Dr. Merrilee Fullerton on Healthcare

http://www.thestar.com/article/703083

Ah, but you do not mention the latest chart-topping scandal plagued eHealth executive from London.

http://lfpress.ca/newsstand/News/Local/2009/09/30/11200316-sun.html

Ms. Diane Beattie walks away from her position with the London teaching hospitals this Friday with a $451,000 severance package. She issued $3M in sole source contracts to a former colleague while she was not in a position - according to hospital procurement policy - to sign any contracts.

I guess because it was not hospital money but e-Health money from the South West LHIN it was okay. If Ms. Kramer did it...I could too.

Can't beat that logic.

In a credibility-poor environment this erodes public confidence in all health care executives; and makes recruitment for a new eHealth Ontario CEO even more difficult than it already is.

This reminds me of an old political commercial from Saturday Night Live: Senatorial Candidate Terry Ferguson (Will Ferrell) claims that he will avoid sex scandals, because he lost his genitals in a fire.

Begs the question: what would be the e-Health equivalent?

You have an entertaining way of putting things, ELB. Good to hear from you. Your comment raises the question: How much more dubious "ongoings" were there in eHealth?

And government is looking for more expansion of scopes of providers with Bill 179 (think of all the associated costs of nurses and physios ordering x-rays, pharmacists extending prescriptions etc. etc.) with more 'regulation'. And gov't wants the ability to essentially take over supervision of the CPSO if necessary. One wonders. It seems government has done such a good job at overseeing eHealth that it thinks it should do more! ha ha. More misplaced nobility.

"Smart Systems had a different role. Smart Systems was to develop a network and host solutions," she said Tuesday. "The eHealth program was to develop a strategy to develop solutions. They were very distinct roles."

This is just geting richer all the time.

I took the liberty of moving mfO's last comment on the previous journal post to this journal entry....didn't want any of you to miss it....

*************************
The plan

In reviewing things for the upcoming decisons for budgetary yaer 2010-11, the parts of the plan have been assessed and found to be good.

We are particularly pleased with the manpower plan. In less than 20 years, we have move the physicians from a large group on independant operators, going off in multiple uncoordinated directions, with uncontrolable budgetary demand, to the position of today, where most enter through fixed budget groups, with caps, and working in teams, controlled by our management personnel. It has been a huge successful with great support from the public, and most physicains are happy. The plan is good.

Meanwhile, eHealth is going to be tough. It really is a mess. It is a reflection of lack of good direction within the MOHLTC, cronyism, and the "entitled" oligarchy state. Waste actually is higher than 2 billion. We must get eHealth in place in order to continue on with other areas of the plan - particlarly the data mining aspects for marginal cases where we are spending way to much money.
September 30, 2009 | Unregistered CommentermovingforwardOntario

"data mining"....has an ominous ring to it

the following link refers back to the old age dependency ratio of a previous journal entry and may seem to have little to do with eHealth...but.....it does....because people are going to have to be more responsible for their care and the power of health care decisions cannot be left in the hands of a few.

Poor decisions made by a handful of people (may I add, the same handful of people, over and over again) will have huge repercussions for all of us. Can you say "Barer-Stoddard"?

So taking the power from a few decision makers who have managed to entrench themselves in the system should be the next aim. The power should be with the people and not with the politicians. You can see why there is such a huge divide in the debate on health care in the US. While "free health care" is always very nice, nothing is really free and when one gives up responsibility of something so personal as health care to a handful of decision-makers, bad things tend to happen.

oopss...here is the link:

http://www.guardian.co.uk/world/2009/jul/20/census-population-ageing-global

If you have any spare time, The Black Swan, by Nassim Taleb, is definitely worth a read....points to the difficulty of leaving decisions in the hands of a few.....some heavy going at times but very pertinent.

http://www.asianinvestor.net/article.aspx?CIaNID=113662

Speaking of old age and the coming demographic trap:

http://www.theglobeandmail.com/news/opinions/canada-is-aging-and-procrastination-just-worsens-the-fiscal-cost/article1305855/

'The power should be with the people and not with the politicians' and
'...when one gives up responsibility of something so personal as health care to a handful of decision-makers, bad things tend to happen' - realist

The power is with the people realist. They choose (or are convinced) that the best strategy for them is to entrust planning, resources and the rest with a professional class who promise (in return for riches and priviledge) to look after their interests in the face of confusing and complex choices. No one expects full delivery on the promise of course so accountability issues are pushed well aside.


