Friday, October 11, 2013

Oh Dear! This Sounds Like Another Bad Example Of E-Health Governance Failure.

This appeared a little while ago.

National vision for digitizing health records has failed as each province does its own thing

By Jules Knox, Special to The Province September 25, 2013
While banking and other industries completed their entry into the digital age years ago, the health-care system is still scrambling to make the transition.
Billions of taxpayer dollars have been spent on digitization but governments continue to struggle to address the diverse needs of health-care practitioners. The vision of a pan-Canadian electronic health record for each patient, which once seemed so important, is now further off than ever.
When the federal government realized a national strategy was needed, it created Canada Health Infoway, a not-for-profit corporation that has received $2.1 billion since its founding in 2001 to invest in provincial electronic health projects and set pan-Canadian standards for interoperability.
There is a reluctance within the field to speak out on the record, but this organization is widely perceived to be a federal boondoggle that has failed to produce results. That’s largely because health care is a provincial responsibility and Canada Health Infoway’s interoperability standards aren’t binding. It received no new funding in 2013.
Provinces have adapted the Infoway standards to suit their own environments and to work with old computer systems that are already in place, says Bill Pascal, chief technology officer at the Canadian Medical Association. “But as soon as you start to adapt a standard, they don’t line up,” he says.
Software vendors have to customize their electronic medical records to meet each province’s individual requirements.
“Because each electronic system needed to be specifically certified in that particular province, it created 10 different marketplaces instead of a countrywide market,” says Dr. Alan Brookstone, a physician and health-care information technology consultant. “And this slowed down overall adoption rates.”
While more than 90 per cent of family doctors in the U.K. and Australia use electronic medical records, Canada has an adoption rate of only about 57 per cent.
More here:
There is further commentary here:

Provincial tweaking of interoperability standards impedes Canadian EHR network

September 24, 2013 | By Marla Durben Hirsch
The U.S. is not alone when it comes to road bumps toward a national electronic health record system: Canada also is struggling to create a nationwide interoperable EHR network, according to an article published this week in British Columbia's The Province.
The non-profit Canada Health Infoway, which provides funding for EHR projects throughout Canada, has set Pan-Canadian standards for EHR interoperability. However, the standards are not binding, and the provinces have adopted the standards in different ways for their own benefit, meaning they no longer line up to share data. 
Moreover, EHR vendors have had to customize their products to meet the different requirements, making interoperability even more elusive.
"Because each electronic system needed to be specifically certified in that particular province, it created 10 different marketplaces instead of a countrywide market," Alan Brookstone, a physician and healthcare information technology consultant, told The Province. "And this slowed down overall adoption rates." 
More here:
In Australia, of course, NEHTA has a similar brief but the problem with here has been that the jurisdictions have essentially not taken all that much notice of what is being said as they are simply working with the systems they have purchased which all come with different basic Standards assumptions.
Of course in GP land we have only limited interoperability between systems as well as rather limited messaging interoperability actually being used.
Just as in Canada we have a little way to go!
David.

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