Richard Alvarez, President & CEO, Canada Health Infoway
If Canadians want to realize the benefits of electronic health records, it's up to the public to demand them
By Richard Alvarez,
President & CEO,
Whether you are a patient, parent or a caregiver to aging parents, nothing matters more than your own health and wellbeing and that of the people you care about.
Canada's health care professionals are among the best in the world, but we need to do more to support their efforts. Information technologies that have revolutionized virtually every other aspect of our lives are painfully absent from the way we manage and share health data. Information is the lifeblood of Canada's huge health care system, yet each year, most of the patient records generated from over one billion health care encounters are still predominantly captured on paper.
Astonishingly, every year almost all of the 100 million physician exams, half a billion lab and radiology tests, and 382 million prescriptions are handwritten. This critical information – buried in the filing rooms of 40,000 doctor offices, test centres, hospitals and clinics – is often inaccessible in crisis situations, when it is needed most.
There are many reasons this antiquated approach cannot continue. It puts our safety at risk, and wastes money and scarce resources. It undermines every health care priority we have.
How can we efficiently reduce wait times if up to 70 million of the medical tests taken annually are wasteful duplicates? (The 2006 Annual Report of Ontario's Auditor General estimates that 10 per cent to 20 per cent of imaging tests ordered in Ontario are unnecessary or inappropriate.) How can we improve access to care when 68 per cent of specialists seeing a new patient receive no up–front information, making the visit less than productive?
A landmark Canadian study completed in 2004 found that between 9,000 and 23,000 Canadians die each year in our hospitals from preventable, adverse events. Despite the efforts of skilled and caring health professionals, many of these deaths occur as a result of missed drug interactions, inappropriate medications or other human errors related to care co–ordination. They occur because our health professionals lack the modern information systems they need to optimize care.
Study after study has concluded that Canada urgently needs a foundation of proven IT systems to manage and exchange health care information. Simply put, the right information must be available to the right health care provider at the right time. Anything less is unacceptable and dangerous.
In stark contrast, technology permeates virtually all other aspects of our lives. I can travel nearly anywhere in the world and use my bank card to securely withdraw money and manage my account. I can send a package across the globe and verify instantly where it is and when it reaches its destination.
But if I'm hit by a bus and taken to a hospital, I could be in big trouble. The doctors will have no way of knowing whether I have low blood sugar, an enlarged heart or six pins in my ankle. They won't know I've had malaria twice, am allergic to nuts and have high cholesterol.
For a number of years, managers and providers within the current health care system have been driving for change. Thankfully, with the co–operation and support of governments and health professionals across the country, by 2010, every province and territory (and the populations they serve) will benefit from new health information systems that will help modernize the Canadian health care system. By then, we anticipate that half of Canadians will have their electronic health record readily available to the authorized professionals who provide their health care services. As significant as this accomplishment will be, it still only represents half of the solution.
Bringing this new level of service to all Canadians will require both time and money – $10 billion to $12 billion over 10 years. We have a complex system that requires a robust, thoughtful solution. There are no quick fixes. We need to do this right. And while that sounds like a lot of money (and it is), consider the fact our current health care system costs an average of $4,867 per Canadian annually. Investing in electronic health information systems would amount to $35 per Canadian each year, over a 10–year period. However, it is estimated that this investment will result in $6 billion to $7 billion in annual cost savings when the system has been fully implemented. As a result, two years after completion, the system will have completely paid for itself.
The value in building a sustainable public health system – one that will realize the efficiencies of a modern IT system, including enhanced health care delivery and lives saved is priceless. This investment, quite simply, is one we can afford to make.
Ultimately, it is not just up to Canada's health care managers and clinicians to seek these improvements – the demand must be voiced by the public our health care system serves.
We must all continuously push for meaningful change – and the investment and widespread co–operation that will allow that change to be fully realized.