The second part: Same as the first really. People see their doctors as entry level consultants who will identify health issues and options. Some even manage to explain options. When the obvious options are not identified the doctor arranges escalation of consult to a specialist. Bottom line is that the average patient has been raised to see doctors as health experts who will know what to do and should be trusted to advise. Delegation indeed.

No fix to this obvious to me; certainly anytime soon.

Hey...thanks Canary! I'll have to read this and see what similarities there are with what has been discussed here.
..

Here is a video by Taleb on "black swans" and it reminds me of how our health care system has taken on an acceptance that few dare to cut open form examination. All who do are considered evil by many vocal and strong union groups. There is a black swan in health care. Exactly where it will show up is the question.

"The power is with the people realist."-HH

nonsense...the power is with politicians who use health care as a political tool...and you know it.

"The long-term options include going into long-term debt, raising taxes or cutting spending. Today's political leaders say they will contemplate none of the above. They are punting for their political lives. But Prof. Fortin is right: “Procrastination conceals a trap. It will only make the problem bigger over time.”"

I have to agree...but the solution is to create an expectation of more personal responsibility not less. Perhaps this will come out of necessity. The solution is NOT more government involvement in more aspects of our lives.

Sorry to disagree in technical terms realist but in a democracy, people choose (or choose not to choose) the politicians they want to have power to be exercised.

We can agree perhaps that this power is not wisely invested by most people during the voting process but by design, in a democracy, the people ultimately have the 'power' that accrues to the duly elected government.

What the politicians choose to do with the power in terms of health care or any other file they control is subject to review by the people at the next election.

The opposition job is to help folks focus on the shortcomings of the government in order that voters can act rationally when mandates come up for renewal.

People do not generally act as good stewards of their civic power and the result of course is that politicians (and others) take advantage. Just like the unscrupulous vendor who takes advantage of aging seniors while peddling service contracts that are not needed or are padded by excess costs.

All this said, it is the responsibility of each elector to vest their share of the power (vote) with a suitable agent and then monitor their effectiveness over time. No different really than you suggest in terms of personal responsibility taking for health matters.

This is what I know.

HH, what was the voter turn-out in the last election...provincial or federal?

More from Andre Marin on Avastin...apparently he believes the decision to cut funding for Avastin is as "dumb as a bag of hammers"...he does have a way with words:

http://www.thestar.com/news/ontario/article/703341

D"eputy health minister Ron Sapsford said in a letter to Marin that the Avastin decision was based on the advice of 20 clinical experts on the government's committee to evaluate drugs, which found the medication not to be "cost-effective" in certain chemotherapy regimens because it is triple the acceptable range for funding such drugs.

"Until such time as we receive and review any new evidence, the ministry intends to continue funding to a cap of 16 cycles," Sapsford wrote. "This is based on cost-effectiveness and overall affordability within a limited drug budget.""

from CTV website:

"What's proposed essentially is a not-so-clever catch-22 solution, where cancer victims continue to be a victim no matter what they do," he said.

"This policy right now as it's proposed is as dumb as a bag of hammers, and has nothing to do with compassion. It's contrived compassion, not genuine compassion. So we can't accept it as a solution. It just doesn't work."

Marin launched the investigation into Ontario's funding of the chemotherapy drug Avastin in June to determine whether it makes sense to cap support for patients suffering from cancer.

The probe of the Ministry of Health and Long-Term Care's policies for the drug was prompted by complaints from patients, as well as a letter from Progressive Conservative Joyce Savoline, that the 16-cycle limit appears to be arbitrary.

"The funding limit flies in the face of the acceptable standard of oncology practice in this province and beyond," Marin said in his report.

