Dear Colleagues,

About eight months ago, the government created a new e-health agency. e-Health Ontario was given the daunting task of improving our health system through the development of electronic diabetes management, paperless prescribing and the achievement of an electronic health record for all Ontarians. In setting up this new agency, the government eliminated the role of a previous entity called Smart Systems for Health- which had spent nearly $700M of taxpayers' money without any noticeable positive impact on our healthcare system.

Two individuals well known to UHN were chosen to lead e-Health Ontario. Dr. Hudson, one of my predecessors as CEO at UHN was asked to chair the e-Health Board and Sarah Kramer, former CIO at Cancer Care Ontario was chosen as CEO. You will recognize Sarah's name since she has been at the centre of a media storm the past two days as a result of a CBC investigation in to tendering contracts at e-Health Ontario in its first few months of existence.

I haven't seen the details related to these contracts. However I do know about Sarah Kramer (and Alan Hudson's) track record in improving healthcare in Ontario. I am very worried that their enormous contributions are being overlooked while the media concentrates on the cost of furniture in the e-Health office and the size of Sarah's bonus for taking on the responsibility of the CEO's role. Spending public money is a sacred trust- every penny needs to be scrutinized and I have every confidence that it will be in the coming weeks.  However lets not overlook that the previous agency was disbanded after wasting $700 million. The current controversy is about $5 million of start-up costs. That is a lot of money but it is important to look at the context of what has been created in e-health in the recent past.

In the past two years we have seen major progress in the accountability and performance of our Ontario hospitals. The reason for this improvement?  We now have comparable data for all hospitals which looks at the services we provide to our patients. We have information about how long cancer patients wait for treatment, wait times for surgery patients, accurate information about how long patients wait in our Emergency Departments and reliable data describing the quality of care in our operating rooms and critical care areas. This information was NOT available two years ago and the reason it is available today- and is being used to create change across the system- is because Sarah Kramer and Alan Hudson put the systems in place while working together, with the right teams of people, at Cancer Care Ontario and at Wait Times.

 

Creating change in healthcare requires more than just writing software. It requires that every process related to the service being described is analyzed, changed and measured. At UHN, our surgical staff book surgery differently than they did two years ago and cases are priorized differently than they used to be because of the implementation of surgery wait times systems. Our emergency departments approach their work in a different way because of the information that we gather about the way patients move through our ER's. Creating that impetus to change is what e-Health is all about. And Sarah Kramer demonstrated to all of us when she was working at Cancer Care Ontario that she is an effective leader of change who is trustworthy and reliable.

The right way to resolve this issue is to allow the provincial auditor to complete his work at e-Health Ontario to ensure that every tax dollar is spent with excellent controls and accountability. However I am very concerned that the current controversy may derail our progress in e-Health which is crucial to the sustainability and quality of patient care in this province. Our SIMS group has worked closely with Cancer Care Ontario in the past to both develop information systems and to implement systems here. I am very proud of the work that we have helped to accomplish to date and I want it to continue.

Bob Bell​

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