(CBC) The idea behind eHealth is to create electronic health records for Ontario, something the auditor says could save $6 billion if implemented in every province and territory.

Instead, Ontario "is near the back of the pack" when it comes to electronic health records, having wasted millions on underused computer systems and untendered contracts.

The report is damning in its criticism of the way governments have allowed eHealth and its predecessor, Smart Systems for Health, to let spending go out of control with few safeguards to protect tax dollars.

McCarter says the province was "lacking in strategic direction and relying too heavily on external consultations."

At one point, the auditor writes, the eHealth program branch had "fewer than 30 full-time employees but was engaging more than 300 consultants."

McCarter said charges that favouritism was shown toward certain companies "without giving other firms a chance to compete were largely true."

At the heart of the report are four recommendations aimed at putting an end to scandals like the one that enveloped the eHealth agency:

• Develop a strategic plan for implementation of electronic health records.
• Improve oversight by board of directors.
• Rely less on outside consultants.
• Ensure procurement policies are followed.

Canada's e-health journey and HIMSS Analytics' Canada Information and Communications Technology Study (2009 - Healthc Q.) NoFull Text
In spring 2007, HIMSS Analytics began developing its first Canada Information and Communications Technology (ICT) Study. Less than one year later, 38 RHAs, DHAs and HAs are already on board, with some 20 more scheduled to participate by year's end. Why are so many Canadian provincial healthcare delivery organizations now participating in HIMSS Analytics' Canada ICT Study? The answer is tied to the character of the HIMSS study, the value offered to all participants and specific Canadian healthcare issues that are addressed by the study.

US: Interoperable electronic prescribing in the United States: a progress report. (April 2009 - Health Affaires)
Although the vast majority of U.S. physicians still handwrite prescriptions, adoption of electronic prescribing is slowly growing. Major barriers to adoption remain, including the inability to electronically submit prescriptions for controlled substances and confusion about standards for data exchange. Federal and state governments and private insurers are using payment and policy incentives to boost e-prescribing because they still believe in its promise for improving the quality and efficiency of health care. However, additional efforts and further investments are needed to reap the benefits of e-prescribing on a national scale.

Health information technology: dispatches from the revolution. (April 2009 - Health Affairs)
Countries around the world are increasingly employing health information technology (IT). These tools hold the promise of powerful health system breakthroughs from Johannesburg to Jakarta. While implementers multiply, a global e-health consensus framework is beginning to take shape among donors, governments, industries, researchers, and policymakers. As plans are formulated in the United States for substantial new federal investments in health IT, this paper details common threads in national and global health IT discourse. Among them are the need for strong stakeholder engagement, workable policy solutions, funding and donor coordination, and the imperative for adequately addressing standards and interoperability.

Exploring antecedents of consumer satisfaction and repeated search behavior on e-health information (2009 - J Health Commun.)::
E-health information has become an important resource for people seeking health information. Even though many studies have been conducted to examine the quality of e-health information, only a few studies have explored the effects of the information seekers' motivations on the perceived quality of e-health information

User information seeking behaviour: Perceptions and reality. An evaluation of the WHO Labresources Internet portal (2009 - Inform Health Soc Care.)
This article discusses the evaluation of a WHO Internet portal: the Labresources website. The evaluation investigates user satisfaction with the resource, usability, demographic information about users and how well they could complete specific tasks using the website and compared this with the actual online behaviour revealing a number of discrepancies

Technorati Profile

IT is a significant driver for a safer and more efficient healthcare system in Ireland, funded to the tune of €17bn per year.  In a move to make the system more efficient and to better track patients through the system, the system is beginning to use patient wristbands with barcodes that provide full access to the patients key information (see Taking the pulse, reported on the SiliconRepublic.com).

"In times of financial prudence, the budget for infrastructure such as IT is often cut to the quick in an attempt to rein in costs. Conversely, industry observers say now is the time to spend because IT has been proven to save money and drive efficiencies. Despite past technology projects going very publicly awry, the HSE is proceeding with smaller projects that it hopes will improve patient care and increase efficiencies.

