TORONTO — CIOs will play a strong role in reforming Canada’s health-care system, but provinces like Ontario are falling far behind the others, medical industry experts said in response to an IBM report published Tuesday.

As it

released “”Heading True North: Giving Canada’s Health-Care System New Direction,”” Big Blue gathered executives from the University of Toronto, Blue Sky Family Health Network and University Health Network (UHN) to discuss their challenges and how IT could help them. Although they generally agreed that the report’s call for network integration between hospitals and other facilities was sound, they also said some parts of the country are becoming more disconnected.

“”Toronto is the worst,”” said Tom Closson, UHN’s CEO and a former public-sector CIO. “”Everyone is developing their own separate system when we should really be migrating to one central system.”” Ontario as a whole is not as integrated as Alberta or B.C., Closson said, but added this should provide incentive for Ontario to catch up.

The IBM report evaluates the potential for electronic delivery of health services and electronic patient records, but Closson said there was also a need for decision support systems that would streamline the way treatment is managed. “”We need systems that would tell patients where care is provided, and from the (health-care) provider side to determine the costs,”” he said. “”Evidence-based medicine has to be embedded in IT systems.””

UHN spends $45 million on IT each year, Closson said, but about 40 per cent of that is contracted out to outsourcers, including desktop services. Blue Sky is also farming out non-core services as a way of managing user demands, said lead physician Wendy Graham. “”You outsource as much as possible because (the IT people) are too busy to keep up,”” she said.

Neil Stuart, a partner with IBM’s Business Consulting Services, said health-care providers will soon face market forces and technology developments that will further complicate the IT is used in their industry. Heading True North notes that patients are fed up with long waiting times for key services and are also demanding higher quality guarantees than before.

This, along with a demographic shift towards health care focused on age-related problems, will see providers search for IT answers, Stuart said. These could include telemedicine and call centre triage, but also more remote monitoring of chronic care patients. There will also be increased automation on the administrative side, he said.

“”E-claims management, for example, will be very important,”” he said, “”as private payment for some services becomes a larger piece of the puzzle.””

Muhammad Mamdani, an associate professor at U of T who specializes in health policy management, said providers are overwhelmed by some of IT projects ahead of them. “”You know what you’re going to spend, and it’s painful,”” he said. “”The question is, what are we really going to get for this investment?””

IBM business development executive Ian Cummins said he has struggled to work with health-care providers who resist electronic health records because they would be hard to maintain and take time away from managing the “”real”” paper record. “”I can’t imagine an interdisciplinary team that’s using a paper chart where a hospital is waiting for the chart to arrive from the general practitioner,”” he said. “”That really points to the need for education.””

Closson recommended starting with more basic building blocks, like an e-mail directory that would allow providers to contact one another easily without calling each other for electronic contact information. “”We need an (electronic) white pages or Yellow Pages in health care,”” he said.

Graham said she wasn’t willing to wait, instead relying on older technologies like broadcast fax to communicate with other facilities. “”It’s cheap,”” she said. “”And it works. We learned that during the SARS crisis.””

IBM plans to follow up Heading True North with a series of reports that dig further into some of the challenges and IT opportunities in the Canadian health-care system, Stuart said.


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