eHealth in Ontario -- why/why not?

Well I sure hope your winter weather experience has been, at a minimum, accident-free thus far. I've been keeping track of the sun's trajectory and I'm thinking Spring's the new kid on the block -- this may appear to be counter intuitive or overly optimistic right now, but trust me, Winter's legs are both failing and flailing!

Speaking of accidents, I saved the "In the wrong hands" headline story from my copy of the January 21, 2009 "Whitby This Week" newspaper; there's a picture of a somewhat bemused gentleman who received a six-page fax of a patient's medical record from the Ajax-Pickering Hospital -- the fax recipient had no idea who the patient was!
Also, a couple of weeks ago, a friend of mine needed emergency care over the weekend; after stabilization, she was admitted and told that the hospital would be holding off on any further treatment until her doctor's office opened the following Monday -- apparently they needed her medical history to formulate the best treatment, going forward.

I picked on the above real-life examples to try and answer the "why" portion of this article -- in the case of the Ajax-Pickering hospital, the latter was apparently trying to send the patient history to a nursing home in the region; just imagine if eHealth was in action -- there would really be no need for anyone to be faxing anything anywhere since all authorized Health Providers would have on-line access to patient data; likewise, for my friend who had to be hospitalized, there would be no need to wait to get important historical information from her doctor's office.
Now, I'm in no way suggesting that anyone's health was compromised during the above events, but I'm sure you can appreciate the value-add of an EHR (see my previous articles for a discussion of the Electronic Health Record).

There are many more instances that one can perhaps list to support a case for the "why", for example:

• you are on vacation and for some reason you need emergency care or a prescription renewed -- wouldn't it be nice to know that all Health Providers involved have on-line access to your medical history? No more drug allergy reactions or illegible prescriptions!


• you alone are responsible for your health, so why not provide the tools to help you manage it, even from the comfort of your armchair?


• there's no way we can keep increasing the tax burden at the current pace for our health care systems -- Information Technology is one of the ways we can get a quick and positive jolt to the efficiency of the system

It's possible that you may have your own reasons to add to the above list, but to be fair, all is not rosy in the land of eHealth; for example:

• many people have privacy concerns about their medical records being available on the Internet


• many voice the concern re their emotional capacity to withstand the shock of finding out bad news, i.e., how would you react if you took a test and had the ability to view the results from your armchair, only to find out you had a few months at best to live?


• many prefer not to be in a position of having to explain why they'd rather not share their health information with their partners -- just imagine you're at home being cajoled with the argument "...but honey, you can see mine, why can't I see yours...?"

I freely admit to only being able to competently debate bullet number 1 (the privacy concern issue), in that banking and taxation information today is freely accessible to authorized consumers over the Internet; compared to the regular occurrences of health information privacy breaches, I've yet to learn of an instance where an account at a banking/government institution was compromised, to date; that's not to say that these systems are infallible by any means, it's just that the rigid standards that have been applied to their implementation makes the possibility minuscule -- there's no reason why the same standards cannot be applied to an eHealth system.

As to bullets 2/3, I humbly defer to the appropriately qualified personnel.

In closing, although the "ayes" seem to outnumber the "nays", I believe the cost factor will have the biggest impact in terms of eHealth implementation; in other words, it's not "if" -- rather, it's just a matter of "when". As educated consumers we need to rev up the debate on this topic -- awareness is a key factor!

Next time I'd like to tackle the implementation roadblocks to eHealth, what I feel our responsibilities are (both as patients and primary care providers) and take a quick look across the pond (at the United Kingdom) and over the border (at the United States).

I look forward to your thoughts!

Take care and watch out for that ice above your head and below your feet!

Ernest A. James

Regal Informatics Inc.