"Regrettably, this situation verges on cruelty for those already afflicted by this unrelenting illness. In the case of Avastin, it is impossible to justify the human price exacted by the current administration's inflexible and dispassionate application of the funding limit."

Marin also noted that the government has the right to decide that a drug is too expensive to fund, but once a decision is made, any move to cap funding should take patient progress into account.

Health Minister David Caplan was expected to speak about Marin's findings Wednesday afternoon."

ministry decision is not evidence based:

http://www.globaltoronto.com/Funding+cancer+drug+verges+cruelty+ombudsman+says/2051080/story.html

and just in case you haven't had enough levity for the day, here is a letter from the CPSO President regarding Bill 179 posted on RateMDs website with various hostile comments regarding the CPSO....sheesh....one wonders why anyone goes to medical school these days when they could be "dancers" and "hairdressers"!

Submitted by katherine1 on Tue, 09/01/2009 - 08:03.

"The Government Screws Up" - True. But these amendments at least take away the fascistic powers of the College of Physicians and Surgeons. It gives the people more clout. But they must use that clout. I have tried to get people to fight back but they don't want to be bothered. Or they are too ruined and alone. We must be aware and fight back. My husband is a nutritional doctor who has been the brunt of their scrutiny for 30 years. I can tell you that it is absolutely horrifying. I have 2 sons and I would drop dead if either of them became doctors. One is a dancer and the other a hairdresser. The public has no idea how terrible the College really is!


http://www.ratemds.com/social/?q=node/38566

Q: What is worse than being a doctor these days?

A: Being a doctor at the CPSO!

just the highlights from the auditor's report
( I expect we will hear more tomorrow):


Sources said McCarter also criticizes:

* A $30 million untendered contract to IBM approved by cabinet ministers on the government's management board.
* Unnamed senior health bureaucrats for thwarting his efforts to get investigators into eHealth for a routine audit in the summer of 2008. McCarter's staff did not gain the desired access until last February – just a few months before Health Minister David Caplan ordered a special audit once the eHealth spending scandal erupted.
* Unnamed consulting companies for driving up each other's fees, artificially creating a higher going rate for their services.
* Too much power in too few hands in awarding of contracts, which did not get enough oversight from top officials in the health ministry.
* The $647 million spent, with little to show for it, by SSHA, set up by former premier Mike Harris's Conservative government.
* What one source called a "war" between SSHA and the health ministry over how to manage and accomplish a complicated endeavour like creating electronic health records.

and we should remember to keep bringing the public's attention back to this....we are so easily distracted!

http://www.wellandtribune.ca/ArticleDisplay.aspx?e=1776571

Niagara Health System president and CEO Debbie Sevenpifer will speak to Niagara Falls city council this month to clear up “inaccuracies” she said were made during Monday’s council meeting when former emergency room doctor Paul Dobrovolskis said the GNGH emergency room isn’t the gem it once was.

... cut ..

Dobrovolskis, reading a two-page letter about the doctors' concerns, said they were upset by the “dismantling of a stable schedule for our emergency room doctors” that won’t solve wait times the way NHS officials say it will.

... cut ,,,

Emergency room delays exist because patients have to wait until there’s a hospital bed they can be admitted to, he said

So true about the depth of the rot.

Allegedly there are tighter spending and accountability controls already put in place at eHealth Ontario but what about the the recent Request for Services issued by EHO on Sept 21 and closing today? According to insiders the entire exercise is fixed to appear as though there is a competitive bid process. In reality, the incumbent resources are simply going to be re-selected for the roles. These are the same old resources who have been sucking at the MOHLTC consulting teat for years. It leads one to surmise that they could be part of the problem.

Given that the resources are pre-targeted and will win out automatically when their vendor submits their resume, how is this RFS procurement process fair to vendors who work hard to compete and who may have more qualified resources to bring to the table? And let's face it, new talent should be considered because there are obvious failures with the current crew. When do they get cut off the gravy train?