ID technology integrator Zetes is involved in a project for patient wristbands with two-dimensional (data matrix) barcodes. The wristband contains key demographic information that includes the patient’s name, surname, date of birth, sex and hospital number. The information is now electronically transferable for use by a PDA-type device, mobile computer or any electronic interface.

“We did this for a hospital in Roscommon that wanted to improve its phlebotomy practices. It previously had to print labels and it now uses electronic wristbands,” explains Barry Long, sales manager with Zetes. “This has two advantages: electronic transfer of information and the details on the wristband is consistent and the same as on the hospital’s system.” Barcoding is a fundamental building block in the installation of wireless networks in hospitals and many hospitals throughout the country are either putting in or piloting the technology, according to Long."

Read the full article Taking the pulse.

A recent agreement between Canada Health Infoway (Infoway) and the Canadian Institute for Health Information (CIHI) has given the green light to establishing a new Canada-wide coordination body.  Housed by Infoway, the Infoway Standards Collaborative will manage, deliver and maintain health information standards, including those standards related to pan-Canadian electronic health records (EHR).

Currently, Canada’s health information standards are managed by several different organizations and initiatives, including CIHI. Having one body responsible for these standards being upheld ensures that the data collected about Canada’s health system meet quality criteria and can be easily compared.

The Infoway Standards Collaborative will take on several of CIHI’s initiatives already underway that support health information standards, including the Partnership for Health Information Standards, HL7 Canada and liaison activities with Digital Imaging and Communications in Medicine (DICOM). While CIHI will no longer be managing the same slate of standardization activities, it will continue to provide leadership in the development and maintenance of the key content standards (such as ICD-10-CA, CCI, MIS Standards) underpinning its information products and services.

Based on extensive consultations and collaboration, the Blueprint is focused on interoperability – the capability of computer systems to seamlessly communicate with one another. It provides guidance for integrating the approximately 40,000 existing health information systems in use across the country, while remaining flexible to allow for incorporating new and better information systems and capabilities.

This announcement follows on the heels of the release of a revised version of the Electronic Health Record Solution Blueprint developed by Infoway. The revised blueprint provides stakeholders developing Electronic Health Record Solutions with a technology framework for sharing health information securely and appropriately across Canada. It also takes a closer look at privacy and security issues.

For more information on Canada Health Infoway, please go to www.infoway-inforoute.ca .

Portion of this article originally published in CIHI’s Directions newsletter, June 2006 issue.

The American Hospital Association (AHA) claims that advances in technology have transformed patient care, particularly in the shift from inpatient to outpatient settings and in the development of less invasive diagnostic and therapeutic techniques.  Perhaps this explains why annual IT spending in the healthcare industry has jumped $12 billion since 2000.

According to industry analysts Sheldon I Dorenfest & Associates, $31 billion dollars was spent on picture archiving and communications systems, and computerized provider order entry systems, among other IT gadgets and software this year.  And it doesn’t look that this spending splurge will end anytime soon.

This detail clearly challenges the view that healthcare organizations spend much less on IT than other industries. According to reports on spending in 2001, banking and financial services spent about 5% to 6% of revenues on IT, compared with 3% to 4% for healthcare organizations.

Data from a Modern Healthcare/PricewaterhouseCoopers annual survey of hospital executives indicate that the typical healthcare organization allocates 2.5% of the operating budget to IT. Senior hospital executives responding to the Modern Healthcare 2005 survey indicated their primary near-term IT priority to be the electronic health record (EHR).

Implementing a national EHR system would be in the realm of $276 billion to $320 billion over 10 years.  Broken down this translates to an estimated initial cost of $2.7 million for a medium-sized hospital and then $250,000 per year, with an expected annual savings of $1.3 million once the system is fully operational.  If accurate, that could mean a $77.8 billion annual savings nationally.

Originally reported in Canadian Healthcare Technology.