Auditor General says EHR still not close to ready after $8 billion spent

The Electronic Health Records (EHR) system that missed its 2015 deadline may be delayed even further than the March 2017 expectation set by eHealth Ontario, according to the annual report of the Auditor General of Ontario.

The report gives credit for progress made over the 14 years down the road to the creation of a province-wide EHR system, but points out some major problems that make it unclear as to when Ontarians will reap its benefits.  Despite the $8 billion spent by various public health agencies since 2002, the province hasn’t established an overall strategy for EHR.

In March 2016, a full year after its deadline passed, seven core projects managed by eHealth Ontario were still within budget but only about 80 per cent complete. It’s suffered difficulties in complete the project because it lacks the authority to require healthcare providers to upload data to its platforms and the Ministry of Health and Long-term Care hasn’t required it, despite having the authority to do so. As a result many of the core projects, such as the Ontario Laboratories Information System and Diagnostic Imaging databases, are missing data and promised functions. The Diabetes Registry was canceled after $71 million was spent on it, and the Drug Information System is four years away from completion, the auditor’s report says.

“Because the EHR initiative is still not complete and lacks an overall strategy and budget… the Ministry does not know how much more public funding is still needed before the initiative is considered effectively implemented,” the report states. “While some individual systems have been developed to collect and provide specific types of patient health information, they do not have complete information and full functionalities, and there is still no provincially integrated system that allows easy and timely access to all this information.”

The report contains 12 recommendations from the AG to improve the EHR system and get the project back on track, as well as responses from the Ministry and eHealth Ontario. Here are some of the highlights:

  • Ministry of Health and Long-Term Care should clarify and document roles and responsibilities of all parties in the development of projects in the next version of the EHR strategy.
  • For purposes of transparent costs, the Ministry should prepare an updated budget that includes all EHR projects beyond eHealth Ontario and publicly report at least once a year on all costs incurred to date compared against the budget.
  • To complete the EHR projects on time, eHealth Ontario should make clinical data available without patient-identifying information in the Ontario Laboratories Information System; set timelines for completing all phases of EHR projects; monitor progress being made compared to the timeline.
  • To ensure complete and accurate information available to the Labs System for healthcare professionals, eHealth Ontario should require healthcare organizations to upload all lab information and confirm that individual labs do not exclude more tests than specified in contracts with eHealth Ontario.
  • To ensure complete and accurate information in the Diagnostic Imaging central repository; require all health facilities to upload diagnostic images and reports, including specialty reports.
  • eHealth Ontario should monitor regional hospital administrators for connecting systems to ensure that all healthcare organizations in their regions contribute required data to the central database.
  • The Ministry should include all medication information for Ontarians in the central drug repository and set targets to connect all healthcare professionals to that repository.
  • The Ministry should amend service agreements to require participation in and contribution of information to projects within the EHR initiative and establish interoperability standards.

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Brian Jackson
Brian Jackson
Former editorial director of IT World Canada. Current research director at Info-Tech

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