CTV Toronto has unearthed more examples of the types of misspending that Auditor General Jim McLarter is likely to highlight when his report becomes public:

* eHealth Ontario paid an on-call consultant $42,000 for six months of work
* it paid $2.5 million per month to maintain inactive or underutilized network circuits
* a $687,000 contract got approved by someone who did not have signing authority
* a consultant saw their pay go to $1,500 per day from $1,100 without approval; eHealth paid anyway
* another consultant was to be paid at $1,300 per day, but billed $1,500; eHealth officials noticed but paid the extra $46,000
* eHealth had a $1-million deal with a recruitment firm to hire 15 senior managers. Most of the money was paid up-front, yet the firm only helped fill five positions. No money was given back
* eHealth allowed consultants to hire other consultants -- who then did so from within their own firms

http://toronto.ctv.ca/servlet/an/local/CTVNews/20090930/ehealth_audit_090930/20090930/?hub=TorontoNewHome

http://www.thestar.com/news/ontario/article/703660

"The IBM contract was approved last November by the management board of cabinet, an influential committee that oversees ministries' annual spending plans and is in charge of human resources, government real estate and information technology.

Finance Minister Dwight Duncan chairs the committee, which includes minister without portfolio Gerry Phillips, Deputy Premier George Smitherman, Government Services Minister Harinder Takhar, Government House Leader Monique Smith, Citizenship Minister Michael Chan, and Consumer Services Minister Ted McMeekin."

Opposition politicians are pounced on the leaked details on how Ontario has spent $1 billion since 2002 to develop an electronic health records system yet has little to show for the money.

"The one billion dollars lost into the abyss of mismanagement, and Ontario still doesn't have an eHealth system," NDP Leader Andrea Horwath said Wednesday in the legislature's question period.

"Meanwhile, 1,200 nursing positions have been axed. Local emergency wards have closed."

Yup.

I was at a committee meeting yesterday involving the presentation of new local delivery concepts where wonderful, very expensive looking buildings were shown from Northern Ireland that basically de-centralized care from hospitals and acted as large community clinics.

I said with looming deficits for years to come that this type of re-organization would be very expensive...real estate always is. I mentioned it would be better to consider how to integrate services virtually where possible, saving on physical infrastructure which would require huge amounts of maintenance...but my attempts to provide a reality check were met with "we can't afford not to do this" which quite frankly is an overused cliche and quite lame.

Anyway, it looks like we are still on a "building monuments agenda" while rural hospitals are denigrated as not having the modern resources to cope with our new era of expectations. I'll tell you what.....when most people are in need of stabilization after an injury, it is the small rural hospitals who are located to provide staff to do this...no MRI required... get the IV lines going, assess major medical problems that may need pharmaceutical intervention immediately and ship......Having a wonderful building centrally de-centralized is not going to do this job.

So as much as there is a need for more chronic care, let us not forget the life and death situations that come through the small ER doors need care on the spot and cannot wait an hour to reach the palace.

Plus, building smaller "community health centres" to provide dialysis in the "right location" and the "right time" is not necessarily going to deal with the growing deficits we will be seeing over the next 10 years or more.

The increasing dependency ratio along with the current deficits and especially in Ontario, no real recovery in sight, I wonder if the government will swallow this plan because of optics instead of logic.

Arrgghhh. More monuments.

HH is correct in that we get the government we elect. It would also be correct ot say that this is legal because there is no law agianst it.

Hever, I think the news media display of government in action has led to a perception of public service waste and an odour of corruption. Has this become the game show equivalent of repercussion-free 4 year "free shopping" term in office?

And, respectfully HH, that is not what we see and hear and are promised in the party platforms presented for election. But for crown and parliamentary immunity ome might otherwise consider such misrepresentation fraudulent and recently divulged excesses to be malfesance.

For the unwashed this reinforces the disbelief of integrity at the highest levels of public office. HH, most of us never actually elected public servants and entitled them to pilfer the public purse.

As such there seem two standards of natural justice in the country. On one hand we have the private citizen who would be suspended, with or without pay, during investigation of breach of contract or duty. On the other, the public servant/elected official continue=ing in office while appearing to stonewall access to information, deny knowledge of the matter and avoiding acountability.

