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A time to make promises and a time to deliver

Greg Reed, CEO of eHealth Ontario, paints this scenario: It's delivery day, 2015. We're gathered outside the low-slung bunker of a data centre. Someone ceremoniously flips the Frankenstein switch. Millions of disks spin to life. Lights across the province momentarily dim as its long-planned health network comes alive.
 
It's not gonna work that way, Reed told the Economic Club of Canada at an event on Wednesday.
 
There's been a dearth of media coverage of eHealth Ontario in recent months, and that's been by design.
 
“A decision we made two years ago was that it was time to start delivering results instead of making promises,” Reed said of the low profile, acknowledging a “legacy problem with (the eHealth Ontario) brand.”
 
As you may recall, in the media, the words “eHealth Ontario” and “scandal” once went together like “peanut butter” and “jelly.” In August 2009, CEO Sarah Kramer was forced to resign over what some media described as $1.4 billion in wasted money. (Ontario auditor general Jim McCarter described those charges as wildly exaggerated, while acknowledging there had been large-scale waste.)
 
Reed took over on April 1, 2010. Since then, it's been about getting things done, even if it's incrementally. Reed puts it this way: Three years ago, eHealth Ontario was a scandal; two years ago, it was a turnaround; last year, it started delivering on its electronic health record promises.
 
After flying under the radar for a while, Reed used the Economic Club venue (amid a flurry of public policy announcements from provincial and federal politicians — he said he felt like “a public servant walking in traffic”) to showcase some of the progress made.
 
First of all, re: the above-mentioned Frankendata centre, it just won't work that way. When envisioning a provincewide electronic health system, consider this, he says: If a patient in Windsor gets sick, he goes to his doctor. If he gets really sick, he might go to a local hospital. If he gets really, really sick, he might end up at London Health Sciences Centre. He's not, however, going to be transferred to Thunder Bay Regional Health Centre. Rather than rip and replace systems across the province, eHealth has focused on helping local networks of health providers connect, using disparate systems, and developing the hooks to make them interact and allow provincial data to be plugged in.
 
He touted a number of delivered, functioning systems that, compared to the original vision of Canada Health Infoway, might seem like small victories, but they have immediate impact nonetheless.
 
 * One hundred forty thousand times a year, a patient who is discharged from hospital ends up readmitted within a month. Reed says studies show that a follow-up with a family physician within a week cuts that number substantially. While paper hospital discharge records take two weeks to reach a patient's GP, they can now be delivered electronically within hours. This saves on the cost of readmitting patients.
 
 * When a patient arrives at one of the provinces 100 trauma centres with a head injury, he or she immediately gets a three-dimensional CT scan. The province now has one of its 70 neurosurgeons on call at all times to remotely view digital versions of the scan and instruct ER teams. Patients don't have to be moved until they're stabilized, if they have to be moved at all.
 
 * eHealth is ready to roll out a laboratory information system that not only cuts delivery time for test results from weeks to hours, it better secures patient information. Paper records get mailed to the wrong address or faxed to the wrong number; the lab information system requires two-factor authentication to access records.”We have a lineup of doctors and hospitals that want to use this,” Reed said. “This could be one of the most meaningfulthings we do in the history of eHealth Ontario.
 
 * Reed said the potential of an integrated health network was most clearly demonstrated to him at Hawkesbury General Hospital, not far from Ottawa. Admissions was swamped with patients and families transferred from smaller hospitals; paramedics and their vehicles stood by idly because they couldn't leave until their charges were admitted. Meanwhile, transfers from Ottawa Hospital were already dispatched for rooms and treatments. When they arrived, hospital staff already knew who they were and what treatment was required.
 
 eHealth Ontario has been flying under the radar for a while. But, apparently, things have been getting done. “We don't have to wait until 2015 to start delivering results,” Reed said. So forgive him if the organization slips under the radar again.
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