A new voice entered the public health care debate this summer, warning that the sector stands at a crossroads and needs major repairs and rethinking if it’s to meet the needs of Canadians over the next 10 years.
The message comes not from government commission or an opposition MP, but from a rather more unlikely source — IBM Corp. IBM has some big ideas when it comes to the future of Canada’s health care system — ideas it outlined in a broad 42-page report that discusses the main challenges facing the sector — and offers some possible solutions.
Prominent among the solutions identified by IBM Canada. Ltd.’s Business Consulting division is the increased use and development of information technology.
“E-health…is a facilitator of the required transformation,” said Ian Cummins, business development executive at IBM. Cummins was one of several health experts invited by the company to comment on the report, entitled Heading True North: Giving Canada’s Health Care System New Direction, at its official release in Toronto. Cummins said much work is needed to lay the necessary technology groundwork. Improving the infrastructure of hospitals, enabling wireless devices and improving the networks that support them are all at the top of the list, he said.
Cummins also singled out the most serious issues facing health care, including:
• “No clear accountability” for the system – which IBM identifies as 13 different systems – amid continual bickering between the provincial and federal governments;
• The silo-like nature of the current health system, where hospitals, pharmacies and family doctors often treat the same patients but have no means to effectively share data, or to transfer patient information to each other in a means other than paper;
• An increasingly disgruntled citizenry, which is demanding the same instant, no-hassle services from hospitals as from other sectors;
• An inability to keep up with rapid medical advances, both a shortage and uneven distribution of doctors and nurses, and a rapidly aging population
By 2020, IBM wants to see all facets of care geared to patients, not illnesses; a tightly integrated system paved by the latest in IT and running 24×7; and clear performance measures, improved accountability and the creation of public “report cards.”
In the short term, the advent of an electronic patient record system is overdue in many jurisdictions, said Tom Closson, CEO of the University Health Network, an amalgamation of three Toronto hospitals. “But we talked about (it) when I started my career in the early 1970s,” he added, noting that a means of securing e-mail transmissions is required before any large-scale system of electronic records can be considered.
Last October, Alberta became the first province in Canada to deploy electronic health records. The $59-million project (which involved IBM) was expected to enable all Alberta health regions, one-third of physicians’ offices and half of all pharmacies to use digital records by the middle of this year. In Ontario, a government-sponsored, independent body called the Smart Systems for Health Agency, in conjunction with Hewlett-Packard Co. and EDS, is currently in the midst of a five-year deployment to get the entire sector connected — 20,000 network sites and 150,000 e-mail and PKI users.
The goal is to improve the way personal health information is shared among health practicioners. Closson, a one-time hospital CIO, used Ontario as an example of what’s wrong with health care technology, pointing to the dozens of IT departments at various hospitals across the province, each trying to grapple with different standards and systems. He identified the Toronto region as the worst offender. “We have every vendor’s product in this region,” he said.
Faced with a lack of funding, hospitals are finding novel ways to solve their IT problems, including integrating the back offices of regional hospitals. Several hospitals in the city of London, Ont., for instance, have combined IT forces, as have facilities in other regions across the province.
Another solution is to outsource IT altogether, Closson noted — a service companies such as IBM provide. The University Health Network alone maintains a $45-million IT budget, “and one-third of that is contracted out,” mainly covering the maintenance of its desktops and servers. “We have staff for development and implementation of research systems, because they understand our organization well,” he added. “But we don’t want to have to worry about the other stuff.”
Michael MacMillan ([email protected]) is editor of ComputerWorld Canada, an IT World Canada publication.