e-Health -- sweet sensations

Beautiful Ontario

Following last month's article, I'm feeling a question, but before I pose it, let's set the scene:
Firstly, there have been numerous media articles (example) detailing the threat of diabetes both to our health and our economy here in Ontario.
Since studies (such as this) tend to prove a definitive link between sugar consumption and the prevalence of the disease, my curiosity got the better of me recently and I was awestruck to find there's nary a processed food item in my local grocery store that does not include sugar in one form or other, as an ingredient.
I've always wondered why the above can't be made in "sugar/no sugar-added" varieties -- I guess marketers feel a sweet taste trumps everything else!

Next, I was watching one of the "Men in Black" movies and was surprised at the profundity of a conversation between actors Will Smith and Tommy Lee Jones, the gist of which went like this:

TLJ:  Do you know the most destructive force in the Universe?
WS: Sugar

Most people laugh at those comments, but it left me wondering how many of us gave that conversation a second thought -- it could well be true, considering the impact it has on many of our lives!

Now for the question:
considering the above, shouldn't sugar be classified as a restricted substance?
I'm not talking here of some government bureaucracy getting involved to control the distribution/consumption of the commodity, but more of an awareness amongst ourselves similar to what's in place for alcohol or tobacco.
In other words, instead of eating it at every meal, why not consciously choose to use it only during special occasions, if at all.
That way, with the help of our EMR systems, we can keep an eye on it.

What do you think -- do we have a chance against "the most destructive force", or is this simply another Germany v. Portugal blow-out situation?

Hope you're enjoying the weather, and the World Cup!
Until next time...

Ernest A. James

President and CEO
Regal Informatics Inc.

e-Health -- things will be different next year...

Raffle items

I had the good fortune recently of being invited to a fund-raiser for breast cancer; attendees included entertainers, presenters from the Rouge Valley Health System, breast cancer survivors, politicians and business owners manning their booths in the foyer.
Since it was my first visit to this annual event, I had no idea what to expect -- what I did see and hear from, were those who:

• informed us, for example, doctors dedicated to the treatment of those afflicted
• as cancer survivors, were proud, not so much that they had beaten back the disease, but that they had the mental and physical wherewithal to survive the grueling journey
• entertained us

I have to admit to being disappointed, impressed and amazed for the few hours I was at the event.

The first of three disappointments came when one doctor stressed that taking supplements does not necessarily improve your chances of dodging cancer -- I tuned in to this comment I suppose mainly because I do believe in supplementing, but this is something I'll have to deal with.

The next two disappointments I'll leave for last.

I was impressed at the degree of artisanship displayed by the surgeon with her before/after breast reconstruction pictures -- I could almost feel the joy patients experience when the process was completed.

I was amazed by the levity in the room when the mammogram process (a serious topic to my mind) was described in a humorous fashion -- the cold rooms, the ice-cold equipment, the crushing pain and the waiting for results -- this definitely sounds like something that could do with some major improvement!

After a great meal, I decided to stand at the back of the room, near what appeared to be the dessert table.

My plan was to enjoy the entertainment and watch what transpired in terms of our reaction to the usual dessert trays, especially after what had just been discussed.

I didn't have long to wait: out came the chocolate cakes, ice cream and the like and I soon found myself jostling with others to satiate my craving -- alas my self-control had dissipated in the warm convivial atmosphere.

Lastly, I was disappointed that no mention was made of available Electronic Health Record tools that should be in our arsenal to perhaps help clue us in to the gradual changes in our health.

Notwithstanding the above, I applaud the organizers for their efforts to increase our awareness of such a life-changing disease and hope that for next year something different (dessert-wise) will be done -- I'm thinking perhaps fruits should be included with the meal, but a slice of that mouth-watering, to-die-for chocolate cake should be prohibitively expensive -- all for a good cause, of course!

Ernest A. James

President and CEO

Regal Informatics Inc.

e-Health -- if at first you don't succeed...

A park, somewhere in Dubai

Reading through the minutes of recent Central East LHIN meetings, I was pleasantly surprised to find that Hospital Information Systems (HIS) appear to be back in favor.
What has me concerned, however, is the fact that we may be staring down the same well-trodden path, in that the LHIN seems content to let hospitals do the heavy lifting.
For example, both Lakeridge and Peterborough hospital Information Technology (IT) representatives gave presentations that appear to suggest either one of them being capable of implementing a new and improved HIS.

