Ontario eHealth, Round 2

Toronto Star, Wednesday October 6 2010, Tanya Talaga

Ontario's eHealth program has a new CEO, Greg Reed. The media have pretty much left Greg alone for the first 6 months of his tenure, but as of today eHealth has become front page news again. The story by Tanya Talaga, Toronto Star's Queen's Park Bureau reporter, quotes Reed as expressing confidence in his organization's ability to deliver "eHealth" by 2015 which was the original completion date set for the program.

The original program was called Smart Systems for Health when it was established way back in 2002. In 2008 the program name was changed to eHealth in line with similar government initiatives around the world. The idea was to totally scrap SSHA and replace it with a new agency. I refer to eHealth and Smart Systems as programs however, they are actually the names of the government agency which will eventually be responsible for managing the electronic health information once the program to convert all health information into electronic records is complete.

Deloitte issued a report on the program at the end of 2006 pointing out some of the deficiencies of the program. Among the key findings in the report were the following:

• Lack of strategic direction from the Ministry (of Health)
• SSHA (Smart Systems for Health Agency) has not demonstrated its value proposition to clients
• The program had made progress introducing networks and data centres but were behind in delivery of the infrastructure to connect them
• An inadequate financial regime
• Management, organizational, and performance issues

Since that time, the program/agency was frequently reviled in the press for pretty much the same issues that Deloitte pointed out. The spending of money without proper oversight was featured in these stories and is repeated in Wednesday's piece. The money spent on consultants seems to be particularly aggravating; the paper quotes payments of $3,000 per day and the expensing of items such as cups of tea for $1.65. A little less sexy was the sole sourcing of contracts without a clear description of what the contract was to discover. For you project managers, that means that there was no Statement of Work (SOW). Since much of the work was labour or services, the lack of a SOW really meant that the organizations chosen to provide the services were free to deliver pretty much what they wanted. These issues were pointed out in a report issued in October of 2007 by Auditor General Jim McCarter.

The original cry for heads to roll was answered by the firing of Sarah Cramer. In a revealing comment on the situation however, Sarah pointed out that these contracts were awarded at the discretion of the Deputy Health Minister, Ron Sapsford. When the government put pressure on Ron he responded by resigning. The carnage didn't end there; George Smitherman was the Minister of Health during this time but David Caplan was hauled in to replace George and almost immediately forced to resign the post.

According to today's article, Greg has been making progress delivering some of the goals of the program. The article mentions the funding of 5,300 doctors to "keep electronic medical records" on their desk top computers. Presumably, this refers to a desktop application capable of storing records in a standard format and communicating with a central server/database. The article also states the program expects to cover 9,000 doctors and 10,000,000 patients by 2012. Another goal is the linking of 43 hospitals, community care clinics and family health teams by 2013.

The number of "consultants" at eHealth has been reduced from 385 to 118. There is no explanation in the story regarding the definition of consultant or how Reed went about the reduction. There is little doubt that Greg was responding to the very public outcry that arose when the media reported on $3,000 per day consultants expensing $1.65 cups of tea. Let's hope that he has not harmed the program in the process of polishing eHealth's public image.