With the resignation of Ron Sapsford this past week the regime that has been associated with eHealth in Ontario for the past five years has completely turned over. The last remaining person is Dalton McGuinty himself who, if he is planning to vie for a third term as Premier, will have to erase much of the last several months from the voters memory. Most voters will remember in the last election that Mr. McGuinty promised significant progress in delivering an electronic health record. His challenge is that there are only two years to the next election and the outcome of the spending scandals has resulted in policies that can only hamper his ability to deliver on his eHealth promises.
With the state that the Ministry of Health is currently in McGuinty really has only one option; assemble a 'dream team': a collection of health care professionals with a proven track record of delivering technical solutions that improve clinical delivery. The problem is that McGuinty has already pulled that card. The dream team was Sarah Kramer, Alan Hudson, and an esteemed Board of Directors. Shortly after their appointment the dream team expanded to include heavy hitters in other regions: Donna Stratling, Chris Dingman, Donna Kline and Allaudin Merali. Think what you may about the reports about the recent activities of these people, but make no mistake: they were the best that Canada had to offer and had a track record to prove it.
To leave eHealth for a moment, recent moves in the Maple Leafs and Raptors organizations have been similar in nature: pay the money for the best executives, specifically, Brian Burke and Bryan Colengelo. This will enhance the credibility of the organization and its operations. By acquiring the best the hope is to deliver long lasting results in an accelerated manner. The previous method of grooming executives with potential who will grow into the job had proven unsuccessful. John Ferguson Jr. and Rob Babcock floundered and in the Toronto media melted under the spotlight of scrutiny. The move to bring in the best by Male Leaf Sports and Entertainment has been applauded by fans and media alike. Bryan and Brian have come in and have spared no expense and bringing in `their team’ to deliver a winner. Why should the tax payer want healthcare to be treated any other way? Yes there were mistakes made, such as expensing coffees and muffins when receiving 3000K a day, redecorating an office for 50K, and a la Murphy Brown not being able to hire an assistant at a reasonable rate. But these transgressions, and they are transgressions, pale in comparison to suffer mediocrity and spend millions year after year to achieve little progress, especially where health in concerned.
However, with the numerous reports that have since been released questioning the character of the key players of eHealth Ontario it is natural to begin questioning even the track records of these individuals. Considering how far some of these relationships had gone back historically and the sheer dollar value that they represented it leaves the public to wonder whether their accomplishments were real or just the self congratulations and propping up of a small network of executives that were cashing in on the tax payers naivety. If this is in fact the case then it is the worst side of cronyism and by finding this out sooner than later the displacement of these people is the best possible outcome for the tax payer. However, on the other hand, maybe these were a close knit group of executives that had the best intentions and abilities to expedite delivery of solutions required to transform the health sector. Sadly, some of this is subjective and the average Ontarian will only be able to draw conclusions based on the information available. Ontarians never see whether the team would have delivered on their plan and reap the benefit of some of the transformations they had planned for the Health sector.
As a former employee of SSHA/eHealth Ontario, I did have an opportunity to work on projects that Sarah Kramer and Chris Dingman were leaders/sponsors of. Although the relationship between organizations, SSHA and Cancer Care Ontario, were at times strained, and project deliverables and timelines did not always meet either organization's expectations, the two organizations did persevere and deliver a solution that has had substantial impact to the delivery of healthcare in Ontario. The award winning, integrated Wait Times Information System, WTIS and Electronic Master Patient Index, EMPI has transformed the delivery of Cancer treatment in Ontario. To briefly describe how the WTIS has transformed delivery of Cancer care: the WTIS provides the ability to track those awaiting to receive Cancer treatment in Ontario. The system is integrated with numerous practitioners across the province and has benchmarks associated to Wait Times. If a benchmark is exceeded it enables the system to find alternate practitioners so that the patient can be rerouted and receive care within the specified threshold. If the same could have been achieved for the Diabetes Registry, ePerscribe Solution and a WTIS for acute care as promised in the eHealth strategy that was created by Dalton’s ‘dream team’ Ontario would have made significant strides at transforming the sector in some of the areas that need it the most.
That said the 'dream team' card has been played. The strategy was formulated by a previous regime with the assumption they could ‘do whatever it takes’ to get the job done. The timelines to deliver were based on that assumption. What does this mean to the Ontario health sector? A new regime will come in. It will likely cause delay and potentially re-evaluate the strategy. The new controls in place for procurement will have adverse impact on timelines, as they were created without these constraints in mind, and the implementation dates will be missed. Dalton McGuinty will not be able to deliver on his promises and an election campaign of explanation will ensue. Potentially a new government will be elected and might dissolve the agency in its entirety. All the while the tax payer continues to receive mediocre service, I won’t expound on those implications. The real problem with the eHealth Ontario scandal is it has amounted to political posturing and not the required progress Ontarians need. I’m not going to excuse the previous regime’s procurement practice as an ‘ends that justifies the means’, but as an interested Ontarian we need to get to an end.
More info about the eHealth Strategy: The eHealth Strategy
More info about Wait Times: Wait Times Awards, Additional Wait Times Information