Here's where we part ways, since, based on my previous postings, I've been a strong advocate for a cloud-oriented HIS, managed by none other than the LHIN itself.
I firmly believe this to be the most efficient way, in terms of:

• having one data repository
• having one owner of that data
• having one IT environment to secure
• having one version of clinical/Office software to source and update
• having one pricing structure for that software
• having one centralized IT management structure
• finding out what's going on health-wise amongst the LHIN constituents

To my mind, no hospital should be expending resources managing IT environments -- they should be concentrating on what they do best -- giving exceptional patient care.

I presume these hospitals wouldn't think twice about provisioning their own hydro, water or telephone systems, so what's with IT?

Granted they have the requisite IT skills sets -- so much the better since here's where the LHIN could leverage local talent at a cheaper rate than having to source externally.

I also assume hospital staff to be professionals in that they wouldn't hesitate to implement best practices for any process used within; for example, if there's one for diabetes care, I'm confident it would be put in place in a jiffy.

Well, guess what? Cloud computing is now a best practice within the IT industry -- deviations within our hospitals are causing unnecessary expenditure of tax dollars.

So, my advice to the LHIN is this: get cloudy now, or pay the piper later.

Resistance is futile!

Ernest A. James

President and CEO

Regal Informatics Inc.

e-Health -- Ontario is sniffling

The beauty of Winter, Ontario, 2014

You may be cognizant of the adage: "when the US sneezes, Canada catches a cold!"
From an economic standpoint, we know this to be true -- e-Health seems to be tacking into that same wind.
For example, an initiative of the ABIM foundation called "Choosing Wisely" will be adopted in Canada, the idea being to ensure medical tests are really necessary and not duplicative.
It's being reported that many of the Provinces are implementing this idea beginning in a couple of months.

Let's hope this trend continues because word is out regarding a new rule in the US mandating patient on-line access to their lab results -- you'd take a test and be in the know in a couple of days.
No more waiting around for the normal built-in healthcare provider time lag -- what a concept!

What's next, access to your medical records on-line, you say?
Well, we can only hope our neighbor blazes the trail on that front as well, sometime soon.
A recent Accenture survey indicates that strong interest exists amongst seniors for on-line access to help manage their health -- one could perhaps infer an even stronger pent-up demand amongst the rest of the population.

So, amidst the various prognostications of gloom and doom concerning our health, I continue to encourage those charged with running our systems to give us on-line access to the data -- you may be quite surprised at the results.
On-line access has revolutionized the banking industry -- I'm convinced Electronic Health Records (EHRs) could do the same, both for our health and the attendant support systems.

In closing I'd like to ask a question, namely:
has anyone seen any evidence of Spring in Ontario? It seems to be nowhere in sight!

Ernest A. James

President and CEO
Regal Informatics Inc.

e-Health -- doing it like Mother Nature...

Ajax, ON, Winter 2013

As I looked out my window after the Christmas 2013 ice storm, I was in awe at what Mother Nature had done -- wreaking havoc with most, if not all of our daily routines -- especially those we're accustomed to carrying out over the holidays.
For example, we were hampered by the fact that many of us had no power for an extended period of time!

Notwithstanding the above, what impressed me most about the storm was its resulting beauty and uniformity -- it's as if every tree was coated with ice in the exact same manner as its neighbor, and as I always love doing, I tried to relate the experience to everyday life in general, and something in particular -- that day it was our e-Health system.
Well, the brain cells scarcely had a chance to warm up before I was drawn to a radio commercial for the Humber River Hospital (HRH) redevelopment plan.
Apparently a brand spanking new hospital is being built that's like nothing we're accustomed to -- seems like they plan to reinvent patient care with the help of technology in terms of Electronic Health Records (EHRs) etc; here's a quote from their web site:

"A digital hospital utilizes the most current technologies possible to enhance all aspects of quality care delivery, improving efficiency, accuracy, reliability and safety. And currently no North American hospital is fully digital. There are systems interruptions in all of them that prevent full integration and full interoperability. We're going to be the first in North America to close that gap to automate all of our processes."

