internal PACS study completed by Université de Montréal and the Department of Radiology at Centre Hospitalier de l’Université de Montréal found that one year after PACS was implemented, dictation turnaround time decreased 45 per cent for radiography and 36 per cent for MRI.
For CT one year post-PACS, turnaround times returned to pre-PACS levels.
One year after implementation, productivity increased 27 per cent, 98 per cent and 19 per cent in radiography, CT and MRI, respectively.
The study concluded that PACS benefits – shorter dictation turnaround time and increased productivity – are evident one year after PACS implementation. In the immediate post-PACS period, results vary with imaging modalities.
In the end, said Green, although having a patient record across Canada is a nice idea, when you actually look at the number of people who travel or relocate within Canada you find only a small percentage of the population.
“The biggest benefit is going to be in local health care systems.”
Brian Eaton (beaton@itworldcanada.com) is associate editor with InterGovWorld.com.