Thursday, 18 August 2011

Aug 18 - comment on e-health

This is a bit of a rant but please do read, especially if you are in Ontario. If you have a few moments please listen to the TED talk on the same subject e-patient Dave, thanks for passing this along Andrew.

One of the hardest things that I've seen since begin diagnosed with cancer is the incredible lack of technology being used in healthcare and the huge risk this causes for us all.

The contrast on how day to day work is done at hospitals is striking for anyone coming from a large company. The database, network and privacy challenges have all been dealt with for several years within banking, insurance, food care let alone high tech companies like RIM where I work. All of the examples that I'll note have been in the market for several years.

Anyone who says that Ontario's challenges implementing e-health have anything to do with technology or privacy delays is either ill-informed or lying to you. This is like saying that we can't extend the 407 until we learn more about pavement technology and how cars work. 

For several years we have all been able to move our money around the world at the push of a button. We can email in photos to our insurance companies who attach them to our files. We have cutting edge data bases of all Ontario students marks for the past 20 years. Health care data bases for all zoo animals around the world. We created encryption technology for BlackBerry devices that governments such as England and India cannot break.

This is not fantasy and almost all of this in-market cutting edge work was done in ONTARIO. I've worked on or worked near the teams who did much of this work . We have some of the top technology, legal and privacy experts in the world as our neighbours. The GTA is a world class banking, insurance and tech capital. So we have the resources available to do this work relatively quickly and painlessly. 

Why I am so upset is the risk with delays to proper e-health are held by the patient. You have no idea how much time and focus Tanya and I have spent ensuing that everyone has the proper data, correcting mistakes and ensuring relevant data is shared with the right teams. 

In my case this is not as bad since Tanya and I are used to doing this as part of our jobs. But how many people go into cancer treatments with this skill or have the time / energy to keep on top of everything   

Billions of dollars have been spent on e-health in Ontario and all my reports are still faxed around in the hospital. My main file is on paper with no backup. To keep my doctor up to date I need to give her a call or send copies of the hospital reports myself. Again the risk of missing or delayed information is borne my me and only me.

The cost to the rest of us is also high. Forgetting about the money spent on e-health so far that could have gone to research or care. There is an on-going cost to all of us for not having centralized data. Most of the tech projects that I've worked on needed a cost benefit analysis. The major  benefits are proving fast and more accurate data so decisions can be made based on data vs intuition. The goal is to make quicker and more accurate decisions on time sensitive issues.  It is hard to understand why companies that manage your money understand the importance of accurate data while heath care management does not.

It is easy to forget how immersed we have all become with technology. Need to think back to the 80's before ATMs were all connected, no cell phones, no google maps no facebook. This is what I feel like as a patient in our health care systems. Most information is passed along by phone, fax or dropped off in person. 

Please have a look at this Ted Talk, he does a great job of expressing some of the same frustration and discussing some of the advancements that should have been made already. e-patient Dave

Not to get too political but feel free to ask your local MPP about this when they come around looking for your vote. If they tell you the delays have anything to do with technology please remind them of the great work that has been launched by local companies.

Sorry for not making this clearer sooner. This rant is about the health care managers not the health care staff. I can't say enough about the quality of the doctors and nurses that I have been working with. They have my full trust and I'm comfortable putting my care in their hands.

What I want is for them to be given the tools they need to do their job better. I'm confident that with modern tools (not expensive and troublesome cutting edge tools, let's learn to walk before we run) that our heath care workers will be able to come up with innovative solutions to outstanding problems.

Not sure if anyone else has noticed this but feel free to comment.

To end on a positive note, the weather has been great this summer and I can't remember one smoggy day. Not sure why but someone needs to keep up the good work!


mklsim said...

Based on my experiences with the Ministry of Health and eHealth.....the issues have never been with the technology or feasibility. It has always been about politics and bureaucracy. The doctors, nurses, and other health professionals do the best they can with what they have, and I agree that there is little they can do. So this may sound callous, but they need to run this like a CEO would make it thru the year if they ran eHealth like a real company. It's not about profit, but efficiency....something that I do not think is done at all currently.

pmnb said...

Well put. My father has be fighting cancer for about 18 years, and has categorically stated that if it were not for his own (meticulous) record keeping, he would not be around today.

Sheila said...

I've heard that the main reason eHealth is lagging is because the hospitals just don't want to share their information for whatever reason, or even use comparable systems.

I've started to collect my old records and request copies of new reports, etc.

Stephen said...

Sheila, I expect this is part of the problem. Several doctors have told me to have my test work done at the same lab so that test results are more comparable. The doctors said that all the labs are fine but they are sometimes just consistently off by a bit.

I’m sure the Newfoundland experience of finding years of incorrect test results, leading to wrong treatments or worse is in the back of the minds of most administrators minds.

Not sure who would owns the data but I’d be surprise if it was the hospital administrators. What the administrators do have is control over is how timely and effectively that eHealth can be implemented in each hospital.

Not to be negative but I hope the quality of our health care is not being impacted by hospital administers who are scared of being measured to a base line.

Agree with the need of patients to keep their own records. It would be nice if this was all online to ensure that doctors / nurses / pharmacy / patients are all working from the same information. It would be nice but it seems that somehow eHealth is being blocked at the expense of patients.