Canadian hospitals and departments of health are reticent to boast about their achievements and hesitant to report on their faults.
Physicians and other providers receive excellent training and are highly motivated to provide excellent care leading to outcomes that in previous generations would have been regarded as miraculous. Yet, central planning by the Departments of Health, in Nova Scotia and elsewhere, imposes medieval medical information practices on clinicians and hospital administrators.
As health organizations avoid adopting modern information techniques, the ongoing refrain seems to be “Better Care-But Not Now.”
If provinces are truly committed to better health sooner, then Provincial governments must work cooperatively and immediately with expert clinicians and administrative experts to develop a clear plan for health information systems.
The lack of proper information systems makes it difficult to track health outcomes. Who are the patients who get better after treatment? Worse? And, which treatments are merely a mischievous waste of time and money?
Every large company in Nova Scotia knows what their customers are doing, their preferences and which of the products they sold is most likely to need repair in the next year and which product is in such high demand that additional inventory is necessary. Companies know that people in one geographic area or another are more or less likely to purchase a particular product compared with people living elsewhere. And, plan accordingly.
The problem is similar to asking whether people in one or another district are more or less likely to get a particular sickness and which treatments are likely to help. Medical practitioners use the word epidemiology to describe the activities that link particular environments and actions (including diagnostic and therapeutic manoeuvres) to health outcomes. Yet, researchers and people working in most Canadian jurisdictions are unable to link health care activities with results.
When was the last time that your family doctor or a specialist called you to see if you were better or worse after treatment? How can government, the owner of your health system, and insurer of your care know how to spend your money when they don’t ask pertinent questions about the results of care?
You would expect Canadian governments to turn to graduates of the various Canadian health informatics programs to help design, develop and implement worthwhile health information systems. Yet, governments continue to flounder. Canadian doctors and nurses collect and record most of your health information using pen and paper, often with illegible scrawls.
Most Canadians don’t have access to an electronic health record, and health providers are usually unable to obtain and link laboratory information with your family doctors record, and your hospital record.
Compare this with inventory control systems in supermarkets with tens of thousands of different products, and banks where it takes less than a minute, on line to get all of the information you need about your account.
Before the next election suggest to your wannabe legislators that you would like the information systems in health care to be at least as sophisticated as the ones used by your bank or local grocery store. Current health information systems are long past their “best before” date.
David Zitner, A family doctor is a Professor in the Faculty of Medicine and Health Policy Fellow with the Atlantic Institute for Market Studies. E-mail [email protected]