Canada is blessed with both one of the world’s most advanced health care systems and sophisticated IT networks. Ironically, when it comes to the interconnectedness of Canada’s more than 40,000 different kinds of points of care, our health system is remarkably disconnected.
IT could be a matter of life and death.
In downtown Toronto, an elderly man finds his way to an emergency ward late in the evening. The ER doctor tries to determine his patient’s medical history, but the man is disoriented and his responses incoherent. As a result, the doctor is left with a single, risk-laden option – prescribing drugs to address his patient’s condition without knowing which other medications he may take.
In a small village in Nova Scotia, a child falls from her bike, banging her head on the pavement. Her frantic parents rush her to the small local hospital. There is a CT scanner – but no radiologist is available to read the film. The little girl is transported to Halifax, delaying what could be life-saving treatment.
A patient with chronic diabetes grows increasingly frustrated attempting to co-ordinate the advice and care of various specialists. As her care narrows to treating emergencies, her condition worsens, putting her at risk of complications as severe as amputation, blindness and heart failure.
“We have the technology,” says Richard Alvarez, president and CEO of Canada Health Infoway, a non-profit organization that serves as a catalyst for electronic health record systems across Canada. “Today, in some parts of Canada, the elderly man could have been treated by a doctor who was able to access his entire prescription record; the little girl’s CT scan could have been transmitted from her local hospital to a leading neurologist for interpretation and treatment recommendations; the diabetic patient could have an integrated plan to maintain her long-term health and prevent potentially devastating complications.”
As the Canadian population ages and the prevalence of chronic diseases increases, our health care system is under siege. Wait times are a primary concern for Canadians, and demand continues to grow. (Twenty per cent of the population will be 65 or over by 2031. By 2010, one in 10 Canadians is expected to have diabetes.)
To overcome these challenges, it is essential that Canada’s health professionals have the tools they need. But with more than 40,000 different kinds of points of care within the health care system, it won’t happen by accident. One health care consumer, speaking about his mother’s last years, said, “I can’t imagine any justification for the continued inefficiencies of paper records. Contrast my mother’s experience in the health system – repeating her medical history over and over to different care providers – with the rest of her life. She had an oxygen tank, so when she called the cab company, her number flashed up on the dispatcher’s screen and a non-smoking car was dispatched to her home. She didn’t even have to speak. The driver knew he had to knock on the door – loudly – and help her to the car. The price was set ahead of time, and the bill was sent directly to me in another city. She used to say that even the video store kept better track of her than her doctor did.”
Fortunately, situations like this are changing. “With more than 230 e-health projects from coast to coast, all provinces and territories are aggressively pursuing what needs to be done – from developing telehealth services in remote regions, to providing patients with chronic kidney disease with online portals to better manage their health,” says Mr. Alvarez. “They are pursuing their plans within a common framework so that best practices and successful systems in one jurisdiction can be shared or replicated in another, reducing risk and development costs, and speeding up progress.”
By 2010, when Infoway’s initial seed money is completely invested, 30 million Canadians will have access to at least some of these new clinical systems; close to 15 million will have a complete electronic health record that integrates all of these systems, providing an accurate history of medications, lab tests, diagnostic images, hospital summaries and immunizations.
Two recent studies estimate that $350 per person, spread over 10 years, is needed to complete this transition in Canada and will deliver a significant return on investment, saving $6 billion to $7 billion each year, when fully implemented.
“We are at a crossroads in Canada,” says Mr. Alvarez. “We have established strong momentum and a solid track record. We know what needs to be done, and we know how to do it. To finish the
job – to transform our health care system – we need the continued support and commitment of governments, health care providers and patients and their families. This is a good health care decision, and an excellent business proposition.”
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