August 17, 2011 8:45 AM

Healthcare is extremely political in Canada! No big surprise to anyone who has been involved in health administration or planning, perhaps because healthcare is viewed as a national right under the Canada Health Act.

Any political party that attempts wide scale change to the healthcare system is courting political disaster — change will be challenging and will provide ample cannon fodder for any opposition party. As a result, we tend to make minor incremental changes to the system.

Unfortunately health information technology has been dragged into the politics of healthcare. Even though the need for health information modernization is a foundational requirement in order for Canada to have a high performing healthcare system, health IT is frequently dragged into physician fee negotiations or suffers embarrassment at the hands of opposition health critics (as we have seen with a number of eHealth scandals that have been prominent in the media).

But how does one build core infrastructure if the requirements are so sensitive to political whim? Imagine the national road system being managed in the same way. Every three to four years, negotiations would take place between those who use the roads and the government to determine whether they would support financing for the next four years. If negotiations went badly, both parties would just walk away from the table. Sounds pretty ridiculous, right? However that is exactly what happens with healthcare and — more to the point — health information technology.

Is it possible to separate core foundational requirements from those that are politically driven? Canada Health Infoway was an attempt to create an entity to do just that, but has fallen short of the goal. Provided with funding to support provincial programs in their adoption of health IT, Infoway has been successful with some provinces, but not all. There was a general underestimation of the difficulty in working with certain provinces because of their perceived unique requirements and pre-existing investment in infrastructure such as hospital information systems.

A single, government driven healthcare system would seem to be a perfect setting to implement health IT; however, that has certainly not been the case. We have a fragmented national EMR strategy with adoption stalled at the 50% mark in most of the major provincial EMR programs. We have no standards for data exchange between EMRs, and we have resistant provinces doing what they feel necessary with limited healthcare budgets. Expect government/physician negotiations to become much more confrontational as many of the provincial agreements expire over the next 2–3 years.

What needs to be done to move health IT forward? Is it possible in Canada to de-politicize EMR/EHR foundational infrastructure and other health IT initiatives so that the foundation can be properly built?

Originally posted on Canadian EMR

Blogger Profile: Alan Brookstone
CanadianEMR is an authoritative and widely recognized national resource for physicians, medical office staff, healthcare planners, government organizations, and vendors of EMR systems.

Posted by Sue Ansell at August 17, 2011 8:45 AM

Categories: eHealth

Comments

Lilly Man email - www.handymoves.co.uk/removals/removals-london.html

It is the first time I hear such a theory , if it is really true that health care in Canada is political - well it is not normal and of course should not be!

Miller End email - http://www.endoftenancycleaning.com/page-end-of-tenancy-cleaning.html

Canadian healthcare is indeed political. It is very well structured and inclined towards assisting the less advantaged. The only trouble is that social security is very expensive!

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