Tuesday, April 30, 2013

Another Report Saying Health IT Is Wonderful - Is It Relevant To What Our Government Is Doing?

The following appeared a few days ago.

EHR use provides Canadian docs billions in benefits

April 24, 2013 | By Marla Durben Hirsch
Electronic health records have proven very useful to Canadian physicians in community-based care, helping them to reap more than $1.3 billion in benefits since 2006, according to a new report by PwC.
The report, commissioned by Canada Health Infoway, involved review of over 250 research articles, surveys and other information. The researchers found a number of advantages to EHR use, including:
  • $800 million in administrative efficiencies in workflow as staff time is redeployed
  • $584 million in health system level benefits, such as the reduced number of duplicative tests
  • Improved outcomes and safety through preventive care and disease management, such as a 49 percent increase in pneumococcal vaccination rates with EHR reminders
  • Increased interactions and communications among providers and between providers and patients
The report's authors also found that most physicians have had a positive return on investment due to overhead cost savings and increased revenue.
Lots more here:
You can find the press release announcing the study here:
You can find the full report to download here:
If ever there was a report that needs to be read carefully to discover just how hard consultants can try to con you this is it!
Carefully reading the report - what it is about is the benefits that can be derived from moving the level of GP EHR usage from 26 to a little over 56% and then taking the benefits estimated to have been acquired over the whole six years. i.e. all the benefits are seen to be cumulative.
If you read closely the vast quantum of benefits - small as they are - flow from clinicians using computers for prescribing, managing results and so on.  Oddly there is no attempt I can see to quantify the benefits of Health Information Exchange which is what the NEHRS is intended to enable.
In Australia, of course, we have already achieved most of these milestones with GP computing a while ago. Rather a pity we did not keep consolidating and incrementally improving before leaping into the PCEHR unknown.
Call me cynical but when one reads this article it is pretty easy to see why this report has appeared just now.

Future of electronic health records agency in question

April 18, 2013 - 1:18pm
Ottawa says Canada Health Infoway not being shut down, despite lack of funding
OTTAWA — Canada’s main electronic health records body received no new funding this year, but the federal government says there are no plans to shut down the agency.
At the same time Ottawa is eliminating the Health Council of Canada, Canada Health Infoway discovered it will unexpectedly receive no new program money in 2013.
Created in 2001, Infoway works with the provinces to create a consistent system of electronic health records across the country.
As is typical for health organizations, Infoway receives block funding every few years instead of annually. It was given $400 million in 2007 and then $500 million in 2010.
That funding is almost entirely spoken for now.
“The vast majority of our funding has been allocated for approved projects,” said Infoway spokesman Dan Strasbourg.
It is not clear how much new money Infoway had asked for in 2013.
A spokesman for Health Minister Leona Aglukkaq said there is no plan to wind down Infoway’s operations. Steve Outhouse said the lack of funding was an austerity budget measure.
“It was a year, obviously, where there was some fiscal restraint that needed to be there,” said Outhouse. “There’s no plan to end Infoway operations at this point in time.
“We’re always looking at how to spend money as best we can, but there’s no immediate decision or anything like that coming up for Infoway.”
Its job for 2013 will be implementing projects already underway, he said. The department can’t guarantee funding Infoway in 2014 because that decision will be made in the lead-up to next year’s budget, Outhouse said.
Since its inception, the agency has received $2.1 billion in capitalization across 370 e-health projects.
Lots more here:
So they have spent $2.1 billion and seem to be suggesting cumulative benefits of a rather rubbery $1.3. I know all the Infoway funds weren’t spent in the area discussed but a good deal was and the return to the public looks rather skinny - to say the least.
I wonder what we will get from the PCEHR program in the years ahead?
David.

4 comments:

Anonymous said...

Infoway is very similar to NEHTA, with a track record to match. While Infoway hasn't come up with anything quite as hare-brained as the PCEHR, it has very little to show for the $2.1 billion it has spent.

Canada has a terrible HIT infrastructure.

Trevor3130 said...

A great long piece by Ezra Klein If this was a pill, you’d do anything to get it.
It's got everything to do with Health IT, though he doesn't mention 'records' let alone 'electronic'.
I'm guessing some private insurers a taking a look at Health Quality Partners. When (soon) DoHA is on its knees, pleading for help to "do it better & cheaper", it won't be public agencies ready to roll with proven pilot programs. But, no-one will be able to prove a program's efficacy without a comprehensive root-and-branch IT system that captures all events so that costs & outcomes can be collected.

Anonymous said...

I got confused initially that Canada have already done something like PCEHR... but it seem they r still talking abt EMR not EHR ... i wonder why the article in this post said EHR not EMR ?

Bernard Robertson-Dunn said...

@Trevor3130

re: It's got everything to do with Health IT, though he doesn't mention 'records' let alone 'electronic'.

I disagree. IMHO it's got everything to do with health information, organisational structure and behaviour. These things might drive the need for Health IT but unless they are the prime objectives, failure is most likely.

In Australia, technology seems to be the prime objective.