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eHealth scandal time, but also why aren’t we doing federal EMRs?

June 9, 2009

Ok, I’m tackling it. Briefly.

Basically:

eHealth Ontario was part of an important next step; digitizing records and creating a pseudo-universal chart has many benefits (and drawbacks of course) [see my previous post], and this agency was working to create a provincially harmonized health IT strategy (of which EMR was just one component)
– somewhere, someone got carried away…
– salaries of $300 000 plus ridiculous expense accounts & bonuses, huge severance packages (of course they fired the head of eHealth, Sarah Kramer), and consulting fees etc. were payed out. These are a) not fair, b) do not send the message of accountability/responsibility, and c) are just not a wise investment of our tax dollars

As a taxpayer I can’t deny that this is a pretty ridiculous situation. Why there was no transparency previous to the current scandal, i.e. why it was not caught sooner, is a curious thing. I do think that whoever approved the contract for Sarah Kramer also at fault here; she may have abused her privileges (and paid inappropriate amounts to consultants) but ultimately it was the government who failed by not having the proper checks in the system to prevent such exorbitant salaries, bonuses, or fees from being paid out.

It feels off topic, but really, the bigger question in my head is why we aren’t doing eHealth at a national instead of provincial level? Yes, healthcare is managed provincially. But a big chunk of the funding comes out of the federal budget.

Ontario has obviously decided that the advantages of digitizing and having a provincially universal record for patients outweighs any negatives (privacy, cost of developing, etc.). All the arguments in favour of a provincial system go doubly for a federal system. If each province makes their own system, then down the road we are going to have to convert/decode/piece-meal it all together for patients that have crossed borders. I used to live in Ontario. Now I live in BC. I wonder what proportion of Canadians spends some time as temporary if not permanent inhabitants of provinces different than the one they first were born in or became a permanent resident in?

Does it not make sense to make one federal EMR, as that would require a fraction of the funding needed to develop individual provincial systems?

I know I’ve veered on to a different topic, but this seems of greater importance for me.

3 Comments leave one →
  1. June 9, 2009 3:31 pm

    I’m guessing that everyone except for Provincial politicians / bureaucrats wants a Federal EMR. Unfortunately, they’re almost certainly powerful enough to kill it, no matter what. Imagine trying to get a Federal EMR past Alberta, let alone Quebec. Sigh …

  2. June 9, 2009 3:34 pm

    Also, as an interesting aside, it turns out that the eHealth fallout has actually leaked into Vancouver city politics: http://www.citycaucus.com/2009/06/ballem-ehealth-ontario-connection-blown-open-by-globe

    • June 9, 2009 7:14 pm

      ha yah, I actually saw the beginnings of that on the Globe site but at the time they hadn’t quite clarified the connection. Our Ministry of Health leadership doesn’t have a very clean history. It both encourages me and frightens me from entering health politics. Hopefully we’ll get this mess cleaned up and stop forgetting to put contracts to public tender (if that’s the right word here).

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