Hallelujah, I thought; however, even though these guys were singing my tune there was something about it that nagged at me; I soon had clarity -- you see, being the first also has its disadvantages.
I have no doubt they'll achieve their integration objectives internally, but how do you convince the other external healthcare providers (at least around the GTA) to mosey on up to the interoperability bar?
To my mind, that will be the challenge.

Someone has to throw down the gauntlet, and it appears HRH has done just that -- it'll be interesting to see what the effect will be after it opens in 2015.
I'm hoping it'll convince the Health Ministry here in Ontario that similar to Mother Nature, if just one tree gets a makeover, sure it'll be pretty initially, but all the others around it will just make it ugly again in no time.
I'd like to suggest you take a peek at their web site and support them if you can -- this sure looks like the direction health care should be heading.

Until next time, remember to practice your penguin moves before you tackle any ice patches on the walkways!

Ernest A. James

President and CEO
Regal Informatics Inc.

e-Health -- what if...

Restaurant in Pickering, Ontario

Whilst waiting for the bus on a beautiful October morning at a busy Kingston Road intersection in Pickering, Ontario, this sign above the entrance to a restaurant (it says: "Sorry we're Open"), caught my eye -- to me it was an obvious error and although I felt for whoever was responsible, I couldn't help smiling.
However, I drove by the area a couple of days after and the same sign was still showing -- it was then I realized that this must be some sort of marketing gimmick -- something purposely contrived so that the name of the establishment would be an easy recall for consideration whenever a potential customer plans to dine out.

Obviously the mere fact that I'm writing about it must mean the tactic works!
I've seen it so often that I've now begun to consider a similar tack for our healthcare system here in Ontario; suppose, for instance that:

• we've now managed to elevate ourselves to the point that our communities are so healthy, our hospitals have been converted to "Emergency only" facilities
• in-home care for the elderly is now the standard
• hospital chronic care departments (CCDs) have, for the most part, been mothballed -- to re-open any of them requires a comprehensive evaluation process be carried out by the Local Health Integration Network (LHIN)
• any CCD that has re-opened must do so with a sign that displays in big bright red letters: Sorry, we're Open
• whenever we see the above on a CCD, it reinforces the fact that as a community, we're failing financially and health-wise, and we need to step things up and work towards quickly getting it closed again

I'm hoping that this is indeed where we're heading -- that we realize we're the arbiter of our health so we use Electronic Health Records, food, exercise, education etc. to maintain our independence.

You could perhaps argue that I'm dreaming in bright red colors, but considering the way we're we going in terms of unsustainable healthcare spending, is there an alternative? Let's hear it!

Ernest A. James

President and CEO
Regal Informatics Inc.

eHealth -- change, when you least expect it

Picov's Horsemen Center, Ajax, Ontario

I have lived in the Durham Region now for decades and it always amazes me how the price of "Bronco fly spray" at the Picov's Horsemen Center has managed to remain constant at $6.99. I have relished the thought many times of approaching the above sign and observing that either the price has increased, or something else is being advertised.
No such luck -- I'm thinking, by now, the owners must have forgotten this sign exists, since it's impossible that a product's production cost and ultimately its price, can remain unchanged for so long a time.
I'm still convinced however that one day I'll be driving by and be so surprised that I'll have to pull over to take a second look.
Even though I now take the sign for granted, a change will happen at some point -- it must, and probably when I least expect it.

Same with our healthcare in Ontario; we're so accustomed to our current processes -- we don't feel well so we visit our healthcare provider during business hours or the hospital emergency department at other times.
We take it for granted that this will always be so, but at the risk of being viewed as a doomsday prognosticator, big changes are coming -- they must, and perhaps at a time when we least expect it.

Case in point: I was jolted from my snooze a few evenings ago whilst "watching" the CBC "Fifth Estate" documentary on the evils of sugar.
One doctor commented that in about 13 years time, if the rate of the diabetes epidemic remains unchecked, the United States will be unable to afford healthcare; Canada will fare no better!

This is a sobering reminder that the level of healthcare we're accustomed to, may not be there tomorrow -- and "tomorrow" tends to come at the most inopportune time!
I've always argued that our LHIN should be leading the charge with educational programs like the Fifth Estate presentation and also giving us the tools (like EHRs, EMRs and PHRs) to manage our health -- I'm just glad that someone has seen fit to take up the gauntlet in the interim.
We have been warned.

See you on the running track soon, I hope!

Ernest A. James

President and CEO
Regal Informatics Inc.