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!

Tuesday, 16 August 2011

Aug 16

It has been a bit since my last update. In a nutshell I've been busy with my kids and working on my health. They are my two most important things at the moment. The blog has been great at helping me get my thoughts together and letting people know my current status.

With the kids back in daycare and heading back to school soon I expect to have some time outside of family and heath to provide more regular updates. If you are looking for a similar blogs with more regular updates you might want to follow Brian Koffman's Great site written from a cancer patients view. He is also a doctor out of California.

My second chemo treatment on Aug 3rd went well. The follow up care from the nurses was fine. My chemo bag was removed on Aug 5th on schedule. No side effects other than some constipation and the opposite of this.

The constipation did get me a bit concerned. When the doctors gave the OK for me to get Avastin they gave me many warnings about my existing partial blockage of my large intestine. The worst case is a full blockage and the need for emergency surgery. They also listed some potential side effects such as blood clots and stroke. If they were looking to freak me out - Mission Accomplished!

On Sunday night, Aug 7 I was feeling fine other than constipated. My last BM was early on Friday. Thinking back to the warnings I was starting to get concerned. Late into the evening I called into Mt Sinai to talk to the on call Oncology Surgeon. We discussed my symptoms and the lack of any vomiting or similar. Can't remember his name but he was great. Very calm and confident. He all but told me to go to relax and verbally patted me on the head, saying to go to bed and have a good sleep.

This might sound a bit condescending but it was exactly what I needed. Later on Monday everything shall we say worked it's self out. Since then I've been fine. More energy than before and re-started daily exercising.

On the movie front we slowed down. Too costly and no more good summer flixs to see. We did make an exception over the weekend for the original Karate Kid. We saw this at the Bell Lightbox downtown TO. If you have not been you should go. Great movie theater and no teenagers talking and texting during the show. One of the neat things for the kids was watching the movie in the Mackenzie Financial theater (Tanya's employer) and playing in the BlackBerry lounge. The only thing I can relate this to is attending the Dofasco Christmas party with my dad. (sorry for losing 97% of you)

The kids loved the movie. Both Cameron and Gavin had seen the remake and didn't really like it. We had to pull rank as Parents to get them out to the original. By the end of the movie both kids were out of their seats and glued to the screen. Cameron said that now he understand how original movies are way better. I'd have to agree.

Most of last week was spent doing chores and prepping for my next chemo treatment. We did have time to take the kids to Wonder Land and a few other smaller day trips.

Today for lunch, went out with the team from work. It was great to see the guys and one gal. It was put together last moment and some people were out of town. Sounds like changes are still going on within RIM. Re-organizing in preparation for new devices and application launches in 2012. Based on the chats today and the quality of the teams I'm confident that RIM has started to turn the ship around. Honestly, I do miss going into work. Some really cool stuff going on and great teams to work with.

Tomorrow I'm staring my 3rd round of chemo. Hope all goes well. Expect I will be sleepy till the end of this week and I need to get to bed soon.

Thanks everyone for your notes, updates and taking the time for lunch. Thanks to Mike for driving an hour each way to meet up for lunch. Also thanks to Kay, Janice and Rebecca for the nice card and notes, it's always a bit of a rush to get an actual card with handwritten comments with the Canada Post mail drop. It's not just for bills and flyers any more.

TX - Stephen