Federal Healthcare Policy

Healthcare in Canada

With a federal election scheduled for April 28^th, Canadians expect parties to propose policies to improve our struggling healthcare system. The federal government role is limited to funding, policy, and standards. The problem with the healthcare system is primarily service delivery (provincial responsibility), not funding.

Data inoperability among the 15 commercial off the shelf (COTS) Electronic Medical Records (EMR) systems used by physicians is a major contributor to administrative burden and frustration. A similar problem exists with the COTS Electronic Health Records (EHR) systems used in acute care. Privacy of Canadian medical information is compromised by EMR and EHR vendors storing data in data centres located in the United States, where it is subject to the USA PATRIOT Act.

Federal legislation (e.g. Bill C-72) requiring data interoperability of health information technology will take too long, and doesn’t address administrative burden or privacy of medical information. Legislation takes time to enact, and vendors then need time to modify their applications. After all that, we’re still left with multiple systems that require application specific training, and Canadian medical information is still stored in the United States.

There is a faster, better, cheaper way. Just pick one and mandate its use. In the late 1990s, the federal government selected a standard word processing application when its Treasury Board Secretariat selected and licensed Microsoft Office (Word, Excel, Powerpoint, Outlook) as the desktop software suite for all federal departments. Problem solved. Yes, I was a combatant in the Great Word Processor War of the late 1990s.

The federal government could select and license a national standard EMR for primary care and a national standard EHR for acute care. This would reduce risk, lower cost, resolve data inoperability, reduce administrative burden, and improve privacy of Canadian medical information. Bulk purchase at a national scale of a proven COTS application would reduce risk, speed implementation, and lower unit cost. One EMR and one EHR would lower training and support costs, and improve mobility of healthcare workers among clinics (e.g. locums) and across Canada. Canada could require the successful vendors to locate their application and data servers in Canadian data centres, not in the United States, which would improve information privacy and application performance.

A national standard EMR and EHR is an essential, first step in addressing stewardship of medical information that would further reduce administrative burden, improve healthcare, and transform obsolete, legacy provincial and territorial healthcare systems into ones designed for team-based care.

greg steer
Enterprise Coach