But that is just my opinion.

Well said and I fully agree, eklimek.

The difficulty with politics and power is in its conflict of interest. In almost all other structures, steps are being taken to monitor and deal with COI issues. Not so in the bureaucracy. We constantly are immune from punishment for errors, that in the real world , would cause at least dismissal or worse. The beauty is that one can not get us because we are protected by the divine nature of the crown.

These isses that are piling on top of the existing government (and they are not to blame for all of them), exist because no accountabilty is present.

As more people get more from the government, they accept that the government will only get their vote if the "more" remains, and "more" is added into the pile. That crossover appears to be soon, where so much is expected, but so few can provided, that cuts are required. No government wishes to be put in that position. Traditionally, in other economies that point is at about the 65%/35% split. Where 65% of the public, get more out than they put in, and 35% put more in than they get out. That's about where Ontario is right now,

The budget is not pretty right now, and this stuff pouring out about the MOHLTC just isn't needed right now. It's true - but we just don't need it now.

When does one ever "need" that kind of "stuff", mfO?

I expect that the reality is that this kind of lack of accountability in government is rampant and only when a whiff of smoke blows past the opposition does FOI get used and the truth out.

However, this kind of wheel spinning is costly too. First, the waste at ehealth etc., then sorting it out with much costly time and energy spent digging into this kind of thing instead of getting on with producing something tangible.

Of course, I do understand that democracy is messy...but truth is we've got a populace that is so disengaged they might as well be spinning off into space.

But I agree with you mfO...we are just about at the tipping point.

"When do they get cut off the gravy train?"-ehealth slice n'dice

Good question "slice n'dice".

Thanks for joining in. How 'bout we call you SND for short?

.

For you Canary:

http://www.theglobeandmail.com/news/technology/science/provincial-flu-plans-all-over-the-map/article1307772/

One of the issues in our area is how to distribute vaccines and administer them. Initially it was felt that this could be handled through CHCs and some FHTs but it seems that in some areas, these facilities are lacking (no surprises there) and so typical family doctors' offices are being considered. Trouble is they typically don't have the resources either human or physical space, to provide this...and of course since most aren't on salary, and without a designated free from providing the "flu assessment", I am wondering exactly how the private physicians' offices will cover the expenses of such a service given that it doesn't seem the MOHLTC is forthcoming with additional funding for these settings....perhaps already spent the money on some well heeled consultants!

not to mention the list of 10 items that must be covered off to meet the MOHLTC requirements for reporting including weekly updates to be sent in at noon on Mondays! Yeah right,...staff is just sitting over the fax machine at noon on Monday with nothing else to do!

a little reality check from the Economist:

http://www.economist.com/opinion/displayStory.cfm?story_id=14548881&source=hptextfeature

the big, big picture as per Mark Carney:

http://www.bank-banque-canada.ca/en/speeches/2009/sp280909.html

"we're not talking about a shot across the bow of the optimists; this is more like a torpedo through the hull."-BMO Capital Markets deputy chief economist, Douglas Porter

http://www.ottawacitizen.com/business/Canada+stalled+economy+shocker/2053269/story.html

oh well, maybe the government will just drive the deficit and debt even higher by implementing more monument building. Could happen. Spend, spend,spend!

Thanks Realist. A brief H1N1 commercial before returning to the eHealth debate.

The second wave has started in earnest in southern Ontario it appears, and I can say there will be absolutely no way we can give flu shots given the current volumes in the office, the like we have never seen before for October. Twenty five percent of our visits are now H1N1 related with some schools now reporting 20 percent absenteeism. Last night we had standing room only for most of the night. In order to administer flu shots we would have to have a second physician but we are already stretched so thin this is not physically possible.

