Control freaks cripple e-health, expert says

VANCOUVER — While much attention has been paid to issues of bandwidth and technology as barriers to the adoption and expansion of e-health, delegates at a Vancouver conference on the subject Wednesday said people remain the biggest problem.

Sufficient bandwidth to run applications, connectivity

to that bandwidth, and the applications themselves all remain issues to the success of-e-health. However Dr. Alejandro Jadad, director of the Centre for Global e-Health Innovation at the University Health Network and a professor at the University of Toronto, said even if all those pieces are in place, e-health won’t fly if physicians haven’t bought in to the idea.

“”There are too many egos involved, too much money and too many control freaks,”” he told the audience at the second annual BCNet Advanced Networks Conference, entitled, “”The e-volution of e-health and e-learning.””

Even older technology like e-mail isn’t being used to communicate with patients today. Doctors are concerned with how bringing technology into the health care system will affect issues like liability and how it might change the way they bill for their work and get paid. They also want to protect their own turf.

Jadad says these issues of politics, money and control will have to be overcome if e-Health is to grow. Physicians will have to see the advantages of using technology. “”They know how to use the tools,”” he said. “”They’re just scared to death.””

A day after the provincial government announced sweeping reforms of the health care system that include the closing of three hospitals and the conversion of a number of others into “”assisted living centres,”” Lee Denny, the province’s CIO, said e-health remains an area of priority for the government.

Denny said BC has been a leader in the e-claims area, with all claims being filed online, and its PharmaNet program has been expanded to link 70 per cent of the province’s emergency rooms. The government is looking at its existing person-to-person backbone network — currently running on 1980s-era technology — with an eye at upgrading it to help drive e-Health applications.

Michael Hrybyk, president of BCNet, a joint project of the province’s university and research institutions, believes he might have the answer to some of the bandwidth issues. The BC ORAN (Optical Regional Advanced Network) will be able to provide the bandwidth needed to facilitate e-Health applications in the province, at gigabit speeds, at least for those near a connection point, he said.

The BC ORAN network will allow a doctor at the hospital in Prince George, B.C. to get advice on a diagnosis from a colleague at the University of British Columbia, for example. Connecting through CANARIE’s national network, meanwhile, a researcher at Vancouver’s Hospital for Sick Children will be able to collaborate with a colleague at Toronto’s Hospital for Sick Children.

Hrybyk said the technology has been developed and is available. The problem is linking up the hospital IT staff with the people that can take advantage of that technology.

“”I think the IT groups at the hospitals are doing a great job,”” said Hrybyk. “”I don’t think the problems are intra-hospital, it’s more internal communication about what the various labs need. The technology is there.””

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