It is pretty clear that for many of those who have asthma, smoke, diabetes, etc. they don't just show up for their first visit but on average over two weeks present for another two or three visits. So not only will 20 to 25 percent of the population want to see their doctor at the start of the illness a large proportion will be repeat visits typically for bacterial pneumonia which will really tax the primary care system. Of course it doesn't help that one of the capitation clinics nearby is telling their patients they can't be seen for a week and to "go to a walk-in or emergency" if they have the flu. They have collected the capitation fee for the year so why bother trying to see these acutely sick people.

Other observations from the area:

Junior football teams out of commission due to numerous sick students.

Grade 12 students are being told not to stay home if sick as this would impact their grades for applying to university. Clearly the guidelines are not being followed which only spreads disease to the younger students.

At one large car plant they had to close a secondary line in order to keep the main line going as there were so many sick.

At another large factory all vacation leave has been canceled and despite plenty of overtime being offered there are still production losses due to sick floor workers. The c-suite execs have decamped to a local hotel where they run the business each from separate rooms.


So the Americans have started vaccinating their high risk population today and we are going to go through the second wave in the GTA, as predicted, without a Canadian vaccine which is not supposed to arrive until Nov. 15.
Some serious questions need to be asked about this immunization debacle in Canada.

And as suggested Halloween will be a no go given we are following the time line of the 1918 second wave very closely.

http://www.healthzone.ca/health/newsfeatures/article/703646

http://en.wikipedia.org/wiki/File:1918_spanish_flu_waves.gif

Oh and doesn't this give one a nice warm and fuzzy feeling about receiving a Canadian vaccine which lacks mid and long term safety data in kids and young adults. At least the US has a public fund for any vaccine injuries but no such fund exists in Canada where one would then have to sue the Crown,...remember the Krever inquiry.

Many in this region are considering a road trip to Buffalo in the next few weeks to purchase a jab once the high risk US patients have been vaccinated.

http://www.healthzone.ca/health/newsfeatures/swineflu/article/703355--canada-will-protect-swine-flu-vaccine-maker-from-lawsuits

Thanks for the info Canary.

I can't say that we are experiencing the same upswing here in Ottawa. Things are relatively quite influenzawise but we are seeing a very mild viral illness starting with sore throat, then nasal stuffiness for a few days then sometimes a dry cough for a few days. This seems rather typical of a run of the mill cold virus rather than influenza...ie no high fever, patients can still function....I'd say large numbers of the student population has had this over the past couple weeks. But it doesn't seem like H1N1. Of course, it could be a very mild case of H1N1 but without testing, we'll never know.

Many of the teens, as was found in that early Halifax private school outbreak, present without fever but do describe chills and sweating. What really seems to differentiate this illness from the other viral stuff at this time of year is the degree of fatigue. Most are in bed for one to three days which one would not see with a cold. The nausea and/or vomiting is another give away in a quarter of the kids.

"If Canadians do experience adverse events, the federal government is not considering a no-fault compensation scheme, he said. Quebec is the only jurisdiction that offers such a plan for adverse events resulting from immunizations.

But like other G-8 governments, Canada has agreed to protect GlaxoSmithKline in case of potential lawsuits, because the vaccine is not licensed under the usual regulatory process, Butler-Jones says. “If there’s a vaccine problem, as opposed to a malpractice problem, then the company is indemnified.”

In practice, that means patients who had a bad reaction to the vaccine would have to sue. If they won, any damages a court awarded would be collected from the federal government — financed by the taxpayer — rather than from the manufacturer."

http://www.cmaj.ca/earlyreleases/30sept09_vaccine_release.shtml

I wonder about Caplan's ethics....first it appears IBM was given an untendered contract then he is quoted as saying that he would put out a tender even if he planned to give the project to IBM! How bizarre is that statement? So he is going to have companies spend time and money putting together a proposal when he knows full well that he will give it to IBM!? Even if a company came back with a better proposal despite all the effort, he would still give it to IBM? Even more scandalous than the untendered contracts!

I look at Iran and Iraq and North Korea and Libya and realize that the world is in the hands of some real kooks. In comparison, the leadership in Ontario looks pretty good......but it still could use some improvement and more scrutiny.....don't want to backslide. I'm trying to envision an Ontario leader wearing Ghadafi's outfits and blithering on about the evil USA.....hmmmmm....I'd better be careful...could happen.

http://www.thestar.com/news/ontario/article/704282

"But the former eHealth official said the health ministry should have called for competitive bids even if they intended to stick with IBM, because any large information technology company could have handled the job."

Mr. Caplan should be relieved of his duties and give us all some relief.

The key issues over funding distribution:

1. Central is poor at "expense" management and always has been. The new rules still have problems - but , properly enforced, should save about 50 -100 milliona year (that's nothing on a budget of 100 billion spend a year)
2. Single source contracting - rules now are improved and beginning to be enforced. Will slow things down - won't save any money.
3. Preworking on contracts not yet bid - has always gone on. It should be stopped. The biggest issues really is that, in health, prework goes on , without contracts, using confidential data. That remains bizarre.
4. Expenses - biggest issue is the people in charge know the loopholes in the expense process, and use the loopholes to gain. It really is the behavior that is bad. You've got idividuals alledging working for the public, who really are first getting out what best for them as individuals.
5. All the activity still won't fix the issue in health care - the hospital boards, hospital foundations, etc are immune from the rule changes.

Humans are human. The public sector is just as bad as the private sector.

The plan is good. Ontario Health Care Lite - love it or leave.

As always mfO, I appreciate your input and perspective...

from info@healthedition.com:

Federal money for Canada Health Infoway delayed

Canada Health Infoway will not be seeing any of the $500 million promised in the January federal budget until at least the new fiscal year, beginning April 1, 2010.

The government’s third report card on its economic action plan, released Monday, said “due diligence” on the $500 million investment will not be completed before the start of the 2010-11 fiscal year.

The budget announced Infoway would be getting $500 million over three years, with $200 million to come in the current fiscal year.

The extra money, bringing Infoway’s total allocation from Ottawa to $2.1 billion, was to support the goal of having 50 per cent of the population covered by an electronic health record by 2010.

Infoway was hoping to reach the 38 per cent coverage mark by the end of next March, and the 50 per cent goal by the end of 2010. However, the funding delay throws this into question.

Provincial and territorial health ministers raised the issue of the missing Infoway funds with their federal counterpart at their recent meeting in Winnipeg. HE

It's unclear to me what these Infoway numbers mean - do they mean that 38 percent of patients will have an EMR (courtesy of their family physician or local hospital), or does it mean that the 38 percent will have an permanent, portable, patient controlled EHR?

I think the true goal is the latter, and, if that's the case, I think we're actually hovering very close to the zero percent mark.

Call me crazy, but are we perhaps looking at the eHealth scandal, part deux?

Coming to an ER near you,....


"We are setting records in the ER, and it seems, day after day, these records become more impressive.

The number of patients we're seeing in a 24-hour period is unthinkable by historic norms. Everyday the tide comes in faster and we struggle to stay afloat."

http://www.cleveland.com/healthfit/index.ssf/2009/10/dr_diane_gorgas_first-person_v.html

There is that leather jacket again. Style over substance it would seem.



"All this makes me wonder if the experts trying to keep us safe and well have any idea about crisis communications. Assuming H1N1 is a crisis, then there are some basic rules about how to communicate with the public: Be clear; be consistent; seem competent; and talk to people that other people will go to for information, like physicians.

But here's what you find when you go to the Public Health Agency of Canada's fightflu.ca website. I wanted to know if and when I should be vaccinated, so I clicked on "vaccine." A pop-up menu offered me the following choices: Pandemic Vaccine Prioritization Framework; Guidance on H1N1 Vaccine Sequencing; and a News Release on Vaccine Sequencing that came up as "file not found." Give them an F on ability to communicate with ordinary mortals.

The government of Ontario gets higher marks for simplicity of communications. They have a nice little graphic of a five-point prevention program that ends with "Get seasonal and H1N1 flu shots." Yup, been trying to do that. They deserve an A for effort, but a D for making it so difficult to follow their own advice."

http://www.ottawacitizen.com/health/H1N1+diagnosis+Confusion+frustration+anxiety/2064464/story.html